CODING CORNER: Escape These 3 Hypertension Coding Pitfalls

Hint:  Specify primary or secondary to secure reimbursement

You need more than “hypertension” on a patient’s chart to report the appropriate code, but that isn’t often what you find. Steer clear of these common hypertension reporting mishaps to ensure you have the proper documentation.
Pitfall 1: ‘Hypertension’ Is Enough
If the physician writes only “hypertension” on the patient’s record, you should point this problem out to him.
“The real key to correct coding for hypertension lies with physian independent workstation

• 76377--… requiring image postprocessing on an independent workstation.
Problem: Many providers were reporting 76375 with too many CT services, and they were starting to code it with ultrasounds incorrectly, says Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga. The new codes limit your reporting options.
Scenario: You perform an axial scan and reconstruct it into the sagittal, coronal, or other plane. 2005 method: You report the original scan along with 76375. 2006 method: Report only the original scan. You won’t be able to bill 76376-76377, because the reconstruction will only be two-dimensional.

Chuck 90780 for Infusion
In lieu of 90780 (Intravenous infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour) and +90781 (…each additional hour) for infusion services, you’ll report new C codes to Medicare. For the first hour of infusion, you’ll report C8950 (Intravenous infusion of a therapeutic agent; up to one hour). For additional hours, you’ll report C8951 (…each additional hour).
For commercial payers that choose not to accept the C codes, you’ll report one of the following new infusion codes with status indicator “B,” Schuler says:

• 90760--Intravenous infusion, hydration; initial, up to one hour

• +90761--… each additional hour, up to 8 hours

• 90765--Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to one hour

• +90766--… each additional hour, up to 8 hours

• +90767--... additional sequential infusion, up to one hour

• +90768--… concurrent infusion.
For example: A 49-year-old female presents with viral gastroenteritis. The physician prescribes intravenous hydration, and the nurse establishes a peripheral IV line. In this scenario, you’d report the infusion with 90760, according to the American Medical Association’s publication CPT Changes.

- Published on 2006-01-20