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Dermatology Coding Alert

CPT 2007 UPDATE:
Go With the Flow to Determine New vs. Established Patient Status
Even if the patient has been to your office before, he might be new Proper billing for var... Read more
DECEMBER'S RECIPE FOR BILLING SUCCESS:
Follow These Filing Tips to Overcome Time Challenges
If you don't file claims within the time limits the payer sets, you won't receive payment ... Read more
BREAKING NEWS:
Watch Out for Steep Cuts in January if CMS Has Its Way
Good news: Expect a boost in E/M reimbursement despite blanket cuts  Your reimbursem... Read more
CLIP & SAVE:
Here's the Quick Way to Find Out if the Patient Is Really New
Answer the new-vs.-established question correctly every time with this tool Take the ... Read more
READER QUESTION:
Strengthen Your Denial Management Efforts
Question: Are there any tips you can offer on how to handle denials? It seems to take a lo... Read more
READER QUESTION:
Give Payers an ABN Heads-Up
Question: When our physicians perform a surgery that we're fairly sure Medicare won't pay ... Read more
READER QUESTION:
Avoid Repeat Denials With Modifier 76
Question: How should I report a service that the physician performs more than once in a da... Read more
YOU BE THE CODER:
Ensure You're Following Compliant Record-Keeping Practices
Question: We have so many files we're hanging onto for patients who haven't been to our pr... Read more
Eliminate Your No-Show Headaches With These Strategies
Tip: Make sure your carriers don't frown on payment penalties Every office has them -... Read more
Combat Critical Care Code Errors With This Chart
Learn when to report critical care codes multiple times Before billing critical care servi... Read more
NOVEMBER'S RECIPE FOR BILLING SUCCESS:
NCCI 12.3 Targets Radiology Codes
The latest version of the National Correct Coding Initiative edits (12.3) went into effect... Read more
CLIP & SAVE:
Let Patients Know Your No-Show Policy Up Front With These Tools
Use a series of letters to explain the consequences of missed appointments Make all of you... Read more
DID YOU KNOW?
Each quarter, you face the often-daunting task of incorporating new bundling edits from th... Read more
READER QUESTION:
Bone Up on Your Incident-to Guidelines
Question: We bill for a nurse practitioner who does initial consultations in our office on... Read more
READER QUESTION:
Forget Address With POS 12
Question: Our doctor made a house call, so our claim will go with code 99347 and POS 12. I... Read more
READER QUESTION:
Meet the 4 R's Before Billing Consults
Question: My physician is being referred patients for "consults" by hospital physicians. W... Read more
YOU BE THE CODER:
Don't Mistake 99221-99223 for Admission Codes
Question: My physician saw a patient in our office, and during the visit the physician det... Read more
News You Can Use:
Brace Yourself for a 5.1 Percent Pay Cut Next Year
Watch for decrease in imaging reimbursement, tooUpcoming cuts in the proposed fee schedule... Read more
Carrier Spotlight:
Cash In on Empire's Changes to Mammography Payments
The contractor instructs you to start using modifier 52 in some casesOne carrier has clari... Read more
October's Recipe for Billing Success:
Modify Your Flu, PPV Coding After Oct. 1
Effective Oct. 1, you'll be able to use diagnosis code V06.6 (Streptococcus pneumoniae [pn... Read more
Look Beyond CMS Web Site For NPI Applications
CMS removed NPI PDF from its Web site, but you have other optionsGetting a National Provid... Read more
READER QUESTIONS:
Base Infusion Code on Method, Route
Question: Our physician administered three drug substances via one infusion. With all the ... Read more
READER QUESTIONS:
Give Collection Agencies All the Details
Question: We've decided to turn over some of our outstanding accounts to a collection agen... Read more
READER QUESTIONS:
Consider a Financial-Hardship Policy
Question: Is it OK for our practice to not collect a copay or deductible from a patient wh... Read more
You Be the Coder:
Switching to EHR? Weigh These Pros and Cons
Question: With new technology emerging all the time, the move to electronic health records... Read more
Winning Strategies Help You Make The Transition to New CMS-1500
Is your software ready to handle the changes?Now's the time to update your billing system ... Read more
Learn How Easy It Is to Get an NPI Number
To save yourself time and effort, gather your info before you startEven though the deadlin... Read more
September's Recipe for Billing Success:
9 Lean Days May End Up Being 12 Days
You're already bracing for the nine days without Medicare payments in late September--but ... Read more
Get Up to Speed on the CMS-1500 Changes
Review the final version of the form onlineThe current CMS-1500 form will not be compatibl... Read more
READER QUESTIONS:
Consider Geographic Differences in Payments
Question: How can I figure out what a procedure code pays in dollars when I'm only given t... Read more
READER QUESTIONS:
Conduct Self-Audits Regularly
Question: Is it important for our office to perform self-audits regularly, or is it OK jus... Read more
READER QUESTIONS:
Planning, Extent Distinguish 58 and 78
Question: When should we use modifier 78 instead of modifier 58?Tennessee Subscriber Answe... Read more
You Be the Coder:
Avoid Writing Off Every Physician Phone Call
Question: Almost every physician has to call another physician or medical professional to ... Read more
Lesion Excisions Done Right:
Measure First, Diagnose Later
Warning:  Length of incision doesn\'t equal excised diameter When it comes to coding ... Read more
News You Can Use:
Prepare for E/M Payment Boost--but Losses for Other Codes
Higher-level codes are biggest winnersNot all CPT codes will see a significant change in t... Read more
E/M Quiz:
Test Your Review-of-Systems Knowledge
2 scenarios from our experts help you improve your skillsBefore you report any E/M service... Read more
READER QUESTIONS:
Include Prescription Writing In E/M
Question: I heard that there's a code we can bill to indicate when our dermatologist write... Read more
READER QUESTIONS:
Avoid Modifiers With 17003
Question: Our dermatologist removed three lesions from a patient's left arm. Should we cod... Read more
READER QUESTIONS:
Untangle These Lidocaine Bundles
Question: I'm fairly new to coding, and I was told that I should submit J2001 for lidocain... Read more
READER QUESTIONS:
For Adhesive Strips Alone, Report E/M
Question: Recently, a payer rejected a claim for wound repair (12005) using a combination ... Read more
READER QUESTIONS:
Use 99201-99205 if Patient Switches to Your Office
Question: When my dermatologist covers for another local private-practice dermatologist, I... Read more
READER QUESTIONS:
Modifier 59 Doesn't Override Payment Reduction
Question: When I remove one lesion and biopsy another with an uncertain nature, Medicare p... Read more
You Be the Coder:
Would You Use 15300-15301 for Graft Changes?
Question: Our dermatologic surgeons often use allograft for temporary wound closure (for e... Read more
Reporting Debridement Separately From Wound Repair? Maximize Pay With These Tips
Look for devitalized or contaminated tissue to justify 11040 Many clinical scenarios do no... Read more
ICD-9 Coding:
Take the Rough Edge Off Corn And Callus Coding
Warning: These little-known terms may show up in your doctor's documentation For dermatolo... Read more
Avoid Being Swamped by Recent CMS Releases -- Here's How
Missing the surrogate UPIN change guarantees denials You've made it through half the year,... Read more
Same Group, Different Specialty:
Collect What You Deserve
Stand your ground when your carrier shoots you down on new patient visits Watch out: It's ... Read more
Reader Questions:
Carriers Differ on Dermabond Coding Rules
Question: An elderly patient had a 1.4-centimeter skin tear on his left thigh. The dermato... Read more
Reader Questions:
3 or 4 HPI Elements Play Big Role in E/M Level
Question: How does a brief history of present illness (HPI) differ from an extended HPI?Mi... Read more
Reader Questions:
Check Wound Size Before You Code Wound Care
Question: Our dermatologist saw a patient status post bilateral wrist arthroplasty and he ... Read more
Reader Questions:
Make Sure You Meet Incident-To Criteria
Question: We have a new physician assistant in our office who sees patients for the dermat... Read more
Reader Questions:
Find Medicare LCD in 1 Stop
Question: Where can I go to look up Medicare carriers' local coverage determinations? Also... Read more
Reader Questions:
Don't Mix Modifiers
Question: I'm always at a loss on whether to use modifier 25 or modifier 57 when the derma... Read more
Reader Questions:
Look to 95004-95028 for Intradermal Allergy Testing
Question: When we perform allergy testing, we bill 86003. Should we use 95004?North Caroli... Read more
You Be the Coder:
Get Specific With Decubitus Ulcer Diagnosis
Question: A patient had decubitus ulcers on his right hip and buttock. The dermatologist d... Read more
5 Steps Take the Heat Out of Burn Diagnoses
Make sure you know the questions to ask to choose the proper code With some diagnoses, the... Read more
Rely on 'Rule of Nines' to Determine Burn Percentages
Infants require different figures To assign the required fourth and fifth digits for diagn... Read more
3 Case Studies Clear Away Excision Coding Confusion
Learn this simple trick to reporting re-excisions during the global period Coding all serv... Read more
Refresh Your NPP Incident-To Know-How With This Checklist
Don't confuse other payers' regulations with Medicare's Correctly billing your nonphysicia... Read more
Reader Questions:
Biopsy by Any Other Name Just Isn't the Same
Question: How should I code for an "excisional biopsy" that our dermatologist performed on... Read more
Reader Questions:
Pay Attention to Modifier 51 Symbol
Question: Our dermatologist often performs multiple procedures. Do I have to append modifi... Read more
Reader Questions:
Paper Claim Doesn't Have to Mean Slow Filing
Question: Our payer says we are not in compliance with "timely filing" requirements when w... Read more
Reader Questions:
Ask Doctor for Correct Units of Measurement
Question: How should I code for a 0.05-cc injection of Kenalog into an acne cyst? The HCPC... Read more
Reader Questions:
You Can Ignore Modifier Indicator '9'
Question: What does the "9" in the modifier indicator column of the National Correct Codin... Read more
Reader Questions:
Weekend Visit Leads to 99050
Question: My dermatologist saw a patient in the office on a weekend. How should I report t... Read more
You Be the Coder:
Cleanly Code an Apligraf Application
Question: If a dermatologist were to apply an Apligraf in his office, how would we code an... Read more
Consider This Case Study Before Coding Your Next Mohs Claim
If a pathologist is involved, think excision or repairThe Mohs codes (17304-17310) probabl... Read more
Learn 5 Neoplasm Facts To Facilitate Coding
Take the guesswork out of malignancy coding with our expert adviceDetermining an initial d... Read more
Ward Off Wound Care Coding Denials With 15340
Learn which common dermatology products line up with new skin graft codesHot on the heels ... Read more
Relax--Rest Home Coding Is Easier Than You Think
Identify place-of-service 33 through lack of medical componentYou may be tempted to report... Read more
READER QUESTIONS:
Apply 691.0 for Diaper Rash
Question: Which diagnosis code should I report for a monilial diaper rash? New York... Read more
READER QUESTIONS:
Code 16000 Requires Burn Treatment
Question: A dermatologist diagnoses a patient with a second-degree burn on her right palm ... Read more
READER QUESTIONS:
Determine Who an 'Appropriate Source' Is
Question: Parents brought their child to our office to discuss her acne. Considering that ... Read more
READER QUESTIONS:
Capture HPSA Bonus With Exact Visit Location
Question: Our practice is in a rural area, but we don't always receive an HPSA bonus when ... Read more
READER QUESTIONS:
Think Specific With Your ABN
Question: We have all patients sign an advance beneficiary notice (ABN), listing services ... Read more
READER QUESTIONS:
Don't Let Coverage Determine Coding
Question: Should we bill exactly the same group of codes to all payers, or can we submit t... Read more
READER QUESTIONS:
Include Dressings in Debridements
Question: Can our practice be reimbursed for the surgical dressing (supplies) of a partial... Read more
You Be the Coder:
Test Your Lesion Removal Skills
Question: A dermatologist excises three benign lesions on a patient's right arm, each with... Read more
NCCI 12.1 Update:
Think Twice Before Using a Modifier To Override These Wound Care Edits
Don\'t code anesthesia separately with wound therapy, Medicare saysIf you're using cutting... Read more
Will Your Current Consultation Procedures Cut It With CMS?
Request consults from same-group colleagues, but be careful with frequencyYou may have spo... Read more
Clip and Save:
Solicit--and Secure--Consult Documentation With This Form
Compliance with new consultation rules is a simple fax awayIf you have trouble getting req... Read more
Identify Separate E/M Services With 2 Wart Removal Notes
Charge 9921x-25 when you see these items in the documentationThe next time you're staring ... Read more
READER QUESTIONS:
Don't Say 'Noncontributory' for Reviewed System
Question: I lose audit points when I use the term "noncontributory" for any portion of ROS... Read more
READER QUESTIONS:
Go Deep With Debridement Code
Question: A patient with uncontrolled type II diabetes presents with an ulcer on his lower... Read more
READER QUESTIONS:
Don't Rely on Non-ASC-List Payment
Question: I code for an ambulatory surgical center (ASC). The dermatologist's documentatio... Read more
READER QUESTIONS:
Use Signs to Substantiate 99050-99051 Services
Question: What documentation do the special services after-hours codes require?South Carol... Read more
READER QUESTIONS:
Forget Bilateral Modifiers for Verrucae
Question: If a patient has bilateral verrucae (078.19) and the doctor treats two sites, on... Read more
You Be the Coder:
Is Modifier 51-59 Kosher?
Question: A dermatologist excises a benign skin lesion with an excised diameter over 4.0 c... Read more
These Clues Help You Tell 3 Integumentary Procedures Apart
Key: Let method drive your biopsy-versus-destruction coding You can more easily determine ... Read more
Carrier Update:
File Away Debridement Woes With This Inside Scoop
Fend off audits of your 11040-11042 claims by correcting common mistakes Because of the fr... Read more
News You Can Use:
Don't Hold Your Breath for New National E/M Guidelines
But keep an eye open for more carrier-level meddling The American Medical Association show... Read more
Adopt Simple Strategies to Protect Modifier 59 Payments
Don't be one of the 40 percent who use the modifier improperly Get ready: Carriers will in... Read more
Reader Questions:
Report 16020 for Sunburn Treatment With Dressing
Question: A mother brought her 5-year-old son in to our office with blisters on his should... Read more
Reader Questions:
Help Patients Understand ABN Contents
Question: We have a patient who signed an advance beneficiary notice, and as we suspected,... Read more
Reader Questions:
Review Insurer's Modifier 57 Policies
Question: A patient presented with a non-healing spot on his hand. The dermatologist diagn... Read more
Reader Questions:
Avoid Last-Minute Documentation
Question: This past July we billed 99213 for an office visit. Now, the patient's insurance... Read more
Reader Questions:
Insurers Won't Pay for Family Counseling
Question: Is there any way we can charge for a visit to discuss a patient's situation if t... Read more
You Be the Coder:
Destruction of Plantar Wart
Question: Which code should I use for cryotherapy treatment of a common or plantar wart on... Read more
CPT Update:
Simplify Your Injection Coding in 2006 With 5 Principles
Lump antibiotics and therapeutic injections into 90772, regardless of payer You can stop d... Read more
Get Up to Speed on Drug Administration Coding for 2006
Clip and save these important infusion crosswalks You can quickly submit drug administrati... Read more
News You Can Use:
Expect Retroactive Physician Payment Adjustments
When Congress finalizes fee schedule, you won't have to resubmit old claims Dermatologists... Read more
Avoid Terminology Traps in Biopsy and Excision Coding
Knowing when to report excisions instead of biopsies can save you $73 When it comes to rep... Read more
Reader Questions:
Charge Outpatient Consult for Observation
Question: Another doctor asked my dermatologist for a consult with a patient who had been ... Read more
Reader Questions:
Look to Lesion Excision for Mole Removal
Question: What is the appropriate code for "removal of mole"? I've searche... Read more
Reader Questions:
Extra Cleaning Earns Intermediate Repair
Question: Our dermatologist removed extensive debris from a wound that then required a sin... Read more
Reader Questions:
Append 51 to Lesser-Valued Procedure
Question: A dermatologist excises a benign skin lesion with an excised diameter over 4.0 c... Read more
Reader Questions:
Written Consult Request Isn't Mandatory
Question: We've heard conflicting information about the requirement for a written request ... Read more
Reader Questions:
Multiply for Correct Graft Code
Question: We have a trauma victim who requires a skin graft. The donor site is the right t... Read more
You Be the Coder:
2 Sebaceous Cysts
Question: The dermatologist excised two sebaceous cysts off of the patient's back. One cys... Read more
Kick Up Your Unna Boot Reimbursement
Tip: Report same-day debridements separately Reporting 29580 for Unna boot applications is... Read more
Unna Boot Basics:
What It Is and Is Not
An Unna boot is a medicated, semirigid dressing that consists of layers of bandage impregn... Read more
NCCI 12.0 Update:
Prepare for 5,700 Drug Administration Edits
Make sure your documentation justifies separate services Brace yourself for a new round of... Read more
Keep Your E/M Modifiers Straight With These Simple Tips
Assign 57, not 25, for E/M prior to a major surgical procedure Modifiers 24, 25 and 57 all... Read more
News You Can Use:
Find Coding Info Faster With New and Improved CMS Site
CMS hopes the new site will be 'easier to browse by audience or topic'  Mention the M... Read more
Reader Questions:
Keep Sweating Through Unlisted for Hyperhidrosis
Question: I heard that CPT 2006 would offer a new code for Botox injections of sympathetic... Read more
Reader Questions:
Attach Modifier 59 by Code Designations
Question: Should I always append modifier 59 to the lower-valued code of an NCCI bundle?Wa... Read more
Reader Questions:
Omit Modifiers for 'Incident-To' Services
Question: Should I use a modifier when reporting services provided "incident-to" the derma... Read more
Reader Questions:
Keep Neoplasm Behaviors Straight
Question: The dermatologist excised an "uncertain behavior" neoplasm from a patient's skin... Read more
You Be the Coder:
Site-Specific Biopsy Codes
Question: I need some clarification of the site-specific biopsy codes. Is the helix of t... Read more
Available Years:  2006  2005  2004