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Dermatology Coding Alert
Dermatology Coding Alert
Dermatology Coding Alert - 2012; Volume 8,Number 12
Lesion removals:
Don't Marginalize Your Lesion Removal Reimbursement
Calculating the lesion size incorrectly can cost more than $30 each time. Lesion excisi...
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ICD-10:
Look for Close Malignant Skin Neoplasm Crosswalk
Melanoma and more report to different codes. Not a lot will change once you start repor...
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Your ICD-10 Transition Plan Should Encompass 6 Phases,
A working budget should include every aspect of planning, including productivity trainin...
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Payer Pointers:
Learn the Ropes of 5 Common Audits Your Practice May Face
Understanding several types of audits can help your practice prepare. If you are gettin...
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Compliance:
Watch For Extra Scrutiny of Your Incident-To Billing, E/M Coding, and More
Pay attention to where the OIG will focus to ensure your practice isn't throwing up red ...
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Reader Question:
Start With 948 for Burn Dx
Question: Our dermatologist treats burn victims, and I'm wondering about diagnosis codin...
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Reader Question:
medical, assistant, E/M, codes
Question: One of our physicians allows his medical assistant to choose his E/M codes. Th...
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You Be the Coder:
Skin Rash With Unknown Cause
Question: We recently treated a patient for a skin rash that seemed to be an allergic re...
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Dermatology Coding Alert - 2012; Volume 8, Number 11
CCI Update:
12001-13153: Bundle Closure With Most Integumentary Procedures
Report repair alone or with lesion excision only.In case you've ever wondered if you could...
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CPT® 2013:
Watch for These E/M Definition Alterations Next Year
Experts ask: Will these descriptor tweaks change your billing?Most dermatology practices b...
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Billing Corner:
No-Shows? No Problems With These 4 Expert Tips
No-show fees are one approach, but beware the PR backlash.These days every dollar and ever...
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News You Can Use:
Get Used to Revalidation Process, Medicare Warns
Plus: CMS will begin accepting faxed, emailed supporting documents.If CMS's revalidation p...
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Reader Question:
15825 or 15828 Best Bet for Rhytidectomy
Question: The dermatologist in our practice removed excess skin from a patient's neck. Is ...
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Reader Question:
ICD-9 Freeze Will Spare You New Updates This Year
Question: Are there any ICD-9-CM updates planned for 2013? Iowa SubscriberAnswer: No...
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Reader Question:
Pull Out ABN for Benign Lesion Excisions
Question: Our state Medicaid doesn't cover benign lesion excisions, but we don't know it's...
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You Be the Coder:
Histofreezer
Question: If the doctor performs 17110 and uses histofreezer for the procedure, can I bill...
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Dermatology Coding Alert - 2012; Volume 8, Number 10
Chemical Peels:
15788-15793 Survival: Diagnosis, Documentation Key to Successful AK Treatment Coding
Applying the right CPT® code in the right circumstance is critical.Expert dermatolog...
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Unna Boots:
29580 Tips: Bundle Same-Day Debridements and Applications
Knowing covered diagnoses is key, but don't be afraid to get a waiver.If your dermatologis...
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News You Can Use:
Double-Digit Cuts May Strike Your Income Starting in January
Some specialties will be hit hard, unless Congress steps inEvery year around this time, th...
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E/M Corner:
3 Steps Lead to MDM Determination Success
Follow our experts' system to calculate each individual piece of the medical decision maki...
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Reader Question:
11042 Gets Deep Into Debridement Service
Question: A patient with uncontrolled type II diabetes presents with an ulcer on his lower...
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Reader Question:
1 Office Visit Translates Into 1 E/M Code
Question: A patient presented at our office with a bruise. The dermatologist examined the ...
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You Be the Coder:
Multiple Arm Lesions
Question: Our dermatologist removed three actinic keratoses from a patient's left arm. Sho...
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Dermatology Coding Alert - 2012; Volume 8, Number 9
Biopsies:
Beyond 11100: Discover Coding Success With More Accurate Biopsy Codes
Watch for specific mention of biopsy site in the documentation.Code 11100 is one of the mo...
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E/M Coding:
Counting Bullets/Points Differently Can Help You Pick Between '95 or '97 guidelines
Physical exam element can point you to the better set.Choosing whether to follow the 1995 ...
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Global Periods:
'XXX'? 'YYY'? Make Sense of the Global Alphabet Soup
Hint: Major and minor procedures differ in days of postop care.Ignoring global periods can...
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ICD-10 Outlook:
AMA and Provider Feedback Impact ICD-10 Delay
Don't let changes catch your ophthalmology practice by surprise.CMS hasn't made a final an...
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Reader Question:
Consider Coding Chemocauterization
Question: A patient came in for wart removal on his right second toe. The physician perfor...
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Reader Question:
Bone Up on Scar Revision
Question: For a patient requiring revision of a scar on his left leg, our surgeon excised ...
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Reader Question:
Catch Up on Incomplete Claims
Question: Our practice has a few claims that have missing or incorrect information. I'm no...
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You Be the Coder:
2 Infected Decubiti
Question: Our physician debrided two sites with infected decubiti. Should I report ea...
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Dermatology Coding Alert - 2012; Volume 8, Number 8
Scar Revision:
11442 Survival Guide: Prove Medical Necessity to Avoid Scar Revision Denials
Tip: Documentation must show that the procedure is not strictly cosmetic. If you're havin...
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Denial Management:
Are You Using the Right Specialty Code for Your Dermatologists?
Check with your MAC to make sure you're reporting your practitioners properly. If you rep...
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Billing:
Prove Financial Hardship Before Considering Waiving Copays
The key: demonstrated financial need. In seminar after seminar, dermatologists and coders...
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Compliance:
Are Your E/M Trends Outside the Norm?
An increase in 99214 and 99215 frequency is attracting attention from OIG. If you examine...
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Reader Question:
Carcinoma Excision With Tissue Transfer Closure
Question: My surgeon excised a carcinoma of the face. He closed the excision using adjace...
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Reader Question:
V67.00 Accurately Describes Follow-Up After Surgery
Question: If a patient receives treatment and the condition was resolved, which ICD-9 cod...
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Reader Question:
Best Bet: Choose 1 Graft Code
Question: We have a surgeon who is placing split-thickness skin grafts on burn patients a...
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You Be the Coder:
Biofreeze
Question: A patient came to the office with a bump on her foot; the dermatologist diagnos...
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Dermatology Coding Alert - 2012; Volume 8, Number 7
Wound Repair:
12001 or 14000? Choose Wisely Between Tissue Transfers and Wound Repairs
3 steps help your dermatologist get the reimbursement he deserves. When a dermatologist cl...
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ICD-10:
172 Update: Look for C43, D03 Melanoma Families in ICD-10
Also: Big changes coming to in situ coding.Even though ICD-10 implementation has been dela...
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Billing Basics:
Avoid 10 Common Billing Errors With 10 Expert Tips
Hint: Benefits verification can solve a lot of your denial problems.What's the top tool in...
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Reader Question:
Take Into Account Mole Removal's Location, Size
Question: I can' t seem to fit "removal of mole" with any of the existing ...
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Reader Question:
Count Prescriptions as Part of E/M
Question: My dermatologist heard that there's a code we can bill and be paid on just for t...
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Reader Question:
Ensure That Diagnosis Matches Patient's Condition
Question: When I bill Medicare for deep debridement (11042) using the diagnosis the physic...
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Reader Question:
Insurers May Require Bundling Same-Day E/M Services
Question: Can we bill two office visits on the same day? We reported 99214 twice for the s...
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You Be the Coder:
Tissue Transfer, Lesion Excision
Question: My dermatologist performed a lesion excision along with a tissue transfer. ...
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Dermatology Coding Alert - 2012; Volume 8, Number 6
CPT® 2012:
15100-15278 Survival: 5 Tips for Large Tumor Excision Exemplify Skin Replacement Rules
Know when to capture pay for preparation, placement, and more. With new codes and an updat...
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Compliance:
OIG to Send CMS Names of 1,700 Docs Who Overbilled High-Level E/M Codes
Frequency of reporting 99214 and 99215 increased 17 percent over 9-year period.If you exam...
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ICD-10 Delay:
Anticipate 1 Extra Year for Your ICD-10 Implementation Schedule
But don't count on the delay quite yet, expert warns.As part of a proposed rule to adopt a...
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Billing:
Overcome Primary vs. Secondary Payer Woes with Answers to Your FAQs
Start with the basics and then move on to learning the intricacies.When a patient is cover...
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Follow These CMS Rules for Submitting Medicare Secondary Payer Claims
Hint: Copy all beneficiary insurance cards, not just the Medicare one.When Part B practice...
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Reader Question:
Use 17110 for Wart Removal Without Cryo
Question: The dermatologist documented, "Dermatology treatment rendered in the form of deb...
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Reader Question:
How Should You Bill Medicare?
Question: We are participating with Medicare. We bill and submit claims to Trailblazer (J4...
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Reader Question:
Remember to Represent Pressure Ulcer's Stage
Question: An established elderly patient reports to the dermatologist for inspection of so...
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Reader Question:
Prolonged E/M Is No Longer Restrictive to Physician Services
Question: How can we report prolonged face-to-face E/M services provided by our dermatolog...
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You Be the Coder:
Repeat Excision
Question: My dermatologist removed a malignant mole last week, which I reported with 11600...
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Dermatology Coding Alert - 2012; Volume 8, Number 5
Skin Procedures:
11100, 17000, or 17110? Use Method to Select Biopsy or Destruction Code
Follow 3 steps to find the right code for these 3 integumentary procedures. A patient pres...
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Billing Errors:
One Medicaid Payer Reveals Its Top 5 Errors -- Know How You Can Avoid Making the Same Mistakes
Coding errors once again top the list of the most common mistakes.Did you catch a miscoded...
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Sunburn:
16000 Pay Depends on Documentation of 'Treatment'
Watch out: Not all burn care is created equal -- you may need to code some as E/M.Whi...
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Fee Schedule:
You Won't Face 27 Percent Medicare Cut for 2012
Congressional 10-month delay pushes payment formula problems to 2013.For practices fearing...
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Reader Question:
15780-15783 Cover CO2 Dermabrasion
Question: How should I code for CO2 laser dermabrasion to treat a basal cell carcinoma?Pen...
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Reader Question:
Employ Modifier 79 for Botox Injection During Global
Question: How should we code if a patient recently had surgery and a Botox injection is sc...
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Reader Question:
Too Small for Intermediate Closure
Question: I'm aware of a "rule" regarding lesion excision and closure charges that I am qu...
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Reader Question:
No Documented HPI Leads to No Coding for New Patient
Question: A new patient visits the dermatologist with a chief complaint. I don't have a re...
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You Be the Coder:
Total Body Skin Check
Question: A patient with a history of skin cancer presents for a total body skin check. Th...
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Dermatology Coding Alert - 2012; Volume 8, Number 4
Excisions:
11640-11646 Demystified: Can You Conquer These Excision Coding Scenarios?
Referrals, unexpected findings, and multiple excisions -- check out these case studie...
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ICD-10:
ICD-10 Date Will Be Postponed, HHS Confirms
Delay could offer practices additional time to prepare for new diagnosis coding system.Jus...
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HIPAA:
With Audits Heating Up, Is Your Practice Ready?
Make sure your privacy and security practices are up-to-date.If your HIPAA protocols fall ...
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Incident-to Billing:
Shore Up You Incident-To Claims or Face OIG Scrutiny This Year
Ensure your visit meets 4 criteria before filing an incident-to claim.If you don't know ho...
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Reader Question:
707.21 Sets the Stage for Complete Pressure Ulcer Dx
Question: An established elderly patient reports to the dermatologist for inspection of so...
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Reader Question:
Insurers May Require You to Bundle Same-Day E/M Services Together
Question: Can we bill two office visits on the same day? We reported 99214 twice for...
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Reader Question:
Remember Debridement Includes Dressings
Question: Can our practice be reimbursed for the surgical dressing (supplies) of a partial...
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You Be the Coder:
I&D of Multiple Cysts
Question: A patient presents to the office with cysts all over her body. The dermatologist...
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Dermatology Coding Alert - 2012; Volume 8, Number 3
Debridement:
11040 and Wound Closure: Look for These Conditions to Justify Separate Reporting
Tip: Pay attention to the level of wound repair to maximize your reimbursement. Many clini...
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Part B Update:
Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012
Plus: Claims reprocessing has completed, so make sure your claims have been corrected.As m...
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Documentation:
Make Audit-Proof Record Corrections With These 5 Tips
Documentation clarifications can be a big help -- if you use them wisely.With the ple...
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E/M Coding:
'Follow-Up' Is Not A Sufficient Chief Complaint
Improve Your E/M Payment Odds With These 5 Quick TipsMost practices report E/M codes every...
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Reader Question:
96900-96999 Cover PUVA, Narrow Band Treatment
Question: What CPT® codes apply for PUVA treatment and narrow band treatment?Maine S...
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Reader Question:
709.9 Dx Selection Must Be Backed by Note
Question: When I bill Medicare for deep debridement (11042) using the diagnosis the dermat...
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Reader Question:
99241-99255: Keep Consults When Possible
Question: Can we still use "consult" E/M codes?North Carolina SubscriberAnswer: The answer...
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Reader Question:
Pay Attention to Month, Not Year, With Birthday Rule
Question: I just received a call from a patient's parent claiming that we didn't follow th...
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Reader Question:
Prepare Wisely for Payer Fee Negotiations
Question: We're getting ready to begin contract renewal negotiations with one of our payer...
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You Be the Coder:
Testing Multiple Allergens
Question: My dermatologist scratch- tested a patient, who complains of skin rashes, f...
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Dermatology Coding Alert - 2012; Volume 8, Number 2
CCI 18.0 Update:
Include Compression Therapy in Many Skin Graft Codes
Look for different sessions or sites before you try to break these bundles. If your dermat...
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Medicare Errors:
Providers Underbilled More Than $1 Billion to Medicare in 2010
CERT results reveal $34.3 billion in improper Medicare payments -- $1.1 billion of wh...
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Part B Payment:
Congress Votes to Boost Conversion Factor Through February 29
At nearly the last minute, lawmakers ensure that you won't lose 27 percent.Although the go...
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CPT® 2012:
Don't Miss These Clarifications About New Patients and 'Qualified Healthcare Professional'
See how changes affect your use of 99201-99205, 99460-99461, and more. Coding guidelines c...
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Reader Question:
692.x May Be Good Choice for Unknown Skin Rashes
Question: We recently treated a patient for a skin rash that seemed to be an allergic reac...
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Reader Question:
ICD-10 Prep Is Different for Paper Claims
Question: If we file paper claims to Medicare, will the claims form change once we be...
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Reader Question:
Only Add Lacerations at Same Site and Level
Question: A patient with a 1.5-cm laceration on his eyebrow presented to our practic...
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Reader Question:
No HPI Equals No Coding for New Patient
Question: A new patient visits the physician with a chief complaint. I don't have a review...
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You Be the Coder:
Chemical Peel
Question: Our dermatologist used glycolic acid to remove actinic keratoses from around a p...
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Dermatology Coding Alert - 2012; Volume 8, Number 1
Biopsies:
11000 Is Just the Start: Explore Site-Specific Bx Codes and Net $78 or More
Boost claims accuracy by avoiding these common biopsy coding pitfalls. If you automaticall...
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Rural Care:
Protect Your Bottom Line: Implement These Revalidation Letter Requirements
Here's the lowdown on how these CMS changes apply to your practice.If you're a rural healt...
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ICD-10:
Prepare for ICD-10 Conversion With 2 Simple Tips
Know your anatomy and physiology if you want a quick transition.It's not too early to star...
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CPT® 2012:
Establish Whether a Patient Is New With CPT®'s Latest E/M Tweaks
New rules place emphasis on subspecialties. It's an age-old debate -- when an establi...
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5010 Readiness:
Medicare Won't Penalize You for 5010 Non-Compliance Until March 31, 2012
Plus: Avoid PO boxes on 5010, despite what your MAC tells you.Sweating over the fact that ...
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Reader Question:
V16.8 Tells Family Melanoma Risk Story
Question: In our practice, we frequently see patients who don't personally have malignant ...
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Reader Question:
Diagnosis Is Related to E/M Level, But Doesn't Dictate Code
Question: Our dermatologist saw an established patient with severe chronic skin allergies....
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Reader Question:
Modifier 55 Won't Apply to Suture Removal
Question: An 11-year-old established patient went to the emergency room in another state o...
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Reader Question:
Know GC Rules for Resident Surgical Assists
Question: When a resident assists a surgeon in a teaching hospital, do we need to add modi...
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You Be the Coder:
Mohs With Frozen Section
Question: The surgeon in our practice usually performs a biopsy of the lesion prior t...
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