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Dermatology Coding Alert - 2013; Volume 9,Number 12
Biopsies:
Specifying Biopsy Site Can Mean $27 Per Procedure
Don’t automatically assign 11100 if a site-specific biopsy site is justified. If...
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HIPAA:
Solidify Your HIPAA Policies and Practices Before the Auditors Come Knocking
All covered entities and business associates are on the audit list, HHS says. HIPAA is...
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ICD-10 Update:
Don't Get Sidelined By These 3 ICD-10 Myths
Don’t assume that ICD-10 will allow you to use the same code twice. With the hea...
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Compliance:
Bust These 5 Common Compliance Myths
Tip: Make a good faith effort to comply with the spirit of the law. Don’t get wa...
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Reader Question:
Malignancy Leads Code Choice
Question: Sometimes our surgeon excises in situ basal cell carcinoma, but sometimes he u...
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Reader Question:
MSP Doesn't Change Medicare Consultation Pay
Question: I know Medicare doesn’t reimburse consults anymore, but a new coder we h...
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You Be the Coder:
Family Melanoma Risk
Question: In our practice, we frequently see patients who don’t personally have ma...
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Dermatology Coding Alert - 2013; Volume 9,Number 11
ICD-10 Update:
Get Specific With Pressure Ulcer Coding in ICD-10
Reporting multiple ulcers? Next year, reduce confusion with separate codes for bilateral...
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CCI:
CMS Takes Back E/M Bundles That Quash Legit Pay
Check your modifier 25 claims for erroneous denials. Since July 1, you’ve been f...
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Advance Beneficiary Notices:
Adding 'G' Modifiers on Your Medicare Claims? Expect Extra Scrutiny
The OIG report puts GA, GZ, GY, and GX in the hot seat. When your practice is billing ...
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Reader Question:
Nail Ingrown Toenail Coding With 11750
Question: A patient presents for a follow-up of an ingrown toenail. The physician f...
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Reader Question:
Ensure That Your Appeals Have a Chance at Success
Question: When we know that the carrier has made a mistake in denying one of our cl...
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Reader Question:
Get Patient Okay Before Disclosing PHI
Question: Who’s authorized to make a request to review a patient’s medi...
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Reader Question:
Clear Up Modifier 59 Confusion
Question: We were just notified that modifier 59 is no longer accepted by Medicare ...
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Reader Question:
Here's What You Can Do to Get Ready for ICD-10
Question: What should we be doing now to prepare for the ICD-10 transition? South...
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You Be the Coder:
Dermabond Closure
Question: An established patient visited our office because of severe hyperkeratosi...
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Dermatology Coding Alert - 2013; Volume 9,Number 10
Neoplasm Coding:
3 Steps Point the Way for Uncertain Vs. Unspecified Neoplasms
238.2 or 239.2? The answer lies in the details. Do you know the difference between neo...
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ICD-10:
Conversion to ICD-10 Won't Be a Huge Financial Burden, CMS Reps Say
Plus: ICD-10 claims will allow you to submit the letters as either upper or lowercase, C...
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Practice Management:
Breeze Through HIPAA Audit With 5 Protocol Tips
Try your hand at internal audits first. Random and targeted HIPAA audits are making th...
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Compliance:
E/M Errors Top Medicare's List of Improperly Billed Codes in 2012
CERT results reveal $29.6 billion in improper Medicare payments — $1.1 billion of ...
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Reader Question:
Calculate the Sequestration Cut Effects
Question: Does the 2 percent sequestration cut apply to claims with dates of service on/...
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Reader Question:
Identify Ulcers by Type, Not Depth
Question: Is there a method of correlating Wagner’s ulcer classification to ICD-9 ...
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Reader Question:
Billing 2 MD Visits on Same Day Is OK if Specialties Differ
Question: Can a patient be seen by two different providers in a billing group on the sam...
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You Be the Coder:
Complex or Simple Integumentary Repair?
Question: Would this be considered complex or just a simple repair? Wound repair of ...
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Dermatology Coding Alert - 2013; Volume 9,Number 9
Lesion Removals:
701.1 Is Your Best Bet for Porokeratotic Lesions
11055, 11420, or17110? Your coding will depend on the method used. There may be no spe...
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Part B Payment:
Proposed 2014 Fee Schedule Suggests Steep Cuts
But in 2015, practitioners could finally see bonuses for non-face-to-face services admin...
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ICD-10 Prep:
Let 4 FAQs Help Guide Your ICD-10 Focus
Don’t limit your training to code selection alone. The ICD-10 implementation de...
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Compliance:
Know the Truth About 5 Common Compliance Beliefs
True or false? Being unaware of accidental overpayments can’t invoke false claims ...
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Reader Question:
Don't Add Wound Lengths in Different Anatomical Sites
Question: A patient with a 1.5-cm laceration on his eyebrow presented to our dermatology...
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Reader Question:
Pay Heed to Complex Repair 'Anatomic Groups'
Question: We had a case with multiple lacerations requiring complex repair to the follow...
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You Be the Coder:
Debridement With FBR
Question: Is it acceptable to code 11042 and 10120 together? If so, do I need to include...
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Dermatology Coding Alert - 2013; Volume 9,Number 8
CCI 19.2:
Greet E/M Bundles for Nearly Every Integumentary Surgery
Focus on three modifiers for unusual cases. If you’re rusty on when evaluation a...
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E/M Coding:
Take Steps to MDM Determination Success -- Every Time
This system will help you correctly calculate each piece of the MDM puzzle. Are you in...
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Electronic Medical Records:
Look Before Jumping on the EMR Bandwagon
Picking the wrong EMR system could mean losing money and system blackouts. Electronic ...
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Reader Question:
Mitigate Late Patient Costs With Block Scheduling
Question: Recently we have had a lot of patients showing up late for appointments. The p...
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You Be the Coder:
3 Skin Lesions With Pathology
Question: Our dermatologist excised three skin lesions from a patient’s back and n...
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Dermatology Coding Alert - 2013; Volume 9,Number 7
Burn Treatments:
16000-16036: Don't Get Burned on Code Choice
Tip: Use the “Rule of Nines” to determine the percentage of skin involved. ...
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Practice Management:
Master X-Y-Zs of Global Period Indicators to Maximize E/M Pay
Make sure to count pre-op day, too. Procedures that your dermatologist performs can ra...
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CCI Primer:
4 FAQs Spotlight Bundling Rules for Dermatological Surgeons
Know when modifiers, ABNs can’t override edit pairs. Keeping abreast of Medicare...
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Documentation:
Leave the HPI Details to the Provider
Identify which portions of the record ancillary staff can capture. Your dermatologist...
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Reader Question:
Choose 17110 for Verruca Vulgaris Removal
Question: The physician used a laser to remove five lesions of verruca vulgaris on a pat...
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Reader Question:
Brush Up on ICD-10 Differences
Question: I’ve seen lots of specific examples of ICD-10 codes, but I think it woul...
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You Be the Coder:
Sebaceous Cyst Removal
Question: If our surgeon removes a sebaceous cyst from the back that measures 2.5 x 1.75...
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Dermatology Coding Alert - 2013; Volume 9,Number 6
Milia:
4 Tips Lead You to Clear Milia Treatment
Understanding irrigation and drainage is essential. Having a hard time reporting milia...
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ICD-10 Prep:
Focus Your Dermatology Practice's ICD-10 Prep With CMS Resources
Don’t miss partial code freeze breather. The countdown to ICD-10 stands at just ...
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Practice Management:
Learn the Basics Before Investing in Practice Management Software
The right tools can streamline your administrative and financial tasks. Medical practi...
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Don't Settle:
Perform an MPM Needs Analysis
Review these system features and decide which ones your practice needs. When your prac...
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Part B Mythbuster:
Check Out These Top 5 ABN Myths
These surprising CMS rules on ABN use are straight from Medicare policy. You’ve ...
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Reader Question:
Amend Documentation With Care
Question: One of our dermatologists wants to amend documentation of a procedure, but we ...
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You Be the Coder:
Melanoma Removal Involving Subcutaneous
Question: The surgeon re-excised a melanoma of the upper arm, removing a 2.9 cm lesion w...
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Dermatology Coding Alert - 2013; Volume 9,Number 5
Dermatitis Tests:
Scratch Test or Patch Test, Make Sure Dermatologist Counts All Allergens
Understand what each test does, and how. If your office is a typical dermatology offic...
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Cash Flow:
5 Hidden Income Opportunities Ease the Pain of Sequestration Cuts
Your Medicare pay was slashed by 2 percent on April 1 — these tips will help bring...
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Denials Management:
4 Tips Set You on Course for MUE Appeals Success
Don’t fall victim to the ABN myth. If you think medically unlikely edits (MUEs) ...
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Reader Question:
Wait Until Oct. 1, 2014, to Use ICD-10
Question: Our practice is considering submitting claims with ICD-10 codes before the imp...
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You Be the Coder:
Atypical Nevus Diagnosis
Question: I can’t seem to find a clear diagnosis code for personal history of atyp...
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Dermatology Coding Alert - 2013; Volume 9,Number 4
Closures:
Simple, Intermediate, Complex Closures: A Many-Layered Coding Decision
Dermatologist’s documentation is the key. All closures aren’t created equa...
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News You Can Use:
You're Saved From 26.5 Percent Physician Pay Cut
But RVU changes still in effect. Dermatologists can expect a reprieve from the dreaded...
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Practice Management:
3 Tips Clean Up Your Incident-To Billing
Steer clear of 2013 OIG Work Plan scrutiny. If your dermatology practice utilizes non-...
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Ordering/Referring:
6 Steps Help You Reduce PECOS Edit Losses
Tip: Check your current referring info to avert financial crisis in May. You’d b...
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Reader Question:
Let Medical Necessity Rule Code Choice
Question: Our dermatologist is a very thorough documenter and treats very sick patients....
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Reader Question:
Keep a Record of Your Provider's Signature Variations
Question: We’re having trouble making sure our providers meet signature requiremen...
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You Be the Coder:
Wart Excision With Fulguration
Question: Our physician performed an excision of two warts (one from the elbow and one f...
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Dermatology Coding Alert - 2013; Volume 9,Number 3
Closures:
12001 or 13100? Consider More Than Layers to Code Correct Closure Level
Follow our tips to dig deeper and find the differences between ‘simple,’ &ls...
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Practice Management:
Get Ready For OIG Scrutiny of Modifiers and More
Audit yourself before the feds come calling. Your dermatology practice could come unde...
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E/M Coding:
Implement These 5 Simple Steps to Boost Your E/M Bottom Line
Heads up: Dig past ‘follow-up’ for acceptable chief complaint. E/M coding ...
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Overpayments:
Medicare Now Has 5 Years to Request Money Back From Your Practice
Previous 3-year lookback period was extended with ‘fiscal cliff’ legislation...
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Reader Question:
Question Medicare for 17003 Claims
Question: We recently reported codes 17000 and 17003 to Medicare for reimbursement. Thou...
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Reader Question:
Capture Margin Re-Excision
Question: The dermatologist performs a lesion re-excision for margin removal becau...
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Reader Question:
Use Physician's Report for Multiple Lesion Fragments
Question: I just received a pathology report back that reads: "The largest se...
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You Be the Coder:
Melanoma Re-Excision, Not Including Fascia
Question: Our dermatologist re-excised a melanoma with an area that was 12 cm long and 3...
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Dermatology Coding Alert - 2013; Volume 9,Number 2
CPT® 2013:
Clear Up Pedicle Flap Confusion with 15740 Changes
Named vessel is key. Changes to CPT® 2013 "other flaps and grafts" instr...
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2013 Payment:
Last-Minute Congressional Vote Reverses Across-the-Board Pay Cuts
Medical societies still hopeful for new formula to halt this annual nail-biter. As man...
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EHR:
Does Your Electronic Prescription System Pass Muster?
Get started now to avoid further pay hits in 2014. Incentives for using electronic pre...
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Documentation:
Avoid Billing E/M Service Based on Cloned Documentation, Or the OIG Will Come Knocking
Ensure your EMR is not setting you up for failure. If you have reviewed the HHS Offic...
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Reader Questions:
Friction Burns Still Count As 'Burns'
Question: A patient presented with multiple friction burns from a treadmill. He had part...
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Reader Questions:
ABN Smooths Billing for Benign Excisions
Question: I bill for a dermatology practice. Our state Medicaid doesn’t cove...
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Reader Questions:
Legibility Matters, CMS Stresses
Question: I have heard payers are cracking down on illegible provider documentation. My ...
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Reader Questions:
Inform Patients Before Collecting Co-Pays Upfront
Question: One of our providers returned from a meeting, saying he had talked to other pr...
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You Be the Coder:
Skin Cancer Screening
Question: My dermatologist sees a patient for a skin cancer screening. Should I use the ...
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Dermatology Coding Alert - 2013; Volume 9,Number 1
Mohs Procedures:
Mohs or Excision Codes? Look at Dermatologist's Role for Answer
Ask yourself: Is the physician working as both the surgeon and the pathologist? The Mo...
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CCI:
Modifiers 24 And 57 Will Soon Allow You to Bypass CCI Edits
Plus: You can also override bundles with modifiers LM and RI We’ve all heard the...
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CMS News:
Update Your Revalidation Plan With New CMS Instruction
Kinder, gentler process forestalls ‘revocation.’ Don’t lose your abi...
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Fee Schedule:
Brace Your Practice for a 26.5 Percent Drop in Medicare Pay Next Year
Watch for deep cuts to some complex repair codes in 2013. Every year at this time p...
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Reader Question:
Re-Excision Depends on Timing
Question: The dermatologist performs a lesion re-excision for margin removal becaus...
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Reader Question:
238.2: Code Original Excision Dx
Question: A patient comes in for a re-excision of a dysplastic nevus. Do I bill the re-e...
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Reader Question:
New Year, New Insurance = New Verification
Question: How should I file a claim on a patient who has new coverage but has not receiv...
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Reader Question:
Get Patient's Signature on Records Transfers
Question: We were forced to discharge a patient. She paid for a copy of her medical reco...
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You Be the Coder:
Follow-Up Coding for 10060
Question: A patient saw our physician because of an abscess, and returned for a follow-u...
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