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Dermatology Coding Alert
Dermatology Coding Alert
Dermatology Coding Alert - 2014; Volume 10,Number 12
Milia Treatments:
Pop These Milia Myths Before They Blemish Your Reimbursement
Know the difference between 10040 and 17110. Milia treatments can be notoriously chall...
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ICD-10:
Keep Clear of Viral Warts Diagnosis Confusion
In 2015, start with the B07.- series for viral warts. For the most part, dermatology c...
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Documentation:
New MAC Tip Reminds Practices What Ancillary Staff Can -- and Cannot -- Document
Documenting HPI is the job of the doctor or NPP. Your ancillary staff might be quite a...
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Privacy:
Update Your HIPAA Policies to Reflect New Same-Sex Marriage Rules
OCR augments the definitions of spouse, marriage, and family member. The U.S. Supreme ...
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Billing:
Get Comfortable with Unruly Consolidated Billing Rules
Uncover who, what, and when to bill so you get your money. Knowing whether your skille...
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Reader Question:
Prove Medical Necessity for 11721 with 99213
Question: Can I bill Medicare for an E/M visit (99213) along with a debridement of ...
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Reader Question:
Consider More Than Time For Modifier 22
Question: One of my doctors performed a procedure to excise a lesion on an obese pa...
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You Be the Coder:
Friction Burns
Question: A patient presented with multiple friction burns from a treadmill. He had...
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Dermatology Coding Alert - 2014; Volume 10,Number 11
Lesions:
Ignoring Shaving and Skin Tag Codes? You Could Lose Up to $88
If 17110 is your automatic choice for skin lesion destructions, read this before you cod...
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ICD-10:
Don't Get Zapped When Radiation-Related Disorders Codes Change
In 2015, look for debut of the L57.- codes . In a previous issue of Dermatology Coding...
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Patient Privacy:
Avoid Brutal HIPAA Fines With These 3 Steps
Take HITECH lessons to heart and protect your bottom line. They might look like ...
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Repairs:
Cue Into Successful Laceration Reporting With This Expert Advice
Don’t forget to check CCI for multiple laceration repair reporting. When reporti...
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Reader Question:
Consider Including Telephone E/M in History or MDM
Question: We have a new patient that called his physician to discuss his visit that...
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Reader Question:
Determine POS Before Checking RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app...
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You Be the Coder:
Staged Carcinoma Removal
Question: A patient of one of our dermatologists presented with a diagnosis of prim...
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Dermatology Coding Alert - 2014; Volume 10,Number 10
Coding Quiz:
Put Your Dermatitis Test Coding Knowledge to the Test
How much do you really know about patch tests and scratch tests? Skin allergy tests ma...
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ICD-10:
New Choices Shine Through for Sunburn and UV Radiation
Next year, you’ll find many more options for dermatitis due to solar radiation. ...
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Coding Quiz Answers:
Keep Your Scratch and Patch Test Coding Irritation-Free
Hint: Remember to code per allergen, not per scratch. How did you do on this quiz? Rea...
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Compliance:
Watch Out For Sophisticated Malware Breaching Your Systems From Overseas
Pay attention: Massive breach teaches you four crucial lessons. The latest HIPAA breac...
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Modifier Review:
Brace Yourself with Modifier 59 for Distinct Procedural Services
Refer to Medicare’s Correct Coding Initiative (CCI) before using Modifier 59 Mod...
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Reader Question:
Bring In ABN Benefits
Question: Should I bill Medicare for services that I know they’ll deny based ...
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Reader Question:
Appeal Is an Option When Patient Prevents Timely Filing
Question: We have a timely filing concern. Our physician saw a patient who didn&rsq...
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You Be the Coder:
Candida Antigen
Question: My dermatologist uses candida antigen for wart destruction. Previously, I...
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Dermatology Coding Alert - 2014; Volume 10,Number 9
Mohs Procedures:
Location, Stage and Number are Critical to Find Correct 17311-17315 Code
The dermatologist is doing double duty; make sure your coding brings in the deserved rei...
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ICD-10:
Specify Malignant Melanoma or Melanoma In Situ
Next year, ICD-9’s 172.x series expands to dozens of diagnosis codes. Dermatolog...
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Payment:
Look For Proposed CMS Global Period Overhaul
You could charge separate E/M, in many cases. A big surprise hit the presses in a rece...
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ICD-10:
These 3 ICD-10 Answers May Surprise You
Hint: Forget everything you know about ICD-9’s ‘excludes’ codes after ...
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Reader Question:
Turn to Unlisted E/M If Visit Doesn't Match Key Element Requirements
Question: Can I use modifier 52 on 99201 if my provider only captures history and M...
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Reader Question:
What's the Big ICD-10 Picture?
Question: I appreciate the monthly ICD-10 example in your newsletter, but I don&rsq...
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You Be the Coder:
Dysplastic Nevus
Question: A patient comes in for a re-excision of a dysplastic nevus. Do I bill the re-e...
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Dermatology Coding Alert - 2014; Volume 10,Number 8
Biopsies:
Biopsy, Excision, or Shave? Read This Before Coding Your Next Lesion Procedure
Clinical accuracy and deserved reimbursement — up to $75 per procedure — are...
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ICD-10:
Spot the Right Acne Dx Code in 2015
ICD-10 will break out an expanded set of codes based on acne type. Starting Oct. 1, 20...
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Modifiers:
CMS Debuts 4 New Modifiers to Substitute for 59
Medicare will still accept modifier 59, but use the new modifiers instead when applicabl...
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CCI Update:
Beware Hospital Outpatient Clinic Bundles
G0643 edits affect more than 5,000 codes. Sometimes you’ll see a lull in new Cor...
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Documentation:
Avoid Faltering on Signature Rules & Exceptions With These 3 Useful Tips
Analyze CMS’s requirements or you risk the wrong use of signatures. If you are n...
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Reader Question:
1 Lesion, 3 Techniques Still Equals 1 Code
Question: Our dermatologist recently performed removal of a plantar wart approximat...
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Reader Question:
Tackle UB-04 vs.CMS-1500 Dilemma
Question: I used to bill for a facility and am new to the role of practice manager ...
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You Be the Coder:
Full-Thickness Graft
Question: The dermatologist placed a full-thickness graft on a patient’s fore...
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Dermatology Coding Alert - 2014; Volume 10,Number 7
CCI Update:
Watch New Rules for Premalignant Lesion Destruction
17000, 17004 get bundled into dozens of excision and destruction codes. The next set o...
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ICD-10:
Look for New Contact Dermatitis Codes in 2015
ICD-10 codes will specify allergic or irritant contacts. Although the contact dermatit...
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Compliance:
OIG Considers Expanding Civil Monetary Penalties
You could be subject to penalties for five additional reasons if the proposal is finaliz...
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HIPAA:
Let This Example Show You What Not to Do With Your BAs
Warning: You can be responsible for your BA’s violations. Your practice has a so...
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Reader Question:
Slow Patient Won't Justify Timely Filing Exception
Question: Our patient gave us her Medicare card but said Medicare was her secondary...
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Reader Question:
Learn The Method to Determine Reimbursement Using RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app...
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Reader Question:
Don't Get Too Comfortable With Blanket ABNs
Question: I recently started working at a practice that I think overuses ABNs. Can ...
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You Be the Coder:
Light Box Therapy
Question: We are applying Vaseline prior to the light box treatment and billing out...
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Dermatology Coding Alert - 2014; Volume 10,Number 6
Vein Treatments:
Verify Varicose Vein Necessity and Earn Deserved Pay
Follow our expert insights on treatment options, Dx codes, and documentation. Sp...
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ICD-10:
Varicose Vein Diagnoses Branch Out in 2015
Specify leg — and part of leg — with new diagnosis code set. As is a recur...
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Advance Beneficiary Notices:
Know These 4 Categories of Noncovered Services
Sometimes it can be hard to determine what’s considered ‘noncovered.’ ...
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News You Can Use:
CMS Answers ICD-10 Questions -- By Not Answering
Representatives stay mum about the details of the delay. The recent delay of ICD-10 un...
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Reader Question:
Code by Number of Warts, Not Injections
Question: If the dermatologist injects two warts five times each, would I need to r...
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Reader Question:
Multiple Lesions, Multiple Fingers
Question: Our dermatologist excised masses in three different areas: one deep in th...
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Reader Question:
Focus on 'Incident-to' Rules
Question: The following scenario occurred in our practice: Physician A covered an e...
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You Be the Coder:
Repeat I&D
Question: A patient came in and had an incision and drainage of an abscess. She cam...
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Dermatology Coding Alert - 2014; Volume 10,Number 5
Coding Quiz:
Can You Cleanly Code These Lesion Removal Scenarios?
Look at the three questions below, then check your answers against our experts’. ...
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Coding Quiz Answers:
Check Your Lesion Removal Savvy
Read our experts’ opinions on coding these scenarios. Answer 1: Referral With Si...
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News You Can Use:
Congress Votes to Halt Your Pay Cuts and Delay ICD-10
Physician associations still plan to pursue a permanent SGR formula revision. Th...
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ICD-10:
Make the Most of the ICD-10 Extension With These Quick Tips
New implementation date has not been announced, but be ready. Whether you’re che...
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Reimbursement:
24 Percent Medicare Pay Cut Averted
Expect level pay through March 31, 2015. You’re probably used to this by now sin...
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Reader Question:
11600 Covers Repeat Excision
Question: My dermatologist removed a malignant mole last week, which I reported wit...
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Reader Question:
E/M, V Code Help Describe Total Body Skin Check
Question: A patient with a history of skin cancer presents for a total body skin ch...
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Reader Question:
Assess Risk on a Regular Basis
Question: We are having a bit of a debate in our practice. Some of us think that pe...
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You Be the Coder:
Surgical Dressing of Burn
Question: Can our practice be reimbursed for the surgical dressing (supplies) of a ...
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Dermatology Coding Alert - 2014; Volume 10,Number 4
CCI Update:
Watch for Dozens of New Mohs Edits
Check modifier indicators for unbundling rules. Dermatology practices that perform Moh...
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ICD-10:
Psoriasis Coding Gains More Specificity
696.1 is out; L40.- will be in. Although it is not exclusively a skin condition, the m...
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Modifiers:
Master Modifier 25 Following These Expert Tips
Haphazardly using 25 on all claims will lead to payer scrutiny. With payers cracking d...
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Documentation:
Adopt 7 Documentation Best Practices for Compliant and Complete Records
While the provider captures notes just once, they may be reviewed countless times. Whe...
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Reader Question:
Append Modifier 22 to 10061 for Multiple Cysts
Question: A patient presents to the office with cysts all over her body. The dermat...
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Reader Question:
Nonexistent Payment Follows Incomplete Claims
Question: Our practice has a few claims that have missing or incorrect information....
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Reader Question:
Consider a Flexible No-Show Policy
Question: During the snow storm last month, we had several patients call in and say...
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You Be the Coder:
Easy Bruising
Question: What is the ICD-9 code for “easy bruising”? Washington Subs...
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Dermatology Coding Alert - 2014; Volume 10,Number 3
Excision Quiz:
Test Your 11640-11646 Skills With These Scenarios
Then read on for our expert answers. Coding all services involved in a lesion removal ...
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Size Matters for Tumor, Skin Replacement Coding
Tip: Automatically reporting surgical prep of the graft? Read this first. Follow this ...
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ICD-10 Prep:
Don't Limit Your ICD-10 Focus to Coding
NGS answers practice questions about how to be ready come Oct. 1. For years the threat...
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Reader Question:
10061 Makes Case for I&D of Multiple Cysts
Question: A patient presents to the office with cysts all over her body. The dermat...
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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 ...
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Reader Question:
Explore Options to Enhance Patient Privacy
Question: Are there specific guidelines that our surgical group should follow to pr...
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You Be the Coder:
Wart Removal Without Cryo
Question: The dermatologist documented, “Dermatology treatment rendered in th...
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Dermatology Coding Alert - 2014; Volume 10,Number 2
Scar Revision:
Establish Medical Necessity to Prove Scar Procedures Aren't Cosmetic
Tip: Documentation should show that excisions are a part of aftercare. If you’re...
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Compliance:
Focus on 5 Areas for Improvement in Your Provider Documentation
While EMRs improve legibility, they may lead to other issues. When your practice faces...
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Part B Payment:
Congress Offers 3-Month Reprieve on Conversion Factor Cuts
Plus: Government moves toward possible SGR repeal. If you weren’t looking forwar...
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E/M Coding:
Follow the 3-Year Rule to Determine Patient Status
Hint: The place of service (POS) won’t influence your choice. The first step to ...
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Correction
An article in Dermatology Coding Alert Vol. 9 No. 12, “Specifying Biopsy Site Can ...
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Reader Question:
Reporting 15851 for Suture Removal Without Anesthesia? Think Again
Question: Our dermatologist recently performed suture removal in the office for an estab...
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Reader Question:
POS Determines Supply Reimbursement
Question: My doctors are concerned that our practice is losing money on supplies, such a...
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Reader Question:
Define Date for Global Package
Question: The CPT® surgery guidelines state that the surgical package includes &ldqu...
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You Be the Coder:
Carcinoma Excision With Tissue Transfer Closure
Question: My surgeon excised a carcinoma of the face. He closed the excision using adjac...
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Dermatology Coding Alert - 2014; Volume 10,Number 1
ICD-9 Coding:
Avoid Tough Callus and Corn Coding
Keep the jargon straight for common foot conditions. For dermatologists treating the s...
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CPT® 2014:
99446-99449: New E/M Codes Capture Doc Discussions
Make sure to include a written report. Who knows if Medicare will pay, but you should ...
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E/M:
Navigate the New-Versus-Established-Patient Maze With Expert Tips
Different locations, same physician? Use established patient codes. When reporting man...
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EHR Mythbuster:
3 EHR Myths That Could Cost Your Practice Heavily
Warning: Blindly relying on your electronic system could mean payer audits. If you are...
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Reader Question:
Minor Changes to Complex Repair Codes for 2014
Question: Are there any changes to the dermatology CPT codes that we should be aware of ...
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Reader Question:
Test Your ICD-10 Coding in March
Question: I have heard that there will be a test period for using ICD-10 codes on claims...
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Reader Question:
Know How to Email Without Violating HIPAA
Question: I sometimes e-mail patient records to consultants for help on how to bil...
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Reader Question:
Opt for First-Initial, Last-Name Privacy Protocol
Question: What guidelines should our group follow to protect the privacy of patien...
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You Be the Coder:
Lesion Removal and Tissue Transfer
Question: If the dermatologist performs an adjacent tissue transfer, can I also code for...
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