ED Coding and Reimbursement Alert
PHYSICAN FEE SCHEDULE UPDATE ~ Find Out Why Your ED E/Ms Will Be Worth More in 2007
CMS knocks down conversion factor, props up RVUs for ED E/Ms Medicare recently firmed up ... Read more
CMS knocks down conversion factor, props up RVUs for ED E/Ms Medicare recently firmed up ... Read more
ICD-9 UPDATE ~ Use These New Diagnosis Codes for Patients With Pain
338 series unveiled to represent acute, chronic pain ED coders now have a host of new dia... Read more
338 series unveiled to represent acute, chronic pain ED coders now have a host of new dia... Read more
CPT 2007 ~ Check This Flow Chart Before Deciding on Patient Status
CPT 2007 manual includes tool for deciding on new, established patients When an ED physic... Read more
CPT 2007 manual includes tool for deciding on new, established patients When an ED physic... Read more
READER QUESTION ~Keep an Eye on Critical Care Bundles
Question: A patient suffering from acute respiratory failure presented to the ED. The phys... Read more
Question: A patient suffering from acute respiratory failure presented to the ED. The phys... Read more
READER QUESTION ~ Don't Focus on Location of Observation Service
Question: Our ED physician performed an observation on a patient who was not in the observ... Read more
Question: Our ED physician performed an observation on a patient who was not in the observ... Read more
READER QUESTION ~ State, Facility Will Have Final Say on NPP's Role
Question: Our coding company recently started processing claims for an ED that employs non... Read more
Question: Our coding company recently started processing claims for an ED that employs non... Read more
YOU BE THE CODER ~ Coding for Asymptomatic Patients
Question: Our ED recently treated two patients that sustained injuries when their car veer... Read more
Question: Our ED recently treated two patients that sustained injuries when their car veer... Read more
Break Down Fracture Care Coding Into 4 Simple Steps
Tip: Modifier 54 is a necessity on most fracture claims When a patient reports to t... Read more
Tip: Modifier 54 is a necessity on most fracture claims When a patient reports to t... Read more
Double-Check for Modifier Q6 on Your Locum Tenens Claims
When the regular doctor is out, follow these rules when coding for the replacement physici... Read more
When the regular doctor is out, follow these rules when coding for the replacement physici... Read more
Reader Question:
Forget POS When Answering Critical Care Question
Question: Our physician provided 100 minutes of critical care to a patient having a stroke... Read more
Forget POS When Answering Critical Care Question
Question: Our physician provided 100 minutes of critical care to a patient having a stroke... Read more
Reader Questions:
Choose 1 Code for Multiple Observations
Question: I have an op report in front of me that indicates two of our group's physicians ... Read more
Choose 1 Code for Multiple Observations
Question: I have an op report in front of me that indicates two of our group's physicians ... Read more
Reader Question:
Physician Presence Required for CPR Direction
Question: Our ED physician got a call from an EMS worker who was en route to the hospital ... Read more
Physician Presence Required for CPR Direction
Question: Our ED physician got a call from an EMS worker who was en route to the hospital ... Read more
Reader Question:
Look to 'Artificial Menopause' for Estrogen Withdrawal
Question: A patient who had a hysterectomy earlier this year reported to the ED for treatm... Read more
Look to 'Artificial Menopause' for Estrogen Withdrawal
Question: A patient who had a hysterectomy earlier this year reported to the ED for treatm... Read more
Reader Question:
Differentiate Between Facial, Dental Nerve Blocks
Question: The ED physician performed a diagnostic nerve block on a patient complaining of ... Read more
Differentiate Between Facial, Dental Nerve Blocks
Question: The ED physician performed a diagnostic nerve block on a patient complaining of ... Read more
Reader Question:
Watch for CPAP/Observation Bundles
Question: A patient with a diagnosis of sleep apnea reported to the ED. In the midst ... Read more
Watch for CPAP/Observation Bundles
Question: A patient with a diagnosis of sleep apnea reported to the ED. In the midst ... Read more
Reader Question:
Can You Code a Biopsy and I&D Together?
Question: A patient reported to the ED with a cyst on her left eyelid. Our physician perfo... Read more
Can You Code a Biopsy and I&D Together?
Question: A patient reported to the ED with a cyst on her left eyelid. Our physician perfo... Read more
Reader Question:
State Guidelines Govern Most Workers' Comp Claims
Question: I am unsure about a workers- compensation claim. The patient, a traveling busine... Read more
State Guidelines Govern Most Workers' Comp Claims
Question: I am unsure about a workers- compensation claim. The patient, a traveling busine... Read more
You Be the Coder:
Can You Report a Separate E/M With Thrombolysis?
Question: A patient complaining of chest pain reported to the ED. The physician performed ... Read more
Can You Report a Separate E/M With Thrombolysis?
Question: A patient complaining of chest pain reported to the ED. The physician performed ... Read more
Complex Anterior Nosebleeds Require Extensive Packing, Documentation
You-ll need detailed notes from the physician to justify a complex repair code W... Read more
You-ll need detailed notes from the physician to justify a complex repair code W... Read more
Perfect Your Posterior Nosebleed Coding With This Expert Strategy
Don't be surprised when patients with posterior bleeds present to the ED When a patient r... Read more
Don't be surprised when patients with posterior bleeds present to the ED When a patient r... Read more
Solve the Riddle of 'Separate' Versus 'Inherent' E/M Before Appending Modifier 25
The physician always performs some type of E/M preprocedure, and not all are separately re... Read more
The physician always performs some type of E/M preprocedure, and not all are separately re... Read more
Reader Question ~ Find Evidence of Fluoroscopy Before Reporting 43752
Question: A patient with complaints of stomach pain and rectal bleeding reports to the ED.... Read more
Question: A patient with complaints of stomach pain and rectal bleeding reports to the ED.... Read more
Reader Question ~ E/M Levels Vary for Migraine Patients
Question: What level of E/M service should I report when a patient reports to the ED for t... Read more
Question: What level of E/M service should I report when a patient reports to the ED for t... Read more
Reader Question ~ Phone Consult Codes Rarely Recognized
Question: A patient reports to the ED after hurting her leg while roller skating. After a ... Read more
Question: A patient reports to the ED after hurting her leg while roller skating. After a ... Read more
Reader Question ~ Check With Insurer Before Coding FBR With Blade
Question: The physician administered topical anesthesia and removed a foreign body w... Read more
Question: The physician administered topical anesthesia and removed a foreign body w... Read more
Reader Question ~ Placenta Delivery May Result in E/M Payment
Question: A woman arrives at the ED having already delivered a baby. Our ED physician cond... Read more
Question: A woman arrives at the ED having already delivered a baby. Our ED physician cond... Read more
You Be the Coder ~ Sequencing ICD-9 Codes
Question: When the ED physician treats multiple fractures, which diagnosis code should I l... Read more
Question: When the ED physician treats multiple fractures, which diagnosis code should I l... Read more
Figure Location, Depth of Penetration Into Eye FBR Coding
CPT sports codes for both conjunctival and corneal foreign-body removalsIf a patient repor... Read more
CPT sports codes for both conjunctival and corneal foreign-body removalsIf a patient repor... Read more
Keep an Eye Out for Separate E/M Services With Eye FBRs
Checking for head trauma is often a sign of separate E/MEach time the ED physician perform... Read more
Checking for head trauma is often a sign of separate E/MEach time the ED physician perform... Read more
Check Physician Notes Before Appealing Critical Care Claims
If you don't meet these documentation requirements, you will not win appeal When you rece... Read more
If you don't meet these documentation requirements, you will not win appeal When you rece... Read more
Follow 3 Principles for Top-Notch Laceration Repair Coding
Remember to report the length of the repairProperly reporting laceration repair encounters... Read more
Remember to report the length of the repairProperly reporting laceration repair encounters... Read more
READER QUESTIONS:
Check for Fluoroscopy With Chest Tube Procedures
Question: One of our ED physicians performed a chest tube insertion for a patient she diag... Read more
Check for Fluoroscopy With Chest Tube Procedures
Question: One of our ED physicians performed a chest tube insertion for a patient she diag... Read more
READER QUESTIONS:
Teaching Physician Required for Resident's E/M
Question: A physician in our ED recently started supervising a resident's services. How ca... Read more
Teaching Physician Required for Resident's E/M
Question: A physician in our ED recently started supervising a resident's services. How ca... Read more
READER QUESTIONS:
Nail Down Modifier 51 Exemptions
Question: I heard a colleague discussing CPT codes that are exempt from modifier 51 (Multi... Read more
Nail Down Modifier 51 Exemptions
Question: I heard a colleague discussing CPT codes that are exempt from modifier 51 (Multi... Read more
READER QUESTIONS:
Varicose Vein Treatment a Simple Repair?
Question: A patient with varicose veins in her left lower leg reports to the ED complainin... Read more
Varicose Vein Treatment a Simple Repair?
Question: A patient with varicose veins in her left lower leg reports to the ED complainin... Read more
READER QUESTIONS:
Dated Entries Key Successful Multiple-Day Observation Claims
Question: I am having trouble with a claim for multiple-day observation care. The ED physi... Read more
Dated Entries Key Successful Multiple-Day Observation Claims
Question: I am having trouble with a claim for multiple-day observation care. The ED physi... Read more
You Be the Coder:
Closed Arm Fractures
Question: A 12-year-old boy reports to the ED with his mother complaining of pain -up and ... Read more
Closed Arm Fractures
Question: A 12-year-old boy reports to the ED with his mother complaining of pain -up and ... Read more
Case Study:
Count On More Than Depth to Justify Intermediate Wound Repair
Also, remember to check notes for E/M service If a patient reports for laceration repair ... Read more
Count On More Than Depth to Justify Intermediate Wound Repair
Also, remember to check notes for E/M service If a patient reports for laceration repair ... Read more
Special Report:
Find Out if Your E/M Levels Can Withstand Heightened Scrutiny
Payers will give high-level E/Ms a closer look, experts say There is some potentially bad... Read more
Find Out if Your E/M Levels Can Withstand Heightened Scrutiny
Payers will give high-level E/Ms a closer look, experts say There is some potentially bad... Read more
Add Laceration Repair Lengths That Have Common Attributes
Get up to speed on laceration coding, because most EDs perform many repairs When a patien... Read more
Get up to speed on laceration coding, because most EDs perform many repairs When a patien... Read more
Reader Questions:
Be Consistent to File Strong Strapping Claims
Question: What is the difference between splinting and strapping, and how can we determine... Read more
Be Consistent to File Strong Strapping Claims
Question: What is the difference between splinting and strapping, and how can we determine... Read more
Reader Questions:
Include Detailed History for Observation Codes
Question: We just received a denial for a moderate- level observation care service (99235)... Read more
Include Detailed History for Observation Codes
Question: We just received a denial for a moderate- level observation care service (99235)... Read more
Reader Questions:
Use Reduced-Services Modifier for Failed Procedures
Question: A patient came into the ED with a medial dislocation of his elbow. The physician... Read more
Use Reduced-Services Modifier for Failed Procedures
Question: A patient came into the ED with a medial dislocation of his elbow. The physician... Read more
Reader Questions:
Child-Abuse Victims Often Have Unexplained Injuries
Question: I am a new coder at a local ED. Recently, a child and her father showed up. The ... Read more
Child-Abuse Victims Often Have Unexplained Injuries
Question: I am a new coder at a local ED. Recently, a child and her father showed up. The ... Read more
Reader Questions:
Get Elemental When Determining HPI
Question: An internal chart audit of our evaluation and management claims showed that our ... Read more
Get Elemental When Determining HPI
Question: An internal chart audit of our evaluation and management claims showed that our ... Read more
Reader Questions:
After-Hours Code Not Always Reimbursed
Question: Is there any way to account for after-hours services that an ED physician provid... Read more
After-Hours Code Not Always Reimbursed
Question: Is there any way to account for after-hours services that an ED physician provid... Read more
You Be the Coder:
File Without a Chronic Condition Dx?
Question: A patient with Group A hyperlipidemia (hypercholesterolemia) arrives at the ED w... Read more
File Without a Chronic Condition Dx?
Question: A patient with Group A hyperlipidemia (hypercholesterolemia) arrives at the ED w... Read more
Check Notes for Incision on Soft-Tissue FBR
If the removal does not meet procedure-code standards, report an E/M Emergency departmen... Read more
If the removal does not meet procedure-code standards, report an E/M Emergency departmen... Read more
Flip to This Code Set for FBRs Of the Foot
You will need to report the same codes regardless of an incision If an ED patient has a f... Read more
You will need to report the same codes regardless of an incision If an ED patient has a f... Read more
News You Can Use:
New ICD-9 to Include Wound Dressing V Codes
Remember: You need to incorporate these codes without a grace period Emergency department... Read more
New ICD-9 to Include Wound Dressing V Codes
Remember: You need to incorporate these codes without a grace period Emergency department... Read more
Prove Separate HEM For Proper Modifier 25 Claims
Certain E/M services are built in to procedure codes When a patient reports to the ED for... Read more
Certain E/M services are built in to procedure codes When a patient reports to the ED for... Read more
Use Transmittal to Check On Modifier 25 Changes
CMS says procedure, E/M can still share Dx When an ED physician treats a patient and prov... Read more
CMS says procedure, E/M can still share Dx When an ED physician treats a patient and prov... Read more
Reader Questions:
Reporting Multiple Injections for Seizure Patients
Question: EMS brought a patient with a known seizure disorder to the ED. The patient was p... Read more
Reporting Multiple Injections for Seizure Patients
Question: EMS brought a patient with a known seizure disorder to the ED. The patient was p... Read more
Reader Questions:
Latest NCCI Edits Affect New Nursing Codes
Question: I heard that the National Correct Coding Initiative released the newest version ... Read more
Latest NCCI Edits Affect New Nursing Codes
Question: I heard that the National Correct Coding Initiative released the newest version ... Read more
Reader Questions:
Beware Bundled Services on Critical Care Claims
Question: Our ED physician performed 64 minutes of critical care on a patient in cardiac a... Read more
Beware Bundled Services on Critical Care Claims
Question: Our ED physician performed 64 minutes of critical care on a patient in cardiac a... Read more
Reader Questions:
Remember the 'Digit Rule' for Asthma Diagnosis
Question: When reporting an asthma diagnosis, do I need a fifth digit?North Carolina Subsc... Read more
Remember the 'Digit Rule' for Asthma Diagnosis
Question: When reporting an asthma diagnosis, do I need a fifth digit?North Carolina Subsc... Read more
You Be the Coder:
Try Your Hand at This Clinical FBR Scenario
Question: A construction worker was handling old wood when a piece split and lodged in his... Read more
Try Your Hand at This Clinical FBR Scenario
Question: A construction worker was handling old wood when a piece split and lodged in his... Read more
Check G Tube Replacement Notes Before Choosing 43760
You need a different code for radiologic supervision If a patient's gastrostomy tube (G t... Read more
You need a different code for radiologic supervision If a patient's gastrostomy tube (G t... Read more
Base Your Subsequent Hospital Care Coding on Interval History
Rules for reporting these encounters differ from rules for other E/M services When th... Read more
Rules for reporting these encounters differ from rules for other E/M services When th... Read more
Use These Guidelines For Subsequent Care Services
- but ask payers before deciding on E/M level While there is no answer key for exac... Read more
- but ask payers before deciding on E/M level While there is no answer key for exac... Read more
Reader Questions:
V Codes Represent Patient's Long-Term Meds
Question: A patient reported to the ED and received a level-two evaluation and management ... Read more
V Codes Represent Patient's Long-Term Meds
Question: A patient reported to the ED and received a level-two evaluation and management ... Read more
Reader Questions:
Capture Complete Eyewash Service With E/M Code
Question: A patient who had a chemical splashed in her eye came to the emergency departmen... Read more
Capture Complete Eyewash Service With E/M Code
Question: A patient who had a chemical splashed in her eye came to the emergency departmen... Read more
Reader Questions:
Follow CMS 'Duress' Rule When Considering ABNs
Question: Are our ED physicians permitted to discuss advance beneficiary notices (ABNs) wi... Read more
Follow CMS 'Duress' Rule When Considering ABNs
Question: Are our ED physicians permitted to discuss advance beneficiary notices (ABNs) wi... Read more
Reader Questions:
Fecal Disimpaction Code Harms ED Claims
" Question: We are wondering how to code for a fecal disimpaction encounter. The ... Read more
Fecal Disimpaction Code Harms ED Claims
" Question: We are wondering how to code for a fecal disimpaction encounter. The ... Read more
Reader Questions:
Make Bronchitis Dx as Specific as Possible
Question: When I use 491.9 to describe a patient's bronchitis, payers often deny the code ... Read more
Make Bronchitis Dx as Specific as Possible
Question: When I use 491.9 to describe a patient's bronchitis, payers often deny the code ... Read more
Reader Questions:
When Baby Spits Up, Foreign-Body Diagnosis Not Always Accurate
Question: A mother presents with her newborn baby and says she is concerned about the baby... Read more
When Baby Spits Up, Foreign-Body Diagnosis Not Always Accurate
Question: A mother presents with her newborn baby and says she is concerned about the baby... Read more
You Be the Coder:
Discharging Patients After Overnight Stays
Question: A patient presents in the ED with unspecified chest pain. After a complete worku... Read more
Discharging Patients After Overnight Stays
Question: A patient presents in the ED with unspecified chest pain. After a complete worku... Read more
Burn Treatment:
Size, Location of Burn Drive Choice of Revised CPT Codes
Also, carriers like 2 diagnosis codes on all 16000 claims When a patient reports to t... Read more
Size, Location of Burn Drive Choice of Revised CPT Codes
Also, carriers like 2 diagnosis codes on all 16000 claims When a patient reports to t... Read more
Burn Treatment:
Heed 'Rule of Nines' When Calculating Burn Area
948.xx series challenges coders to compile TBSABefore you can select the appropriate burn ... Read more
Heed 'Rule of Nines' When Calculating Burn Area
948.xx series challenges coders to compile TBSABefore you can select the appropriate burn ... Read more
2006 Update:
Successful Diabetes Dx Coding Starts With 250.xx Set
ICD-9 revamps the fifth digit for diabetes mellitusIf you haven't gotten up to speed on th... Read more
Successful Diabetes Dx Coding Starts With 250.xx Set
ICD-9 revamps the fifth digit for diabetes mellitusIf you haven't gotten up to speed on th... Read more
READER QUESTIONS:
Marshfield Auditor's Sheet Not a CMS Tool
Question: What exactly is the Marshfield Clinic Auditor's worksheet? I have heard that it ... Read more
Marshfield Auditor's Sheet Not a CMS Tool
Question: What exactly is the Marshfield Clinic Auditor's worksheet? I have heard that it ... Read more
READER QUESTIONS:
Choose Most Specific Dx Possible on ECG Claims
Question: What codes should we use to report diagnostic electrocardiography (ECG) tests? A... Read more
Choose Most Specific Dx Possible on ECG Claims
Question: What codes should we use to report diagnostic electrocardiography (ECG) tests? A... Read more
READER QUESTIONS:
Private Payers, Medicare Differ on Dermabond Coding Rules
Question: An elderly patient presented to the ED with a 1.4-centimeter skin tear on his le... Read more
Private Payers, Medicare Differ on Dermabond Coding Rules
Question: An elderly patient presented to the ED with a 1.4-centimeter skin tear on his le... Read more
READER QUESTIONS:
Separate E/M Possible When Fracture Patient Has Another Problem
Question: If a patient reports to the ED for treatment of a broken bone, can I ever report... Read more
Separate E/M Possible When Fracture Patient Has Another Problem
Question: If a patient reports to the ED for treatment of a broken bone, can I ever report... Read more
You Be the Coder:
Get Specific With New Decubitus Ulcer Diagnoses
Question: A patient with decubitus ulcers on his right hip and buttock presents to the ED.... Read more
Get Specific With New Decubitus Ulcer Diagnoses
Question: A patient with decubitus ulcers on his right hip and buttock presents to the ED.... Read more
CPT 2006 Update:
Don't Miss These Crucial Injection, Infusion Coding Changes
Also, use new codes for hydration this yearIf you-re reporting injections and infusions th... Read more
Don't Miss These Crucial Injection, Infusion Coding Changes
Also, use new codes for hydration this yearIf you-re reporting injections and infusions th... Read more
Here's How to Capture E/M With Injections, Infusions
Typically, these encounters involve moderate MDMWhen the ED physician performs an injectio... Read more
Typically, these encounters involve moderate MDMWhen the ED physician performs an injectio... Read more
Improve Your Accuracy:
Bill Separately for Critical Care During Postoperative Period
The keys are diagnosis codes, time-based documentationWhen a patient becomes critically il... Read more
Bill Separately for Critical Care During Postoperative Period
The keys are diagnosis codes, time-based documentationWhen a patient becomes critically il... Read more
Moderate Sedation:
Report the New Codes--But Don't Hold Out for Pay
Medicare is watching your usage of these codesMedicare never paid for conscious sedation i... Read more
Report the New Codes--But Don't Hold Out for Pay
Medicare is watching your usage of these codesMedicare never paid for conscious sedation i... Read more
READER QUESTIONS:
Slow Down When Coding FAST Exams
Question: What are FAST exams, and how should I report one in the ED?Massachusetts S... Read more
Slow Down When Coding FAST Exams
Question: What are FAST exams, and how should I report one in the ED?Massachusetts S... Read more
READER QUESTIONS:
New Diagnosis Codes Split CKD 5 Ways
Question: I heard that there have been some ICD-9 coding changes for chronic kidney ... Read more
New Diagnosis Codes Split CKD 5 Ways
Question: I heard that there have been some ICD-9 coding changes for chronic kidney ... Read more
READER QUESTIONS:
Opt for 1 Code With Drainage Versus Excision
Question: A patient has an existing diagnosis of benign inflamed seborrheic keratosis in h... Read more
Opt for 1 Code With Drainage Versus Excision
Question: A patient has an existing diagnosis of benign inflamed seborrheic keratosis in h... Read more
READER QUESTIONS:
Check Documentation to Discover MDM Level
Question: A patient with frequent classical migraines presents to the ED for an exam. The ... Read more
Check Documentation to Discover MDM Level
Question: A patient with frequent classical migraines presents to the ED for an exam. The ... Read more
You Be the Coder:
Choosing the Right Wound Care Code
Question: Our ED group also operates a wound care clinic. I have a procedure note that sta... Read more
Choosing the Right Wound Care Code
Question: Our ED group also operates a wound care clinic. I have a procedure note that sta... Read more
3 Tips Help Ensure Foolproof Coding For Chronic Conditions
Hint: Why you should ax conditions irrelivant to treatmentDiabetes, asthma and migra... Read more
Hint: Why you should ax conditions irrelivant to treatmentDiabetes, asthma and migra... Read more
E/M Guideline Answers You Need to Know
Here's how to make smart choices about HPI, MDMDiagnostic tests, HPI elements, and radiolo... Read more
Here's how to make smart choices about HPI, MDMDiagnostic tests, HPI elements, and radiolo... Read more
Polish Your Modifier 59 Use And Master NCCI Edits
Crack down on incorrect unbundlingThe National Correct Coding Initiative (NCCI) has been a... Read more
Crack down on incorrect unbundlingThe National Correct Coding Initiative (NCCI) has been a... Read more
READER QUESTIONS:
Determine Payer for Dermabond Repair
Question: If the physician closes a wound using Dermabond, should we report a simple lac... Read more
Determine Payer for Dermabond Repair
Question: If the physician closes a wound using Dermabond, should we report a simple lac... Read more
READER QUESTIONS:
Ensure 3 Elements for Sedation Documentation
Question: Is it mandatory for the physician to be at the patient's bedside the entire time... Read more
Ensure 3 Elements for Sedation Documentation
Question: Is it mandatory for the physician to be at the patient's bedside the entire time... Read more
READER QUESTIONS:
Divvy Up Time for 99291 and 99292
Question: The ED physician spent a lot of time and energy treating a patient, whom he even... Read more
Divvy Up Time for 99291 and 99292
Question: The ED physician spent a lot of time and energy treating a patient, whom he even... Read more
READER QUESTIONS:
Don't Count on Drug for Sedation Level
Question: What are some examples of drugs that commonly fall within the categories of -lig... Read more
Don't Count on Drug for Sedation Level
Question: What are some examples of drugs that commonly fall within the categories of -lig... Read more
READER QUESTIONS:
Use Reason When Returning Charts
Question: What is the legality of returning charts to the physician to amend the documenta... Read more
Use Reason When Returning Charts
Question: What is the legality of returning charts to the physician to amend the documenta... Read more
READER QUESTIONS:
Investigate POS for 99291
Question: A patient presented to the ED as critical care, and the physician subsequently a... Read more
Investigate POS for 99291
Question: A patient presented to the ED as critical care, and the physician subsequently a... Read more
READER QUESTIONS:
Check Time of Status Change for Observation
Question: How should I report a patient's 23-hour stay in observation? Virginia Subscriber... Read more
Check Time of Status Change for Observation
Question: How should I report a patient's 23-hour stay in observation? Virginia Subscriber... Read more
You Be the Coder:
Account for Specific Case With Hydration Code
Question: When a patient receives multiple injections and infusions, how do I determine wh... Read more
Account for Specific Case With Hydration Code
Question: When a patient receives multiple injections and infusions, how do I determine wh... Read more
5 Foolproof ICD-9 Tips to Start the Year Off Right
Don't let signs and symptoms throw you for a loopYou-re never surprised when the doctor li... Read more
Don't let signs and symptoms throw you for a loopYou-re never surprised when the doctor li... Read more
Top-7 Ways to Smooth Out Wrinkles in Your Observation Coding
Avoid these common pitfalls to drop problem-free 99218 claimsEven though you know the gene... Read more
Avoid these common pitfalls to drop problem-free 99218 claimsEven though you know the gene... Read more
FBR Answers You Need to Know
Expert Q & A to satisfy your curiousity--and your bottom lineDon't lose your anatomica... Read more
Expert Q & A to satisfy your curiousity--and your bottom lineDon't lose your anatomica... Read more
READER QUESTIONS:
No Time Frame for Late Effect Codes
Question: A patient fell five weeks ago, and now presents in the ED complaining of chest p... Read more
No Time Frame for Late Effect Codes
Question: A patient fell five weeks ago, and now presents in the ED complaining of chest p... Read more
READER QUESTIONS:
Steer Clear of Sketchy Rx
Question: A private physician calls the ED physician to tell her a patient is coming in wh... Read more
Steer Clear of Sketchy Rx
Question: A private physician calls the ED physician to tell her a patient is coming in wh... Read more
READER QUESTIONS:
Leave Dx to Physician With EKG
Question: If the physician hasn't indicated the EKG results in his final diagnosis, should... Read more
Leave Dx to Physician With EKG
Question: If the physician hasn't indicated the EKG results in his final diagnosis, should... Read more
READER QUESTIONS:
Talk to Payers About 90760
Question: Are new infusion codes 90760 and 90761 appropriate for use with ED physician bil... Read more
Talk to Payers About 90760
Question: Are new infusion codes 90760 and 90761 appropriate for use with ED physician bil... Read more
READER QUESTIONS:
Evaluate Context for Modifier 25
Question: If a patient presents in the ED with a minor laceration and no other injuries, b... Read more
Evaluate Context for Modifier 25
Question: If a patient presents in the ED with a minor laceration and no other injuries, b... Read more
READER QUESTIONS:
Ensure Personal Visit for HPI
Question: If a nurse documents an HPI in her notes and the ED physician documents that he ... Read more
Ensure Personal Visit for HPI
Question: If a nurse documents an HPI in her notes and the ED physician documents that he ... Read more
You Be the Coder:
Do I Need a Complete ROS for 99285?
Question: A patient presented in the ED with sudden onset of pain in the left side of his ... Read more
Do I Need a Complete ROS for 99285?
Question: A patient presented in the ED with sudden onset of pain in the left side of his ... Read more
Extinguish These 5 Critical Care Myths
And watch your reimbursement rise from the ashesIf your payment for critical care services... Read more
And watch your reimbursement rise from the ashesIf your payment for critical care services... Read more
Clip and Save:
Know What's Included in Critical Care
When you-re in doubt about whether to bill a procedure separately from 99291 and 99292, co... Read more
Know What's Included in Critical Care
When you-re in doubt about whether to bill a procedure separately from 99291 and 99292, co... Read more
Milk HPI Info for More Than 1 E/M Category
Here's how to make economic choices with E/M documentation Elements from the physician's ... Read more
Here's how to make economic choices with E/M documentation Elements from the physician's ... Read more
Correction
In the article -Don't Skimp on Multiple-Day Observation Care- that appeared in the August ... Read more
In the article -Don't Skimp on Multiple-Day Observation Care- that appeared in the August ... Read more
Reader Questions:
Ask Payers for Vital Signs Number
Question: Our practice is debating how many vital signs we need documented to count as a -... Read more
Ask Payers for Vital Signs Number
Question: Our practice is debating how many vital signs we need documented to count as a -... Read more
Reader Questions:
Wait for Diagnosis to Report Code
Question: Can we code a condition or disease if the physician notes in the documentation t... Read more
Wait for Diagnosis to Report Code
Question: Can we code a condition or disease if the physician notes in the documentation t... Read more
Reader Questions:
Fight for 93010 Claims
Question: Should we charge for contemporaneous EKG readings? If so, what CPT code should w... Read more
Fight for 93010 Claims
Question: Should we charge for contemporaneous EKG readings? If so, what CPT code should w... Read more
Reader Questions:
Encourage 'Negative' for ROS and PFSH
Question: I know that the provider can state -all other systems reviewed and negative or a... Read more
Encourage 'Negative' for ROS and PFSH
Question: I know that the provider can state -all other systems reviewed and negative or a... Read more
Reader Questions:
Separate Ankle From Foot
Question: I received documentation stating:-Patient presented with small needle embedded i... Read more
Separate Ankle From Foot
Question: I received documentation stating:-Patient presented with small needle embedded i... Read more
Reader Questions:
Consider Certainty for Fracture Dx
Question: When a patient presents with a fracture, we usually get an x-ray confirmation be... Read more
Consider Certainty for Fracture Dx
Question: When a patient presents with a fracture, we usually get an x-ray confirmation be... Read more
Reader Questions:
Opt for Dx Over Signs and Symptoms
Question: Can I report signs and symptoms as diagnoses?Florida Subscriber Answer: Multipl... Read more
Opt for Dx Over Signs and Symptoms
Question: Can I report signs and symptoms as diagnoses?Florida Subscriber Answer: Multipl... Read more
Reader Questions:
Go Straight to Source for Pain Code
Question: A patient came in to the ED with a chief complaint of -dental wire poking into h... Read more
Go Straight to Source for Pain Code
Question: A patient came in to the ED with a chief complaint of -dental wire poking into h... Read more
Reader Questions:
Avoid 63688 for Neurostimulator Traction
Question: A physician at a pain clinic implanted a spinal cord neurostimulator in a patien... Read more
Avoid 63688 for Neurostimulator Traction
Question: A physician at a pain clinic implanted a spinal cord neurostimulator in a patien... Read more
Reader Questions:
Look at MDM for 99282-99283 Split
Question: We regularly see these two diagnoses:- dental pain, abscess, no tests, discharge... Read more
Look at MDM for 99282-99283 Split
Question: We regularly see these two diagnoses:- dental pain, abscess, no tests, discharge... Read more
You Be the Coder:
Choose E/M for Fecal Disimpaction
Question: The ED physician performed a manual fecal disimpaction after administering IV ... Read more
Choose E/M for Fecal Disimpaction
Question: The ED physician performed a manual fecal disimpaction after administering IV ... Read more