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Internal Medicine Coding Alert

Do You Freeze Up When Coding Wart Removals? Not Anymore
From multiple procedures to modifiers - here are the solutions you're looking for The nex... Read more
What You Need to Know About Coding FOBT Screenings
Don't overlook lab methods and patient's age  You can ensure your internist gets... Read more
Clip-and-Save Quick Tips:
Understand When Diagnostic FOBT Codes Apply
You've got more ICD-9 choices than you may think Now that you've got the rules for reporti... Read more
Don't Fall for These Migraine Diagnosis Coding Pitfalls
Report specific ICD-9 codes or get ready for denials Because the ICD-9 manual provides sev... Read more
Condition of the Month:
Migraines --2 Easy Steps Improve Your E/M Documentation and Coding
 Use these tips to cure coding headaches If your internist treats established patient... Read more
Reader Questions:
Make the Right Flu Code Choice
Question: What are the differences between 87804 and other influenza codes 90471/G0008?Geo... Read more
Reader Questions:
A Late Finish Doesn't = After-Hours Codes
Question: In what instances should we bill after-hours codes 99050, 99052 and 99054? Shoul... Read more
Reader Questions:
Separate Internist's Critical Treatments
Question: The internist saw a patient for subsequent hospital care, and then later in the ... Read more
Reader Questions:
Don't Let Venom Injections Poison Reimbursement
Question: We are having problems getting reimbursed for allergy injections for stinging in... Read more
Reader Questions:
Elements Drive Your History Documentation
Question: The chart that physicians use to select the level of history includes identifier... Read more
Reader Questions:
Modifier -52 Covers Extra Infusion Time
Question: What guidelines govern reporting a patient who receives less than two full hours... Read more
You Be the Coder:
Are You Reporting 99281-99285?
Question: Our internists often treat patients in the emergency department (ED). Can they s... Read more
CPT 2005 Update:
Get Geared Up for 2 New Wound-Care Codes
Key tip: You now base coding choices on wound size Next year, when the internist or nonphy... Read more
CPT 2005 Update:
Reporting VAD: Say Goodbye To Unlisted-Procedure Codes
And say hello to more specific coding and improved reimbursement You can stop frettin... Read more
CPT 2005 Update:
Having Trouble Deciding Between 94060 and 94070?
Revealed: New descriptors clarify your internist's evaluations When your internist admini... Read more
NCCI News:
Why Observation and Consult Codes Don't Mix
You can't count on modifiers to smooth things over, either The jig is up for IM practices ... Read more
3 Scenarios Improve Your Nursing-Home Coding
Knowing the documentation requirements makes all the difference From admissions and re-eva... Read more
Reader Question:
Don't Get Carried Away With Flu-Shot Visits
Question: We set up certain days and times to give flu shots to our patients. Prior to pro... Read more
Reader Question:
Ask Your Physician for More Hepatitis Info
Question: If a patient once had hepatitis but is now free of the disease, should we still ... Read more
Reader Question:
Hold Off on Meet-and-Greet Charges
Question: We want to report an E/M code for our doctor's "meet and greet" sessions with ne... Read more
Reader Question:
ECG Interpretation Requires 93010
Question: How can I get reimbursed for the internist's interpretation of an ECG for an inp... Read more
Reader Question:
Keep Your Primary and Secondary Rules Straight
Question: My internist often writes "hypertension" as a diagnosis. It is important for him... Read more
Reader Question:
Play by the Rules When Coding Burns
Question: Recently I read an article that instructed coders to use the "Rule of Nines" whe... Read more
You Be the Coder:
Teaching-Physician Setting
Question: Do teaching-physician documentation rules cover medical students working in an i... Read more
Nebulizer Services:
Don't Let the Differences Between Treatment and Training Trip You Up
Tackle common coding problems with our case studies Does your internist treat respiratory ... Read more
Are You Ready for an Internal Chart Review? 4 Quick Tips
Why modifier -25 could be costing you deserved payment If your office has been receiving m... Read more
You Can Report CPO Services With Confidence - Here's How
Medicare and private payers require different codes If your internist isn't documenting hi... Read more
Here's Why the 5th Digit Isn't Always the Key to Accurate ICD-9 Coding
Get the expert tips you need to prevent denials If you are submitting CPT codes with three... Read more
You Be the Expert:
Has ICD-9 Coding Lost Its Grace?
Question: Has CMS ended the 90-day grace period for getting used to new ICD-9 codes? I've ... Read more
Reader Questions:
Time, Documentation Critical to 99291 Payment
Question: In the afternoon, our internist saw a patient for 30 minutes on the hospital flo... Read more
Reader Questions:
Modifier -25 Use Means Global Period
Question: Am I supposed to use modifier -25 when I bill an E/M service in addition to medi... Read more
Reader Questions:
Look for Diabetes Screening Coverage Next Year
Question: I've heard that Medicare will start covering diabetes screening tests soon, but ... Read more
Reader Questions; X-Ray Interpretation Only? Add -26
Question: How should we report a scenario in which the physician did not take x-rays but i... Read more
Reader Questions:
Breathe Easy When Coding Asthma Visits
Question: One of our asthma patients presented with a little chest tightness and required ... Read more
Reader Questions:
Charge for Bottles of Tylenol
Question: Is there a HCPCS code for the supply of Tylenol for a sick patient? Alabama Subs... Read more
Reader Questions:
Here's Why You May Not Need Modifier -51
Question: I noticed that CPT includes modifier -51 for "multiple procedures." I never appe... Read more
Reader Question:
ICD-9: You Should Claim Primary Reason as D1
Question: Should I first report the original diagnosis or the manifestation?North Carolina... Read more
You Be the Coder:
Which Conditions Get Priority?
Question: Our physicians are treating a patient's respiratory insufficiency. They think th... Read more
3 Injection-Coding Tips That All IM Coders Must Master
Know the difference between 90782 and 90471 - or face denialsInternists often give injecti... Read more
Condition of the Month:
Are You At Risk for Using Incorrect CVA Diagnosis Codes?
Why the rules change when you report a stroke's 'late effects'Heads up, coders: When you r... Read more
Here's How to Report 'Late Effects' Codes With Confidence
2 quick tips will keep 'complications' out of your coding Don't be fooled... Read more
Don't Let Initial Hospital Payment Slip Through Your Fingers
Get the lowdown on how to code same-day office visits and hospital admitsYour internist ad... Read more
READER QUESTION:
Look to 99221 for Glucometer Training
Question: Our nurse often teaches patients how to use a glucometer. Which CPT code shoul... Read more
READER QUESTION:
Home Services or Rest Home Codes?
Question: Once a month, our physician visits home-bound elderly patients who live in a ret... Read more
READER QUESTION:
Report 36415 for Cholesterol Blood Draws
Question: We perform regular cholesterol checks on a few of our hyperlipidemia patients. W... Read more
READER QUESTION:
Use V15.81 for Noncompliance
Question: We performed a nine-panel drug screen on a patient because the internist believe... Read more
READER QUESTION:
Physician Who Examines Patient Bills 99235
Question: Dr. Smith was on-call and admitted a patient to the hospital. On the same day, D... Read more
READER QUESTION:
Include Wound VAC Treatment in E/M
Question: Which code should we report if the physician uses a vacuum device to clean out a... Read more
READER QUESTION:
Carriers Reimburse Only Patients for A4627
Question: Can we get reimbursed for drugs (e.g., J7619, Albuterol, unit dose) and durable ... Read more
You Be the Coder:
Fatigue or Anemia?
Question: A patient complained of fatigue and shortness of breath. We sent blood samples t... Read more
ICD-9 Update:
Why Location Now Matters to Your Decubitus Ulcer Coding
You'll also have more specific DVT, protein codes to use Beginning Oct. 1, your internist ... Read more
Clip-and-Save Checklist:
Here Are 9 New Ulcer Codes You Should Know
To ensure that you don't fall behind with the latest decubitus ulcer code changes, clip an... Read more
ICD-9 Update:
Get Ready for 2005's Allergic Rhinitis, Bronchitis Dx Codes
You can finally code for animal hair, dander If you want to avoid denials this fall when y... Read more
Will NCCI 10.2 Reduce Your G0328 Reimbursement?
Why you should stop reporting screening and diagnostic tests together You can no longer re... Read more
3 Nurse-Visit Coding Tips You Can't Do Without
Solid documentation could bring you $22 a pop for 99211 Although you may think reporti... Read more
Reader Question:
Don't Confuse Vaccine, Therapeutic Injections
Question: I'm having trouble with my Medicare carrier denying our tetanus injections usin... Read more
Reader Question:
No Global Days Mean Few E/M Choices
Question: How should we report 99233 and 49080 to Medicare on the same day? I don't belie... Read more
Reader Question:
Here's How to Report Hospice Modifiers
Question: What are the differences between modifiers -GV and -GW? Louisiana Subscriber An... Read more
Reader Question:
Avoid -Q5 and -Q6 When Using Group PINs
Question: We have two internists in our multi-specialty group of 65 doctors. When one of ... Read more
Reader Question:
Who Performed the CPAP Check? It Matters
Question: When a patient comes to the office and the respiratory therapist completes a pr... Read more
Reader Question:
Get to Know Medicare's New CBC Codes
Question: An office staff member draws a Medicare patient's blood and performs a complete... Read more
Reader Question:
Check Report Before Selecting Benign or Malignant
Question: When coding removal of a skin lesion, how do I know whether I should select the... Read more
You Be the Coder:
Colonoscopy Diagnoses
Question: The patient presented with rectal bleeding (569.3, Hemorrhage of rectum and anu... Read more
Diabetes Coding Made Easy:
Get the Lowdown on CMS' 5th-Digit Revisions
Why insulin dependence becomes less important to coding in 2004-2005 Starting Oct. 1, your... Read more
3 Easy Steps Lead to 93784-93790 Reimbursement
Why assigning 796.2 is key for Medicare claims You can get paid for the internist'... Read more
Look for New V Code to Track Insulin Use:
Look for New V Code to Track Insulin Use:
Deletions don't mean you can forget about insulin dependence Although internal medicine pr... Read more
Reporting 99231-99233:
Don't Risk Losing $2,400 a Year
Expert answers can strengthen your documentation Are you worried that your internist is do... Read more
Reporting Related Codes? Use Modifiers -59, -51 to Keep Claims Clear
Modifier -59 is for procedures you would not normally report together When a patient r... Read more
You Be the Expert:
Same-Day Spirometry/Bronchospasm Tests
Question: Our internist conducted a spirometry and bronchospasm test on a patient on the ... Read more
Reader Question:
Dig Out Ring-Removal Payment With 10121
Question: How should we code the removal of a belly-button ring that's infected and embed... Read more
Reader Question:
Take Dermoid-Cyst Removal at Face Value
Question: The internist assigned 11442 for the excision of a dermoid cyst on a patient's ... Read more
Reader Question:
List 92950 x 2 for Double Your CPR Charge
Question: One of our internists spent critical-care time with an inpatient on two separat... Read more
Reader Question:
1 Muscle Injection Means 1 Code
Question: Our internist has begun performing pain management. Do you have any tips on rep... Read more
Reader Question:
Don't Let Bee Stings Complicate Your E/M Coding
Question: A patient presented to our office with complications from a bee sting. Our inte... Read more
Reader Question:
Why You Should Try 401.1 Instead of 401.0
Question: When should I use a malignant hypertension diagnosis? For example, if a patient... Read more
You Be the Coder:
2 Internists, 2 Days of Observation
Question: I work for a group practice with three internists. Late one night, Internist A ... Read more
Real-Life Solutions:
Here's How to Simplify Your Diabetes Coding
Hint: The fourth digit is key to payment To submit solid diabetes claims, you should know ... Read more
Get a Grip on Coding In-Office Coumadin Monitoring
Do you know the different payer requirements for accurate reporting? You should understand... Read more
Want to Earn an Extra $30 in Deserved E/M Payments?
Why you should value your internist's medical decision-making When internal medicine coder... Read more
Reader Question:
2 HH-Services Criteria Your Carrier May Impose
Question: What type of documentation does Medicare require from a physician in addition to... Read more
Reader Question:
Append Modifier -91 for Multiple Glucose Tests
Question: When we billed three blood glucose tests (82947, Glucose; quantitative, blood [e... Read more
Reader Question:
Expect Denials? Use Modifiers -GY and -GZ
Question: What are the -GY and -GZ modifiers, and how should I use them?Oregon Subscriber ... Read more
Reader Question:
2 Days of Critical Care Require 2 Codes
Question: The internist began to provide critical care at 11 p.m., and the service continu... Read more
You Be The Coder:
Cut Through a Trio of Lesion-Excision Codes
Question: Our internist saw a patient with lesions on his face and cheek. He excised a 2.6... Read more
Want to Keep Your Cerumen Removal Coding Out of Trouble?
How your practice can make $48 a pop on 69210 Don't let confusion over coding guidelines ... Read more
6 Surefire Tips Get Your Cerumen Removal Claims Paid
Why you'll get denied if you report 69210 more than once per episode With numerous CPT and... Read more
Condition of the Month:
Acute Chest Syndrome: Bone Up on Initial Exam, Diagnosis Coding
Signs-and-symptoms coding is key to solid claims Now that sickle-cell disease patients are... Read more
Here's How to Earn Ironclad NPP Reimbursement
You can bring in an extra $35 for each 99202 claim Knowing whether to bill under the nonph... Read more
Reader Question:
Modifier -25 Is Not Required for 99291 Payment
Question: When billing for critical care visits, should I use different diagnosis codes fo... Read more
Reader Question:
Give V Codes Priority When Coding Pre-Ops
Question: What is the correct sequencing for the diagnoses associated with a preoperative ... Read more
Reader Question:
Double-Check the NCCI Edits, Your Modifier Use
Question: When an insurance company denies a claim, stating a procedure is inclusive to th... Read more
Reader Question:
Prove You Submit Timely Claims - or Else
Question: Although no law requires us to send claims or appeal by certified mail, insuranc... Read more
Reader Question:
Give the Flu Shot, Skip the Extra Office Visit
Question: A new patient came to the office just for a flu shot. Because the patient is new... Read more
Reader Question:
Find Out What Separates 84153 From G0103
Question: Are 84153 and G0103 interchangeable for prostate specific antigen screening labs... Read more
Reader Question:
An E/M Code Works for Smoking Counseling
Question: Will Medicare insurers pay for smoking-cessation treatments? If so, what codes a... Read more
You Be the Coder:
Choose Between 99313 and 99302
Question: A physician performs a history, evaluation and medical decision-making on a nurs... Read more
Are You Losing $275 on Lesion Excision Coding? We Can Help
Why your 11400-11646 reporting may not measure upWhen your internist excises a lesion (114... Read more
Get the Pay You Deserve With Multiple Lesion Removals
Experts say you have to know which modifiers to useIf a patient presents to your internal ... Read more
Coding Quiz Bone Up on Your Lesion Excision Reporting
To ensure you know a lesion's pathology and size, test your coding knowledge of codes 1140... Read more
News You Can Use:
Say Goodbye to Your Coding Grace Periods
Tip: Review the Federal Register to update charge formsCMS has scrapped the 90-day grace p... Read more
Let the Right Answers Earn You $70 for Observation Care
Experts show when to choose 99218 instead of 99212Reporting established patient codes (992... Read more
Coding Quiz Answers
Answer 1. False. Before supplying a procedure or ICD-9 code for lesion excision, you shoul... Read more
Get ABNs, or Risk Picking Up Patient Tabs
Without ABNs, unpaid Medicare bills may become your problem If you aren't obtaining a... Read more
ABNs:
What to Change, What to Leave Alone
Got an itch to make a switch on an ABN? Proceed with caution When it comes to manipulation... Read more
You Be The Expert:
ABNs and Uncovered Medicare Services
Question: Our office obtains advance beneficiary notices each time there is some doubt abo... Read more
Reader Question:
Report 99341-99345 for Home Visits
Question: How should we report home visits?New Jersey Subscriber Answer: You should code h... Read more
Reader Question:
Preventive Medicine = Carve-Out Coding
Question: A Medicare patient had a preventive visit (99397), E/M (99213-25), vaginal cance... Read more
Reader Question:
Bill Established Patients Under Incident-To
Question: Do you have any tips for reporting a non-physician practitioner's service to Med... Read more
Reader Question:
Patient Presence Means E/M Payment
Question: The internist spent more than an hour with a family discussing an elderly patien... Read more
Reader Question:
Use 99385 for Sports Physicals
Question: Recently our internist performed a sports physical for an established patient&... Read more
Reader Question:
Get Specific With E Codes
Question: When should we use E codes? Do they help us receive reimbursement?Arizona Subscr... Read more
Reader Question:
No More Starred Procedures Means More Modifiers
Question: What's the practical significance of losing the starred designation in CPT 2004?... Read more
Reader Question:
Medicare Says 11719 Is Routine
Question: A Medicare patient presented with a painful ingrown toenail. The internist trimm... Read more
Reader Question:
Follow the CMS Definition of 'Deliver'
Question: Since the purpose of an ABN is to inform the patient about a service, our office... Read more
You Be The Coder:
Concurrent Care With Pulmonologist
Question: In our multi-specialty group, an internist and pulmonologist wanted to bill for ... Read more
Want to Make an Extra $32 Each Time You Report 90784? Experts Show You How
Why E/M bundles could cause denialsIf you want to get the most out of recent increases in ... Read more
Get $90 for Each Therapeutic Infusion Service
Supervision is key to avoiding denialsTo get your internist paid for therapeutic infusion ... Read more
3 Tips Improve Your Respiratory Diagnosis Coding
Ensure payment with these ICD-9 coding strategies Are you up to speed on 2004's new and re... Read more
Quick Tips Revive Your Critical Care Claims
We'll show you how to capture $250 with 99291Do you want to sort through the confusion tha... Read more
Reader Question:
Get Paid for Telehealth Consultations
Questions: We heard that CMS introduced a new code for physician-to-patient Internet consu... Read more
Reader Question:
Report S Codes to Private Insurers
Question: What are S codes and when should we use them?Arkansas Subscriber Answer: HCPCS 2... Read more
Reader Question:
Relieve Stress With 94620
Question: Which CPT codes should I use for a cardiac stress test and a pulmonary stress te... Read more
Reader Question:
Ask Private Payers for a -59 Alternative
Question: One of our private payers uses the National Correct Coding Initiative (NCCI) edi... Read more
Reader Question:
Charge Patients for 99080 Claims
Question: I have tried using special reports code 99080 for a Regence Blue Shield report a... Read more
Reader Question:
Know How to Add E/M Points
Question: If the internist orders an x-ray and provides personal, independent visualizatio... Read more
You Be The Coder - Determine Type of Diabetes
Question: When I'm choosing the "type" of diabetes, at what age is the patient considered ... Read more
Tired of Payers Denying Your Burn Treatment Claims? We Can Help
Experts show you how to improve reimbursement with 16000 When internists serve as primary-... Read more
What Is the 'Rule of Nines'?
Learn how CPT's burn rule can get you paid Don't let lackluster ICD9 Coding ... Read more
4 Steps Reduce Denials for Teaching Physician Services
Use these techniques to clarify confusing Medicare guidelinesYou can ensure that your inte... Read more
NCCI 10.0 Bundles Meningococcal Vaccines
Learn how new bundles affect reimbursement Have you been billing the meningococcal polysac... Read more
Correction:
Use 780.5x for Bad Nighttime Habits
In the December 2003 Internal Medicine Coding Alert, the reader question "Use 780.5x for B... Read more
Reader Question:
Use 87086 and 87088 for Urine Culture
Question: The internist obtained a Medicare patient's urine culture for suspected urinary ... Read more
Reader Question:
'Fat Pad Biopsy' Code Depends on Method
Question: Our internist wrote in the documentation that he performed a "fat pad biopsy." I... Read more
Reader Question:
Try FluMist Code With Private Payers
Question: How should we report the new FluMist vaccine? Do payers place restrictions on it... Read more
Reader Question:
Avoid Assigning Primary E Codes
Question: When should we report an E code as the primary diagnosis code?South Dakota Subsc... Read more
You Be the Coder:
Administration of Two Vaccines
Question: How should I report the administration of both influenza and pneumoccocal vaccin... Read more
CPT 2004 Update:
Report Multiple Vaccines With 90698 and 90715
3 new codes simplify your vaccine coding CPT 2004 introduces 90698 and 90715 to reflect a ... Read more
CPT 2004 Update:
New Injection Descriptors Make Your Coding Easier
Although CPT revised injection codes 20550-20552 to clarify injection site and physician a... Read more
CPT 2004 Update:
Think You Can Bill 11100 with 11400? Think Again
Use 11100-11101 for specimens You can avoid denials the next time you report the internist... Read more
CPT 2004 Update:
CPT Gives Starred Procedures An Overhaul
After Jan. 1, 2004, if you report your internist's incision, excision and repair services ... Read more
CPT 2004 Update:
Ensure Payment With Revised Venipuncture Code
Use 36410 for physician's services If you want to get your internal medicine practice paid... Read more
3 Strategies Improve Your ECG Reporting
Tip #1: Don't attach modifiers to 93000 When you code electrocardiogram (ECG) services, kn... Read more
Restructure Appeals With These 6 Steps
Get organized for easier, more productive appeals When your practice receives a denia... Read more
Read EOBs Before Responding to Denials
What 'noncovered service' really means to your office You can't streamline... Read more
You Be the Expert:
What Makes a Clean Claim?
Question: We are having problems in our internal medicine practice with the number of cl... Read more
Reader Question:
Complete Well-Woman Exam Requires G0101
Question: After our internist performed a Pap smear and pelvic exam on a Medicare patient,... Read more
Reader Question:
Choose Between Malignant and Benign
Question: Do you have any advice on how I should differentiate between benign or malignant... Read more
Reader Question:
Use 99231-99233 for Post-Op Consult
Question: A surgeon asked me to perform a pre-operative cardiac clearance consult. Followi... Read more
Reader Question:
Bill Workers' Compensation Visit
Question: Our internist saw a patient as a follow-up for a workers' compensation claim. Th... Read more
Reader Question:
Patient's Status Drives Component E/M Coding
Question: During an office visit, my internist performed an expanded problem-focused histo... Read more
Reader Question:
New Category Tracks Office Performance
Question: I heard that there's a new code section coming in CPT 2004. What is it and how w... Read more
Reader Question:
Bridge the Communication Gap ASAP
Question: The physicians and billers in my office don't practice open communication, and i... Read more
You Be the Coder:
Unlisted MIP and MEP Tests
Question: Recently Medicare denied my claim for 94799, which I used when my internist perf... Read more
Available Years:  2004  2003  2002  2001  2000  1999  1998