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Internal Medicine Coding Alert

Vaccines:
Delete 90658 for Medicare Patients in Favor of New Q Codes
2011 brings changes to flu vaccines and counseling codes. Your vaccine coding in 2011 ... Read more
E/M Coding:
99213 to 99214: 4 Tips Help You Look Toward Correct Service Levels
Teach your physicians to write iron-clad MDM notes.You can't get inside your internist's h... Read more
Clip & Save:
Which Elements Stack Up to Moderate Complexity? Find Out Here
Save this chart as your MDM breakdown guide.You can easily calculate the correct number of... Read more
Foot Coding:
735.0 or 727.1? Tackle This Condition Terminology for Foot Claims Success
Have these modifiers handy to distinguish areas of the feet and toes. Don't let an... Read more
Reader Questions:
Emergency Could Justify 99058
Question: A Medicare patient came on an emergent basis with several lacerations to the arm... Read more
Reader Questions:
Pinpoint Diagnosis for CPAP Machine
Question: We received charts for using a CPAP machine with diagnosis V46.8. Is that the be... Read more
Reader Questions:
Don't Mix Family History With Personal History
Question: My understanding has been that I cannot bill for "family history of" a condition... Read more
Reader Questions:
No CCI Bundle? Here's Where to Find Modifier Details
Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which c... Read more
You Be the Coder:
Choosing 94640 or 94664 for Emphysema Visit
Question: Which CPT code should we report when an established patient with emphysema prese... Read more
Vaccines:
90655-90660: Learn the Best Ways to Navigate Flu Codes
Answer 4 questions to keep your claims on track during flu season.With flu season getting ... Read more
Medicare:
Keep Flu Shot Billing Simple With These Reminders
Don't bill separately for vaccination supplies, intermediary warns.With fall comes flu sea... Read more
2011 Fee Schedule:
CMS Slashes 2011 Conversion Factor by Over 30 Percent Vs. Current Rates
Good news: New wellness visit codes get covered.Get ready for another year of nail-biting ... Read more
Documentation:
Watch Out: Nurse's History Note Might Be Audit Bait
The physician must indicate that he or she reviewed any nurse's notes. Caution: Do... Read more
Reader Questions:
Counting 99211 for Unexpected BP Check
Question: A patient came to our office for a flu shot. The physician ordered the LPN to ch... Read more
Reader Questions:
Yes, "Calming Shot" Fee Allowed
Question: One of our patients was on his way to have an MRI at the hospital. He stopped by... Read more
Reader Questions:
Checklist for Sports Physical Components
Question: Most of our insurance companies won't pay for a sports physical after the patien... Read more
Reader Questions:
Stop Omitting 25 Because of Same Diagnosis
Question: I was recently told in a class that you do not need different diagnosis codes to... Read more
You Be the Coder:
J0559, J0696 Calculations
Question: We have a difficult time getting paid when our internist administers CR Bicillin... Read more
CPT 2011:
New 90660 and Related Codes Expand Your Flu Vaccine Choices
Plus: Subsequent observation codes apply to longer hospital stays. CPT 2011 is just ar... Read more
E/M:
Check Out New Subsequent Observation Codes
Look for them in "Hospital Care" section.CPT 2011 adds a new section to your E/M options: ... Read more
CCI:
0228T, 0230T Play Big Role in CCI 16.3 Edits
Only report primary procedure -- except for 99455 edits. The latest version of Co... Read more
Compliance:
Practices Collected Over $8 Million in Part B Pay for Services Rendered After Patients Died
OIG identified massive overpayments for services rendered after patients' dates of death.P... Read more
Reader Questions:
294.11 Not Always Best for Dementia, Behavioral Disturbance
Question: Our coder reports 294.11 and 294.8 when our physician notes dementia with behavi... Read more
Reader Questions:
15850 With S0630 Leads to Denials
Question: An ER physician placed sutures that our internist later removed. The government ... Read more
Reader Questions:
Consider 692.xx for Surgical Tape Reaction
Question: Our physician documented that the patient had an allergic reaction to surgical t... Read more
Reader Questions:
Submit 99211 for Blood Pressure Check
Question: An established patient came to our office for a blood pressure check because he ... Read more
Reader Questions:
Yes, 94664 for Nebulizer Education Is Legit
Question: Should we be reporting 94664 when a nurse provides nebulizer education/demonstra... Read more
Reader Questions:
Apply 'Birthday Rule' to Double-Covered Patients
Question: If a married couple has a baby who becomes our patient, what insurance do we bil... Read more
You Be the Coder:
Medicare Stance on B12 Coverage
Question: Medicare denies our claims for B12 injections. Do they only allow one unit,... Read more
Medicare:
Prepare for Medicare to Cover Tobacco Cessation Counseling for All Smoking Beneficiaries
New coverage announcement brings good news for physicians who haven't collected in the pas... Read more
Casts and Splints:
Avoid the Cast Trap of Coding Within the Global
Tip: Remember you can always report supplies, if you meet one simple test. Football se... Read more
ICD-9 Update:
Cocaine Poisoning? Add 970.81 to Your Coding Options
Try your hand at this critical care scenario.When an internist in the emergency department... Read more
Reader Questions:
Let Diaphragm Guide Aneurysm Coding
Question: What distinguishes a thoracic aortic aneurysm from an abdominal aortic aneurysm?... Read more
Reader Questions:
Watch Procedure to Determine 25 With E/M
Question: An established patient came to our office because of knee pain. Our internist x-... Read more
Reader Questions:
Document Vitals Even If Not Required
Question: Does our provider need to document vital signs before we can charge an [injectio... Read more
Reader Questions:
Knock Out 'Normal ECG' Question
Question: A patient presents with complaints of periodic fainting spells and perception of... Read more
ICD-9 2011:
Avoid H1N1, Fecal Incontinence Denials With 5th Digit Savvy
488.1x Cheat sheet makes fast work of snagging correct code.Don't let rumors of few ICD-9 ... Read more
ICD-9 2011:
V49.8x, V13.2x Expand Status, History Options
This fall indicate a do not resuscitate order using new V code.Struggling to find a V code... Read more
ICD-9 2011:
Make Your Superbill 2011 Compliant Using This Quick Guide
The headache-free solution to getting your ICD-9 codes up to date.Space crunched on your s... Read more
Quiz:
Get Your Staff Ready for ICD-9 2011
This ready to go test puts everyone on denial-reducing same page.Making sure internists, N... Read more
Reader Questions:
2 Lesion Treatments: Is 11400 + 17000 OK?
Question: A physician destroyed a premalignant lesion on a patient's arm and excised a ben... Read more
Reader Questions:
Does Modifier SA Mean NP Pay Reduction?
Question: Please verify the correct way to bill for a nurse practitioner. When the NP prov... Read more
Reader Questions:
90669, 90670, or 90732 for Pneumococcal Vaccine
Question:Medicare and private payers are denying Prevnar 13 (90670, Pneumococcal conjugate... Read more
Reader Questions:
No CCI Bundle? Here's Where to Find Modifier Details
Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which c... Read more
Reader Questions:
Is 69210 Allowed for Partial Removal?
Question:Documentation states that the physician personally removed a small portion of imp... Read more
You Be the Coder:
What Caused 81001 Denial?
Question: A patient came in for a painful vaginal area. The internist provided a leve... Read more
Money-Making Procedures:
5 Principles Take the Tricky Out of FBR Coding
Snag $100 more for removal from foot \" Codify shows you how.If you automatically look to ... Read more
Coding Changes:
ICD-9 2011 Solves Partial Removal Stumper
Squeeze these V90 retained fragment codes onto fall tickets.When you can't get all of a sp... Read more
Auditing:
Check Your HPI, Risk IQ With Pre-op Exam Case Study
Hint: Your internist's recs are the ones to count under mgt options.When a patient needs p... Read more
Auditing:
MDM: Weigh Surgical Risk to Snag the Correct E/M Level
These definitions take the mystery out of moderate vs high surgical management options.If ... Read more
Reader Questions:
3 Ways to Handle Trays
Question:How do I code products like laceration trays for minor wounds, suture trays, face... Read more
Reader Questions:
The Hard Truth about Phone Call Pay
Question:Another physician told my doctor that he's receiving payment from his contractor ... Read more
Reader Questions:
Unplanned Departure = No 99315-99316
Question:A patient leaves a nursing facility (NF) against medical advice (AMA). Can an int... Read more
Reader Questions:
Drug Index Requires Generic Code Name
Question:I can't find the HCPCS Level II codes for Ethyol, Treanda, Trisenox, and Zoladex.... Read more
You Be the Coder:
SI Joint Area: Hunt for the Correct Injection Code
Question: An internist dictates, \"Injection (L) sacroiliac joint, depo medrol 80mg, lidoc... Read more
Incision and Drainage Mythbuster:
Avoid Denial Dilemmas on I&D Abscess
You'll get twice the payment when you know where to look. Incision and drainage (I... Read more
Coding Quiz:
Are You Receiving Denials For Lesion Removals? Help is Here
The success of your lesion excision coding relies on right timing, accurate reading.If you... Read more
Pulmonary Stress Test:
How to Differentiate Stress Test Codes and Get Your Claim Paid the First Time Around
Find out what blood-draw and analysis codes you can report separately.Pulmonary stress tes... Read more
Coding Quiz Answers:
Here's What You Need Before Coding Lesion Removals
Learn why preempting 11600 could send $55 down the drain.Pathology tests aren't there for ... Read more
On page 40 of May issue (Vol. 13 No. 5):
On page 40 of May issue (Vol. 13 No. 5):
On page 40 of May issue (Vol. 13 No. 5): The answer to the Reader Question "PAP/Pelvic Cod... Read more
Reader Questions:
Be Wary of Time When Discharging Patients
Question: Before discharging the patient from the hospital, our internist spends more than... Read more
Reader Questions:
Clarify Temp Services Using Modifier Q6
Question: Our regular internist is taking some time off, and a temporary internist takes h... Read more
Reader Questions:
Get Paid for 94760 Based on Its Physician Fee Schedule Status
Question: My practice has just started to bill pulmonary function tests (PFTs). In one cas... Read more
You Be the Coder:
Consider Other Factors Besides ICD-9 and CPT In Case of Denial
Question: A patient undergoes prostate cancer screening in my practice. On the claim, I re... Read more
Preventive Services:
Sidestep 5 Traps When Offering Yearly PSA, DRE
Warning: Code 84153 does not belong on these claims.Pay attention to prostate screenings' ... Read more
ICD-9:
Use This Step-By-Step Guide to Become an ICD-9 Coding Pro
Bypass presenting complaints in outpatient setting if diagnosis is clear.Your CPT codes ar... Read more
E/M:
Mistake ROS Level and You Could Lose $53.77
Differentiate extended and complete systems review to judge if 99204 wins out over 99203.I... Read more
Reader Question:
Remember Primary Diagnosis Code for These Diabetics
Question: I am coding a claim for which the notes indicate that the nonphysician practitio... Read more
Reader Question:
Anemia Could Lead to H1N1 Admin
Question: An 18-year-old female established patient, fearing she has H1N1, reports to the ... Read more
Reader Question:
Count Calendar Day Before Using 99217
Question: The internist met an established 40-year-old male patient, who was complaining o... Read more
Reader Question:
PAP/Pelvic Codes Depend on Payer
Question: I noticed that there are multiple codes for pap smears and for routine gynecolog... Read more
You Be the Coder:
Anemia or Underlying Disease: You Decide
Question: A patient with mild (stage II) chronic kidney disease presented for increased le... Read more
Follow 5 Sure-Fire Tips to ECG Coding Success
E/M code lets you capture review credit. Attaching an incorrect modifier to an electrocar... Read more
Turn to 'G' Codes for New Patient ECG Screens
For medically necessary ECG + IPPE, add this tool. ECG CPT codes (93000, 93005, 93010)... Read more
4 Q&As Reveal How to Handle 95905 for Nerve Conduction Studies
Attention: New NCS code changes how units are reported. If you've been hesitant on how to... Read more
YOU Be the Coder! Question & Answer:
White Coat Hypertension Hinges on 3 Points
Question: We have a patient who was diagnosed with white coat hypertension. Is there an ... Read more
Reader Questions:
Interpretation Does Not Equal Established Patient
Question: The internist performed the interpretation and report of a patient's ECG for an... Read more
Reader Questions:
Consider All Aspects for Hypothyroidism Diagnosis
Question: An established patient who recently had  surgery and radiation therapy to ... Read more
Reader Questions:
Apply 99211 to E/M Nurse Visits
Question: I am unsure when I can bill 99211 for a nurse visit, and when to not. Could you... Read more
Reader Questions:
Don't Overlook Shared-Visit Billing for Inpatients
Question: I know I cannot bill services incident-to in the hospital setting. Is there any... Read more
Follow 4 Steps to Win Approval for Expanded HIV Screens
Make sure to get your diagnosis codes right -- here's the rundown. Retroactive to De... Read more
Look Here For HIV Risk Factors that Equal Coverage
Most beneficiaries can receive a test with V73.89. CMS is opening the door for just about... Read more
Don't Overlook New Vaccine Codes Omitted From CPT 2010
Be at the ready with these codes if H1N1 resurfaces. You'll be hard-pressed to find recen... Read more
Rely On P Modifiers to Earn PQRI Credit When No Data Is Collected
Here are 4 ways to avoid missing out on reporting measures. Your internist... Read more
READER QUESTIONS:
V Means Victory on 'No Injury' Claims
Question: A 68-year-old established Medicare patient reports to the office for a visit st... Read more
READER QUESTIONS:
Most Med Checks Merit 99211
Question: An established patient with a plan of care in place for her gastroesophageal re... Read more
YOU Be the Coder:
Look Beyond 250.00 for 'Charcot Foot'
Question: The internist diagnosed an elderly patient with "Charcot foot" that requires tr... Read more
Lasso In PQRI Dollars:
Counting Asthma Evals Is One Key to 2% Incentive
Tried-and-true time saver gives you an efficient way of reporting Measure 64. Don't let p... Read more
Keep Infectious Diseases at Bay With This 1-2-3 Approach To Vaccinations
Use this refresher to keep age-group coding accurate. Did you know Medicare covers ce... Read more
4 Q&As; Help You Fall In Line With Heart Disease Screening Criteria
Don’t forget the appropriate E/M code if the patient presents with a separate comp... Read more
READER QUESTIONS :
Consider Immediacy on Critical Care Claims
Question: I've experienced some denials on critical care codes for patients I considered ... Read more
READER QUESTIONS :
Don't Bill One Physician Incident-To Another
Question: Is there any circumstance in which a group can bill all services and all provid... Read more
READER QUESTIONS :
Coding for Supplies Depends On POS
Question: Can I use 99070 to report the use of supplies at our office? Colorado Subscribe... Read more
READER QUESTIONS :
Peripheral vs. Autonomic Neuropathy Diagnosis
Question: What are the guidelines for differentiating between peripheral and autonomic ne... Read more
YOU Be the Coder! Question & Answer:
Time Determines Inhalation Code
Question: Can I report an individual inhalation treatment, such as with a nebulizer, in a... Read more
Use These 4-Steps to Solve Pelvic-Pap Coding Questions
Medicare covers routine exam and Pap at same office visit. Code cervical cancer screening... Read more
Determine High-Risk, Average-Risk Patients Before Reporting Pap Screens
Know when reporting a Pap smear can equal payment -- or denial. If you don't know a ... Read more
Recoup E/M Time on 2+ Days with New Prolonged Services Guidelines
Catch: Medicare won't accept this CPT change. Not capturing all the time your internist s... Read more
Reader Questions:
Don't Slip Up on Consults in 2010
Question: The internist saw a patient for a preoperative consult before a tumor removal&n... Read more
Reader Questions:
Identify Code Combos for 2-Plus Vaccinations
Question: How should I report the administration of the influenza vaccine along with anot... Read more
Reader Questions:
Add E/M to Screening for Separate Services
Question: Our internist recently treated gastrointestinal upset during a well-woman visit... Read more
Reader Questions:
Consider Incident To For Follow Ups
Question: One of our non-physician practitioners saw a patient during a follow-up visit&n... Read more
Reader Questions:
Report Vitals with 3 Components
Question: Can you explain how many of the vital signs our new internal medicine physician... Read more
You Be the Coder:
Code the Highest Level for Counseling
Question: I have an internist who documented 60 minutes on an established patient's offic... Read more
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