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Internal Medicine Coding Alert
Internal Medicine Coding Alert
Internal Medicine Coding Alert - 2011; Volume 14, Number 12
2012 CPT® Updates:
Learn CPT® 2012 Updates in Next Two Months
Updates to vaccine, E/M, Dermatology procedures. CPT® 2012 goes into effect in a ...
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Rural Health:
Revalidation Letters and Diagnostic Imaging Requirements Affect payment
Understand how CMS changes affect healthcare serviceCMS officials discussed several issues...
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Platform 5010:
Last Minute Look Through for 5010 Electronic Transactions Implementation
Buffer time required to handle glitchesAre you ready to say goodbye to forms 4010/4010A1 f...
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E/M Update:
99218-99220 Will Have Typical Times in 2012
Rumor has it the revisions could add options for reporting these observation codes.Have yo...
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ICD-10:
Malignant and Benign Hypertension: 404.0x Differs From I13.
4 ICD-10-CM for hypertensive heart and CKD.You can expect ICD-10-CM to provide you with co...
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Reader Question:
Turn to 99214 to Give Credit for Extra Time
Question: Our physician spends lot of time discussing treatment options, imaging results, ...
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Reader Question:
For E/M Services, 3 'Vitals' Equals 1 Exam Bullet
Question: Would you please explain how taking the vital signs contributes to determining t...
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Reader Question:
Glucose Monitoring with 95250, 95251
Question: What is the best way to bill for continuous glucose monitoring? Do we bill for t...
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Reader Question:
Add Lacerations Only If Found at Same Site and Level
Question: A patient with a 1.5-cm laceration on his eyebrow presented to our practice. Our...
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Reader Question:
E Code for Initial Fall Visit
Question: An established patient came to the office complaining of back pain related to a ...
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You Be the Coder:
HCPCS for Kenalog Injections
Question: How should I report an intra-epidiymal injection of Kenalog? South Carolina ...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 11
HCPCS Supplies:
Medical Supply Claims Require Proper Modifiers Application
Get acquainted with modifiers NU, KX. When a patient leaves your office with crutches, you...
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CCI Edits Update:
Latest CCI Edits 17.3 Target Annual Wellness Visit Codes
New bundles for G0438 and G0439 shouldn't hit your bottom line.The latest updates from the...
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ICD-9 2012:
414.4 Lets You Get Specific About Calcified Coronary Lesions
But 425.1 will bring instant denials as of October 1.Don't consider your ICD-9 2012 update...
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ICD-10 Watch:
Prepare for ICD-10 Conversion Following Easy Steps
Analyze your practice's mostly used diagnoses to familiarize with It's not too...
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ICD-10:
Narrow Choice for Essential Hypertension to I10
ICD-10 streamlines to single diagnosis. Many diagnoses will expand to multiple options...
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Reader question:
Avoid Confusion of Block Code With Simple Repair
Question: If a physician performs a digital block on a finger and repairs a 2 cm lacerat...
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Reader question:
Choose Between 99213, 99214 for Pre-Op Examination
Question: The local orthopedist requires clearance before scheduling patients for total kn...
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Reader question:
99078 vs. 98960-98962
Question: Our physician wants to implement group patient education meetings, when he'll br...
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Reader question:
HCPCS code for Lidocaine During Block or Injection Not Separately Billable
Question: Our physicians often use a local anesthetic or a mixture of triamcinolone and li...
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Reader question:
Claim Dermabond Supply With 12001-12007
Question: An established patient visited our office because of severe hyperkeratosis affec...
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Reader question:
Follow-Up Visit: Fill In Two Of Three E/M Components
Question: I am auditing some of my physician's E/M visits, and discovered that he's not di...
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Reader question:
Remove J0570 From Your Superbills
Question: We're receiving denials when we report codes J7610 and J0570. Can you advise reg...
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Reader question:
Tinnitus Coding
Question: The internist documented "ringing in head" for a new patient. What diagnosis cod...
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You Be the Coder:
Report Arthrocentesis with HCPCS Code For Medicines
Question: The physician used ultrasound guidance when performing arthrocentesis on the p...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 10
Annual Visits:
Be Cautious Reporting EKG With AWV
New Medicare stance steers you away from modifier 25. Medicare now requires a modifier on ...
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Modifier Review:
Extremity Fractures: Learn Correct Modifier Usage
Tip: Repeating a procedure or service doesn't always mean extra pay. With football season ...
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News You Can Use
786.50 and 786.51 Land on PT 'Paid' ListIf your practice provides prothrombin time (PT) te...
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Part B Forms:
New Format ABN Form To Be Used From Nov. 1, CMS Sources Say
Switching to new form is mandatoryIt may seem like just yesterday that you transitioned to...
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ICD-9 2012:
Skin Cancer Codes of 173.x Series Are Now More Specific
Physicians need to pinpoint the type of diagnosis. When the updated version of ICD-9-CM go...
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ICD-10:
Come 2013, 786.05 Will Have New Code, But Same Descriptor
If your internist notes in a chart today that a patient's presenting complaint is "shortne...
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Reader question:
Add Modifier 59 for Repeated Epistaxis treatment
Question: My physician saw a patient in the office for a nosebleed. Later that day, t...
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Reader question:
99339-99340 Not Autometic Choice for Assisted Living Facility Coding
Question: One of our physicians evaluated a new patient in an assisted living facility for...
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Reader question:
Collect From Secondary Payer Before Approaching A Patient
Question: We have many patients with secondary insurance, some of which have deductibles o...
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Reader question:
Coding Negative Strep Test Forces You to Rely on Symptoms
Question: We performed a strep test on a patient who presented with vomiting, rash, and he...
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Reader question:
Set Wellness and E/M Visits on Separate Days To Avoid Possible Denial
Question: We often bill well woman and sick visits on the same day if the sick visit warra...
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Reader question:
36140-59 Needs Supporting Documentation
Question: Do codes 99144, 36140, 36245, and 75710 require any modifiers to be paid when re...
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You Be the Coder:
Patient Wheezing? 519.11 Might Outweigh 786.07
Question: Sometimes our internist suggests diagnosis 519.11 for wheezing, but sometimes he...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 9
Diagnostic Tests:
Colonoscopy Screening: Always Check Frequency Rules and Risk Categories
Watch out: Medicare has specific requirements other payers might not follow.The days have ...
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Polypectomy; 45380-45385:
Learn 3 Tips For Proper Polypectomy Coding
If the surgeon spends double time on 45385, bill with modifier 22.If you know how to work ...
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ABNs:
Use ABN-Style Waiver for Non-Covered, Non-Medicare Services
Steer clear of angry patients and lost reimbursement by covering your bases up front.When ...
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ICD-10:
Separate Fibromyalgia, Myalgia Diagnoses in 2013
ICD-10 also establishes new myositis code. If your internist diagnoses a patient with ...
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Reader question:
Count Toes to Choose Between 11720 and 11721
Question: What CPT® code is best for cutting and filing ten toenails?Indiana Subscri...
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Reader question:
Code Malignant Facial Lesion With 173.3
Question: The physician removed a lesion from the patient's temple area. The pathology rep...
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Reader question:
Coumadin Coding For 99363, 99364
Question: I know Medicare doesn't cover Coumadin clinics, but thought some commercial plan...
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Reader question:
Get To Know Modifier 33
Question: We get denials from several insurance companies, stating that modifier 33 is inv...
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Reader question:
Incident-To Rules For Follow-Up Visits
Question: One of our non-physician practitioners saw a patient during a follow-up visit. W...
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You Be the Coder:
93458's Global Period Offers Coding Clues For Catheterization
Question: The cardiologist was called in to consult for an inpatient presenting with angin...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 8
CCI Edits:
CCI Version 17.2 modifies Annual Wellness Visit With ECG, E/M, and Behavior Assessment Codes
Appending modifier 25 can save AWV with some claims.Until now, you've been able to report ...
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Diagnosis Coding:
Take A Look Into New V Codes That Will Affect 'History' Diagnosis
New ICD-9 codes also stress anaphylactic 'reactions' only, not 'shock'.New and revised ICD...
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E/M Service:
Double Check Documentation Before Shifting from 99204 to 99203
Do not attract unnecessary audits due to regular downcoding.National insurer data from pre...
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ICD-10:
Atrial Fibrillation Directly Maps to a Single Code in ICD-10
Be aware of the code(s) to use when ICD-10 arrives.Reporting an atrial fibrillation diagno...
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Reader Question:
Age, Medicare Status Help Decide Pap Test Codes
Question: What CPT® code should we submit for a Pap smear?Rhode Island SubscriberAns...
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Reader Question:
Select 079.99 or 079.89 for Diagnosis "Viral Syndrome"
Question: Our internist often uses the phrase "viral syndrome" to describe a patient's sym...
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Reader Question:
Skip Reporting Separate E/M With 94760, 94761 for Medicare Patients
Question: Our payers deny a significant number of pulse oximetry codes because they state ...
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Reader Question:
Steer Clear of 'Seen and Agreed' Note or Face Claim Rejections
Question: Our physician works with residents each year. It's very time consuming, but he d...
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Reader Question:
Don't Avoid 25 Because of the Same Diagnosis
Question: I recently heard that you do not need different diagnosis codes to use modifier ...
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Reader Question:
Select 20610 for Trochanteric Bursa Injection Procedure
Question: How should I code injection of trochanteric bursa and sacral crest? My physician...
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Reader Question:
Remember Face-to-Face Factor in New vs. Established
Question: We saw a patient for pain injections earlier in the year and he is now coming in...
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You Be the Coder:
Understanding Multiple Uses of HCPCS code G8553
Question: We're still working to become compliant with e-prescribing. We don't have a larg...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 7
Case Study:
Affected Systems Tell When to Code Anaphylaxis Vs Allergic Reaction
Tip: Count the number of body systems involved to make the right choice.Summertime is here...
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Knee Injections:
When Coding Trigger Points, Count Muscles, Instead of Injections
Here's your guide to success with TPI versus other knee injections.All knee injections&nbs...
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E/M:
Refrain Getting Caught in These 3 Common Evaluation& Management Traps
Incident to, critical care must meet certain criteria.As a coder, you're accustomed to rep...
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ICD-10:
Make Ready for Extra Code Reporting for Foreign Body Removal
Once ICD-10 goes into effect, check the type of retained body.Choosing your primary diagno...
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Reader Question:
See Beyond Obesity for Primary Diagnosis
Question: Some of our insurers refuse to pay for obesity as a primary or secondary diagnos...
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Reader Question:
Select Between Codes 782.9 and 705.89 for Body Odor
Question: A mother brought her 6-year-old daughter to our office because she was concerned...
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Reader Question:
Maintain Your ABN for U/A Screening Tests
Question: Is a urinalysis (screening) included in or bundled with a patient's initial prev...
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Reader Question:
Coding Procedure for Simple Repair with Dermabond
Question: An established patient visited our office because of severe hyperkeratosis affec...
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Reader Question:
Disregard Preventive Exam Codes for Skin Cancer Screening
Question: My physician saw a patient for a skin cancer screening. Should I use the prevent...
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Reader Question:
Obtain Specific Diagnosis Before Coding Tissue Infection
Question: Our physician treated a soft-tissue infection on a patient's finger. Which diagn...
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Reader Question:
Payer Tactics Outweigh Coding Guidelines
Question: Our Medicaid carrier refuses to accept the new vaccination codes, but we know it...
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You Be the Coder:
Picking Correct ICD-9 Code for Multiple Burns
Question: An established patient reports to our physician with firstand second-degree burn...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 6
Injection Coding:
Ask Yourself 3 Questions While Coding CTS Injections
Verify evidence of previous treatments for successful claims.If you're coding for a patien...
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Pediatrics:
Follow 3 Steps When Coding and Billing Summer Camp Exams
From ICD-9 coding to your forms policy, we've got you covered.Summer camp season is coming...
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PEG Tube Coding:
PEG Tube Removal: Avoid Common Errors By Sticking To E/M
Find out why 43247 just won't do you any good.If you've asked yourself frequently what CPT...
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Documentation:
MD's Notes is Crucial to Find if E/M Is 'Separate' or 'Inherent'
The answer to your question gives 'yes' or 'no' to modifier 25.If your internist performs ...
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ICD-10:
Conjunctivitis Coding Will Bring Direct Cross-Code in 2013
Tip: Check whether more detailed diagnoses are more appropriate.Conjunctivitis (also known...
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Reader Questions:
Imaging For Different Purposes? Multiple X-Ray Charges OK
Question: A new patient presented to the office because of an injured left ankle she hurt ...
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Reader Questions:
Origins of Blood Indicate Either 569.3 or 578.1
Question: I'm not sure when I should use 569.3 and 578.1 for bloody stool. Are they one an...
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Reader Questions:
Review Incident-To Guidelines For Follow-Ups Cases
Question: One of our nonphysician practitioners saw a patient during a follow-up visit. ...
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Reader Questions:
V70.0 Counts for Well Woman Urinalysis
Question: One of our providers wants to order urinalysis as a routine part of a well woman...
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Reader Questions:
Check All Notes for Chronic Condition Detailed Info
Question: The 1997 audit guidelines state that I can reach an extended history by updating...
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Reader Questions:
Difference Between 20610 And 27096
Question: Which CPT® code applies to a sacroiliac joint injection? Would we bill it ...
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Reader Questions:
Append Proper Code To Secca Procedure
Question: I've heard about the Secca procedure being utilized as a treatment for fecal inc...
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Reader Questions:
Code NERD And Carditis With 530.81
Question: Has anyone come across chronic carditis on a biopsy taken from the gastroesophag...
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You Be the Coder:
Use -79 for Repeat Wart Freezing Within Global Period
Question: Eight days after an initial wart freezing, the patient returns, and the physicia...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 5
Nosebleeds:
Instrumentation and Methods Help Avert Nosebleed Or Epistaxis Coding Problems
Warning: Reporting 30901 for ice stoppage might not be proper. A patient comes to your ...
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CCI 17.1:
Newest CCI Edits Teach You to Take Note of Involved Joints Before Coding Arthrotomy
Tip: Exploration and drainage codes override some biopsy or synovectomy codes. The late...
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ICD-10:
Significant Changes Will Come for ADD/ADHD Coding Under ICD-10-CM
Prepare for 5 --" not 2 --" code choices in 2013. You may know the diagnosis codes for ...
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Collections:
Learn Your State's Prompt Pay Laws -- Overcome Regular Payer Headaches
Medicare contractors must pay clean claims within 30 days, but private payers vary.It's a ...
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ASC Payments:
5 Tips To Make Your ASC Coding Better
Check out the new 2011 payment rates for dermatology procedures performed in an ambulatory...
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Reader Questions:
Choose From 99393-99395 Based on Patient's Age
Question:Our internist saw a patient for a sports physical clearance. During the visit, th...
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Reader Questions:
Check Out HCPCS Code G0372 for Power Wheelchair Evaluation
Question:What code applies to a face-to-face evaluation for a power wheelchair? Maryland S...
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Reader Questions:
No MPFS RVU Means No Medicare Coverage
Question:Can you explain to me why some codes (such as 99172) do not have an associated re...
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Reader Questions:
Denote Abnormal Feces Fluidity With 787.91
Question:A patient says she has had chronic bowel problems for the last 10 years, with dia...
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Reader Questions:
Nurse Could Count for 98960 Professional
Question:Is it appropriate to use code 98960 for a nurse who completes extensive asthma ed...
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Reader Questions:
Subcutaneous Foot Splinter Removal Could Be 28190
Question:The physician removed a 1.5 cm splinter from beneath the dermis of the patient's ...
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You Be the Coder:
Friction Burns Are Still Counted As 'Burns'
Question:A patient presented with multiple friction burns from a treadmill. He had partial...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 4
Osteoporosis:
Check Out 3 Areas to Stay Within New Osteoporosis Screening Regulations
Medical necessity and acceptable timeframes are must-haves before coding.New recommendatio...
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Modifier Mythbuster:
Bust 3 Myths to Avert the Trap of 'Increased Procedural Services'
If you decide to append modifier 22 always in certain situations, be prepared to head towa...
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Dermatology:
Do Not Forget Office Visits for Initial and Follow-Up Patch Tests
Plus: Count every test to get the money your physician is due.When your internist conducts...
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Audits:
Follow This 3-Step Strategy To Get Through Irrational Denials
The contract a patient signs with the insurance company holds true no matter what.Have you...
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Reader Questions:
Don't Expect Insurance Company To Pay for Driver's Physicals
Question: What is the best way to code and bill for driver's physicals? I'm thinking the p...
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Reader Questions:
692.4 or 995.2x Could Fit Multiple Chemical Sensitivities (MCS)
Question: What diagnosis code applies to multiple chemical sensitivities?Wyoming Subscribe...
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Reader Questions:
Removal Technique Helps Guide Lesion Coding
Question: We have an ongoing discussion in our office regarding how to code for excisions ...
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Reader Questions:
Choose Either 17110 or 17111 for Removal, Not Both Codes
Question: The physician removed plantar warts from each of a patient's feet. Do I submit t...
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Reader Questions:
99211 Vs. 69210 for Ear Wax Removal
Question: Can you explain how we know whether to report a procedure or E/M code for ear wa...
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Reader Questions:
Verify Payer Details Before Billing 99307
Question: How do I bill if our physician went to the nursing home to see Medicare patients...
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Reader Questions:
45385, 45380: Resolve Colon Polyps With 2 Colonoscopy Methods
Question: How should I report the procedure based on this physician's notes:"Patient with ...
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You Be the Coder:
Add A Secondary Dx With 702.11 or 702.19
Question: Our physician excised a 0.4 cm lesion and documented, "She has a bleeding black ...
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Internal Medicine Coding Alert - 2011; Volume 14, Number 3
Closures:
12001 or 13100? Consider More Than Tissue Layers to Code Exact Closure Level
Follow these tips to find the differences between 'simple,' 'intermediate,...
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CPT 2011:
New Observation Codes 99224, 99225, 99226 Help Answer the 'Middle Day' Code Dilemma
Expanded choices eliminate payer-to-payer coding variation.2011 brings a new coding option...
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Rural Care:
Medicare Lagging on Implementing Preventive Service Fee Waivers
PPACA waived fees starting Jan. 1, but CMS won't until April 4.The Centers for Medicare &a...
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Reader Questions:
Bilateral X-Ray Doesn't Always Mean -50
Question: Our internist x-rayed a patient's symptomatic knee and ordered an x-ray of the o...
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Reader Questions:
Medical Necessity Could Mean Extra Hemoccult Pay
Question: Preventive care guidelines state that hemoccult slides are covered once each yea...
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Reader Questions:
Dates and Physician Presence Dictate 99221 Alone or With Office Visit
Question: Our physician saw a patient in the office, and then admitted her to the hospit...
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Reader Questions:
Consider Skin Biopsy Timing, Location, Intent
Question: How do I know when to report skin biopsy separately with, or in place of, other ...
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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...
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Reader Questions:
Check Each Component Before Submitting 80053
Question: The physician ordered a basic metabolic panel and hepatic function panel for a p...
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You Be the Coder:
Remember Your Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The internist used a scalpel and tweeze...
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Internal Medicine Coding Alert - 2011; Volume 14, Number A
CCI 17.0:
Newest CCI Edits Include More Procedures Related to "Guidance"
Don't submit 77001 or 77002 with fracture care, TPI, arthrocentesisThe newest edition of C...
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CPT 2011:
5 Tips to Sail You through G0438, G0439 Coding Scenarios
Boost your revenue by reporting new annual wellness visits correctlyIf you want your annua...
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CPT 2011 Errata:
93268-93272 Require Attended Surveillance -- Mark The Guidelines
Plus: 93923 replaces 93922 in a key parenthetical note, and your index requires updateIf y...
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PECOS Dilemma:
CMS Says It May Not Deny PECOS Claims Initiating in January
New CMS DirectiveYou may -- or may not -- face claims denials in January due to ...
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Reader Questions:
Start and Stop Times Important to Infusion Coding
Question: We're starting to bill for hydration and therapeutic infusions at our clinic. Do...
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Reader Questions:
36416 With 85018: True, But Better To Be Aware of Bundles
Question: Are we allowed to bill 36416 with 85018?Answer: Yes, you can submit 36416 (Colle...
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Reader Questions:
414.2 Should Follow Atherosclerosis Code Based On ICD Guidelines
Question: I heard at a conference that you shouldn't use 414.2 as a firstlisted diagnosis....
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Reader Questions:
No CCI Bundle Applicable? 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...
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Reader Questions:
Look to The Cause Responsible for Coding Bruises
Question: What is the ICD-9 code for "easy bruising"?Answer: Easy bruising is a symptom of...
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Reader Questions:
Remember Your Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The internist used a scalpel and tweeze...
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You Be the Coder:
Coding 96372 With 90471
Question: During an office visit, our nurse administered a B12 injection and a flu shot to...
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