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Internal Medicine Coding Alert
Internal Medicine Coding Alert
Internal Medicine Coding Alert - 2013; Volume 16, Number 12
CPT® Coding Strategies:
Perfect Your Flu Vaccine Coding With These 4 Tips
Hint: Don’t forget to report administration with separate codes. As your code ch...
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Back to Basics:
3-Year Rule Determines Patient Status
Hint: The place of service(POS) won’t influence your choice. Many times, the fir...
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ICD-10 Update:
Concentrate on Severity While Coding Asthma With J45
Hint: Identify symptoms and medication use for accurate reporting. When your internist...
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Reader Question:
Facing Denials For Same Session ''Tobacco Counseling'' and E/M? Check This
Question: I am billing ‘99407’ with ‘99213’ and getting denials....
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Reader Question:
Time and Provider Holds Key For Appropriate DSMT Coding
Question: A patient seen for diabetes (250.02) in the doctor’s office and the phys...
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You Be the Coder:
Count Number of Muscle Groups For TPI Coding
Question: Our internal medicine specialist recently performed trigger point injections t...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 11
CPT® 2014 Update:
New E/M and Ultrasound Wound Care Therapy Codes in 2014
Good n ews: Common TCM guidelines will rid confusion while reporting transitional care. ...
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2014 Physician Fee Schedule:
Possibility of Fee Deductions If Proposed MPFS Gets Accepted
Sunny side: Chronic care non-face-to-face services might bring in bonuses in 2015. Whi...
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ICD-10 Update:
Bust Major ICD-10 Myths and Mysteries
Don’t assume that ICD-10 will allow you to use the same code twice. With the hea...
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Reader Question:
EF Modifier For EPSDT Examination Codes
Question: We are receiving denials from Medicaid stating 92551 (hearing exams) whi...
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Reader Question:
Supply Codes Can Be Reported With Administration For Depo Provera
Question: Our FP saw a patient for her third Depo Provera shot. What is the appropriate ...
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Reader Question:
Modifier to Report Destruction and Excision Procedures
Question: One of our physicians destroyed a premalignant lesion on a patient’s arm...
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You Be the Coder:
Choose Appropriate Vaccine Administration Codes
Question: Rotovirus vaccine is only given to children less than the age of eight at 2, 4...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 10
CPT® 2014 Update:
2014 Changes: Gear Up With New Year CPT® Codes
Good News: You will now have a new code set for inter-professional discussions. If you...
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EHR Mythbuster:
Get The Ground-Reality On 3 EHR Myths That Could Cost Your Practice Heavily
Warning: Blindly relying on your electronic system could mean payer audits. If you are...
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ICD-10 Update:
More Specificity For Pressure Ulcer Coding in ICD-10
Separate codes for bilateral locations reduce confusion while reporting multiple ulcers....
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Reader Question:
DOS Decides Bundling Between Epidurals and E/M Depending
Question: I have done continuous epidural for my patient and injected different concentr...
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Reader Question:
TPI Coding Depends On Number of Muscles
Question: Our physician administered bilateral trigger point injections in three locatio...
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Reader Question:
Report Appropriate E/M for Suture Removal by Another Physician
Question: We recently had a patient coming into our practice to meet our family physicia...
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You Be the Coder:
Joint Codes for Sinus Tarsi Injection
Question: I recently received a denial for a cortisone injection to the sinus tarsi that...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 9
CCI Bundling:
Changing Code Reporting Rules: E/M With Office Procedures
In addition: Watch for these bundles affecting negative wound pressure therapy. Apply ...
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Money Matters:
PQRS Reporting: Ethical Coding By Selecting Right Options
Hint: Base your decisions by analyzing the number of providers in your group. If you&r...
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ICD-10 Update:
Broader Reporting Options For Anorectal Abscess
Hint: Use separate code when you clinician diagnoses anal and rectal abscesses. When y...
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Check These Anorectal Abscess Types
Based on location of the abscess in the anal and rectal regions, anorectal abscesses can...
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Reader Question:
Include 94010 for Spirometry During Office Visit
Question: What is the proper way to bill an E/M visit when performing spirometry during ...
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Reader Question:
Pay Heed to Complex Repair 'Anatomic Groups'
Question: We had a case with multiple lacerations requiring complex repair to the follow...
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Reader Question:
Block Scheduling to Balance Late Patient Back-Ups
Question: We’ve had a lot of patients showing up late for their appointments...
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Reader Question:
Clear Documentation Required for Unexpected Shot for Nerves
Question: One of our patients was on his way to have an MRI at the hospital. His daughte...
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You Be the Coder:
Debridement With Foreign Body Removal
Question: Is it acceptable to code 11042 and 10120 together? If so, do I need to include...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 8
Well Visit/Problem Oriented Visit:
Guidance to Accurate Newborn Exam Reporting
Hint: Appropriate ICD-9 codes will help a robust claim When your internal medicine spe...
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E/M Coding:
PFSH Missing PFSH Documentation Might Cost More Than $70 Per Encounter
Hint: Omitting history captured in previous visits will mean loss of revenue. When you...
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ICD-10 Update:
Diabetes Mellitus: Segregate Your Codes Based on Type
Hint: Use fourth and fifth digit expansion to specify complications. When your interni...
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Reader Question:
Medical Necessity Drives E/M Code Choice
Question: Our physician documents office visits very thoroughly. Because he documents in...
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Reader Question:
Coding E/M With G0438, G0439
Question: Can we bill an E/M code with a 25 modifier along with annual check-up codes G0...
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Reader Question:
Block Scheduling to Balance Late Patient Back-Ups
Question: We’ve had a lot of patients showing up late for their appointments latel...
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You Be the Coder:
Reporting Pre-Op Clearance for Surgery
Question: What CPT® code should we submit for pre-op clearance by one of our interna...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 7
Transitional Care Management:
4 Points To Remember When Reporting Transitional Care to Medicare
New rules apply when you follow CMS guidelines instead of CPT® Now that you’...
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Well Visits:
Understand Payer Differences Before Coding Pap Smears With Annual Physicals
Heads up: Medicare follows its own guidelines, not CPT® rules. If your physicians ...
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E/M Coding:
MDM Determination: Steps You Can Follow
This system will help you correctly calculate each piece of the MDM puzzle. The Office...
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ICD-10:
Neck Pain: From 723.1 to M54.2
Good news: Official descriptor remains same. Internal medicine physicians often see pa...
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Reader Question:
CDL Physicals: Special In-House Code Might Be Best
Question: One of our physicians wants to bill an E/M code for a commercial driver’...
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Reader Question:
Verify Anatomic Locations Before Submitting Multiple Lines of 20600
Question: Our physician treated a patient who has osteoarthritis in her hands by i...
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Reader Question:
Switching Order of Diagnoses on Claim Can Be OK
Question: Our physician documented gingivitis as a contributing factor in a patient&rsqu...
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Reader Question:
Verify MD/NP Collaboration Agreement Before Locum Tenens Time Starts
Question: One of the physicians in our practice will be traveling for two months and has...
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Reader Question:
Include Retained FB Code With Toe Blister, If Applicable
Question: I’m coding a case of treatment for an ischemic blister of the right grea...
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You Be the Coder:
Reporting 11042 With 10120
Question:Is it acceptable to code 11042 and 10120 together? If so, do I need to include ...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 6
CCI 19.1:
Injection Administration Coding Edits: New Bundling Policies
Start reporting vaccine administration with office consultation. The latest update fro...
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Office Visits:
Recognize 3 Opportunities to Bill Services With Preventive Care
Tip: Check whether the payer also requires modifier 25. Preventive wellness visits are...
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Incident-To Billing:
Follow These 3 Steps for Better Incident-To Claims
Don’t forget to check your state’s laws for NPP scope of services. Having...
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ICD-10:
Viral Infection Diagnosis: Extra Details Required to Avoid 'Unspecified' Code
Code 079.99 makes an easy switch, but payers might not reimburse. When your physician ...
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Reader Question:
Bill 92504 Alone, Not With 69210
Question: The physician cleared cerumen impaction from the patient’s left ear and ...
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Reader Question:
G0402 or G0403: Replacement Code for Deleted Code G0366
Question: A 65-year-old patient who just enrolled in Medicare came to our office f...
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Reader Question:
Q2038, G0008: Acceptable Fluzone Pairing for Medicare Patients
Question: Medicare denies our claims for flu vaccines with claim status codes of 254 and...
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Reader Question:
692.6 for Poison Ivy Diagnosis
Question: I’m having trouble finding a diagnosis code for 96372 when the physician...
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Reader Question:
Code 90714 for All TD Vaccines in U.S.
Question: I know that, as of the first of the year, code 90718 has been deleted. I...
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You Be the Coder:
Diagnosing is Important in Initial Vs. Follow-Up Fracture Visit
Question: Our physician treated a patient for a fracture of the second metatarsal. A fol...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 5
Preventive Services:
Separate Problem Can Be Billed During a Well Check Visit
Watch for significant and separately reportable service that could boost pay. When a p...
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ICD-10:
4 J Code Options Help You Identify Strep Throat Diagnoses
Wait for lab results before assigning the final code. ICD-9 coding: When using the ICD...
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Billing:
Waiving Co-pays: Beware of The Fallouts
Tip: Get your own verification of financial hardship. Every physician wants to collect...
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Reader Question:
Penalties Could Be On Your Way for Illegible Documentation
Question: My physician’s handwriting really is difficult to read sometimes, ...
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Reader Question:
Watch Details While Deciding Between Levels 4 and 5 E/M
Question: We have enough details for an encounter to reach these levels: HPI &...
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Reader Question:
Removal: No Incision Means No 10120
Question: My physician documented that a tick was embedded in the patient’s abdome...
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Reader Question:
Look at 917.2 for Toe Blister Diagnosis
Question: What is the correct diagnosis for an ischemic blister of the right great toe? ...
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Reader Question:
Choose V13.3 for Atypical Nevus Diagnosis
Question: I can’t seem to find a clear diagnosis code for personal history of atyp...
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Reader Question:
Do Not Bill 92504 With 69210
Question: The physician cleared cerumen impaction from the patient’s left ear and ...
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You Be the Coder:
Billing Same-Day Physician/Nurse Practitioner Services
Question: Our nurse practitioner (NP) is working with our internal medicine physician in...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 4
BMD Coding:
Bone Density or DEXA Scan Coding: Tips to Help You Out
Check your LCDs to see if coverage is once every 2 years. The restrictions Medicare se...
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Documentation:
New CMS Guidelines To Be Followed To Keep Record Amendments Updated
Heads up: Single-line corrections are fine. No practice – or physician – i...
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ICD-10:
BMI Coding: Becoming More Specific Under ICD-10
Most ICD-9 codes have straight crosswalk for ICD-10. Obesity in adults and children co...
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Reader Question:
Use V65.40 or V65.49 for A Visit to Discuss Lab Tests
Question: A patient would like to schedule an appointment with her physician to review l...
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Reader Question:
No Separate Simple Repair Work Coding with CPT® 17110
Question: Our physician performed an excision of two warts (one from the elbow and one f...
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Reader Question:
Begin With 95004-95071 for Allergy Testing
Question: Our physician’s documentation regarding an allergy test is as foll...
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Reader Question:
'Health Coach' Services: Preventive Codes To Be Applicable?
Question: I am looking for CPT® or HCPCS codes for health coach services that would ...
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Reader Question:
Second Cast Placement: Submit 29405 and Q4038
Question: A patient was put in a cast after surgery, then came to our clinic the very ne...
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Reader Question:
Report Both COPD and Chronic Bronchitis, but Not With Separate Codes
Question: Is it appropriate to code 491.0 with 496 when the patient has chronic bronchit...
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Reader Question:
No CC or Prescribed Service Could Mean Preventive Counseling
Question: A patient met with our physician to discuss his need for a scooter. He denied ...
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You Be the Coder:
Decide E/M Level Even Without Patient History
Question: Our physician saw patient in the office, but couldn’t get all necessary ...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 3
CPT® 2013:
Learn All About Transitional Care Management (TCM) Codes of 2013
Tip: Watch individual days, not just calendar months. CPT® 2013 introduced two new...
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CCI 19.0:
Immunization Coding Affected By Latest CCI Changes
Tip: Pay special attention to influenza vaccines. The latest Correct Coding Initiative...
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ICD-10:
Otalgia Coding in 2014: Watch For Fifth Digits
ICD-10 will introduce 4 new options. Otalgia is one of the most common complaints in a...
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Reader question:
Signature Variations Are Acceptable, If You Maintain Signature Log
Question: We’re having trouble making sure our providers meet signature requiremen...
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Reader question:
Report 255.0 for Hypercortisolemia
Question: One of our providers ordered labs with hypercortisolemia as the supporting dia...
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Reader question:
E/M Without Vitals: OK To Bill When Documentation Is Good
Question: A daughter brought her mom to our office. The mother was seen by the doctor, b...
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Reader question:
+99354 Applicable to Office Visit After Hospital Stay
Question: What is the best way to code for an extended office visit following an acute h...
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Reader question:
No Patient History? E/M Level Can Be Decided Based On Other 2 Components
Question: Our physician saw patient in the office, but couldn’t get all necessary ...
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You Be the Coder:
Routine Screening and Diagnostic Test: Choose Code Based on Purpose of Test
Question: A patient came in for a bone density scan, which was positive for osteopenia. ...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 2
CPT® 2013:
Learn To Use New Care Coordination Codes
Your chance to report services across multiple specialties for a single patient. CPT&...
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Compliance:
Understand Your Electronic Prescription System
Get started now to avoid further pay hits in 2014. Incentives for using electronic pre...
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ICD-10:
K Codes: Extract More Details For Acute Appendicitis
Hint: Start your search based on the presence or absence of peritoneal involvement. Ab...
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News Flash:
Modifiers 24 and 27: New Resources to Bypass CCI Edits Bundling
Plus: You can also override bundles with modifiers LM and RI Coders learned years ago ...
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Reader Question:
Consider Each Additional Service While Billing With HCPCS Code G0402
Question: I’m trying to understand what we can bill to Medicare during a patient&r...
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Reader Question:
Check Payer Guidelines for Submitting Modifiers
Question: One of my third-party payers is denying L4360 because they are asking for &quo...
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Reader Question:
Differentiate Between Multiple Diagnosis and Symptoms
Question: Can I code tonsillitis, pharyngitis, and upper respiratory infection together?...
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You Be the Coder:
Choose Proper Modifier for Non-Surgical Service within Global Period
Question: A patient came to our office for a minor skin surgery procedure. He was back f...
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Internal Medicine Coding Alert - 2013; Volume 16, Number 1
CCI:
Modifiers 24 And 57 Will Allow You to Bypass CCI Edits in 2013
Plus: You can also override bundles with modifiers LM and RI We’ve all heard the ol...
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News You Can Use:
Internal Medicine Specialists Should Prepare for Transition Codes, PCIP Pay
Here’s Your Rundown From the 2013 AMA Symposium. The American Medical Associatio...
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E/M Coding:
5 Simple Tips to Boost Your E/M Bottom Line
Heads up: Dig past ‘follow-up’ for acceptable chief complaint. E/M coding ...
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ICD-10:
Mononucleosis: Prepare for Infection, Complication Details
Coding under ICD-10 will depend on the level of detail providers note. When your inte...
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Reader Question:
Modifier 50 Not Applicable to 69205
Question: The physician administered anesthesia before removing a bead from each of a ch...
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Reader Question:
Check These Code Families for 'Case Management' Scenarios
Question: Services such as phone calls to patients, filling out forms, and coordinating ...
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Reader Question:
Never Submit 99211 With 96372
Question: One of our patients purchases her medicine through her prescription program an...
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Reader Question:
Use Various ECG Service Codes for Professional and Technical Components, Not Modifiers
Question: Our office owns an EKG/ECG device. How should we bill for tests performed in o...
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Reader Question:
Headache Doesn't Always Point to 346.x, Check the Actual Diagnosis modify erase
Question: A co-worker says we can submit "headache" and "migraine" o...
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You Be the Coder:
Follow-Up Visit Coding for 10060
Question: A patient saw our physician because of an abscess, and returned for a follow-u...
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