Internal Medicine Coding Alert
Look for New V Code to Track Insulin Use:
Deletions don't mean you can forget about insulin dependence Although internal medicine practices will be using pancreatic cells, not insulin use, to determine types of diabetes, your internist should still document whether a patient takes insulin. To help you accurately report insulin use, CMS has created new ICD-9 code V58.67 (Long-term [current] use of insulin). You should list V58.67 for any patient who's taking insulin regularly, says Beth Fisher, medical systems specialist with the National Center for Health Statistics (NCHS) in Hyattsville, Md. Watch out: Don't let the phrase "long-term" in the code's descriptor trip you up. Neither CMS nor NCHS has defined long-term, Fisher says. Also, because the descriptor lists "current" beside the phrase, you can assign V58.67 for nearly "anybody who is using insulin," she adds. For instance, you could use the code for a gestational diabetes (648.8x) patient who's on insulin. What to do: Typically, internists will use V58.67 as a secondary code to identify patients with Type II diabetes who take insulin. That means you will likely report V58.67 with the following fifth digits:
For example, suppose the physician diagnosed a patient with 250.12 (Diabetes with ketoacidosis; type II or unspecified type, uncontrolled), and the patient was on insulin. In that case, you may be able to list V58.67 as a secondary diagnosis code.
Internal Medicine Coding Alert
- 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 internist [...] - 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 [...] - 3 Easy Steps Lead to 93784-93790 Reimbursement
Why assigning 796.2 is key for Medicare claims You can get paid for the internist's [...] - Look for New V Code to Track Insulin Use:
Deletions don't mean you can forget about insulin dependence Although internal medicine practices will be [...] - Reporting 99231-99233:
Don't Risk Losing $2,400 a Year
Expert answers can strengthen your documentation Are you worried that your internist is downcoding subsequent-care [...] - 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 embedded [...] - 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 [...] - 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 separate occasions [...] - Reader Question:
1 Muscle Injection Means 1 Code
Question: Our internist has begun performing pain management. Do you have any tips on reporting [...] - 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 internist [...] - 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 has [...] - 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 requires [...] - You Be the Expert:
Same-Day Spirometry/Bronchospasm Tests
Question: Our internist conducted a spirometry and bronchospasm test on a patient on the same [...]
