Internal Medicine Coding Alert
READER QUESTION ~ Charge for PPD Readings in Certain Situations
PDF
Question: We charge for a PPD placement but historically have not coded for reading the test result. Can we report the reading separately, or is it included in the first visit when the nurse places the PPD? Answers to You Be the Coder and Reader Questions were reviewed by Kathy Pride, CPC, CCS-P, director of government program services for QuadraMed in Reston, Va.; and Bruce Rappoport, MD, CPC, a board-certified internist who works with physicians on compliance, documentation, coding and quality issues for Rachlin, Cohen & Holtz LLP, a Fort Lauderdale, Fla.-based accounting firm with healthcare expertise.
Virginia Subscriber
Answer: Start by coding 86580 (Skin test; tuberculosis, intradermal) for the test.
The answer to whether you code for the reading depends on the situation -- and on whom you ask. Some coders say the PPD reading is inclusive, which means you should not code it separately from the initial test.
Other coders say a negative PPD reading is inclusive, but a positive PPD reading is worth coding separately.
Their reasoning: A positive reading usually results in a formal office visit because of the additional work involved by the provider (patient history, examination, laboratory studies, chest x-ray, patient education and potential treatments). If your physician initiates the workup following a positive PPD test, it's reasonable to report the appropriate E/M code based on the encounter's specifics. If you have doubts about how to code this scenario, check with your carrier.
Internal Medicine Coding Alert
- Here's Why Multiple Lesions Don't Always Mean Multiple Codes
Under certain conditions, you should add repair areas and report 1 code
When patients develop lesions, [...] - When You See a 'Targeted' Code, Forget About Moderate Sedation Code
Coders report that some insurers are now reimbursing sedation
When your physician performs moderate (or conscious) [...] - YOU BE THE CODER ~ ICD-9 Coding for Patients Who Exhibit Depressive Symptoms
Question: What ICD-9 codes should I use when a patient exhibits signs of depression, but [...] - READER QUESTION ~ Stress Test Code Depends on Physician Equipment, Involvement
Question: A morbidly obese patient who was having chest pains reported to the office for [...] - READER QUESTION ~ Use Biopsy Code for Diagnostic Removal
Question: The physician saw an established patient with a patch of rough skin on his [...] - READER QUESTION ~ Suture Removal Usually Bundled Into Surgical Package
Question: When an established patient reports to our physician for suture removals, what code can [...] - READER QUESTION ~ Beware Bundled Services on Critical Care Claims
Question: Our physician performed 64 minutes of critical care on a patient in cardiac arrest. [...] - READER QUESTION ~ Location Won't Drive Observation Service Coding
Question: Our internist performed an observation service on a patient who was not in the [...] - READER QUESTION ~ Patient Specifics Provide Keys to Best 'Chronic Pain Syndrome' Code
Question: What is the best diagnosis code for chronic pain syndrome?
Indiana Subscriber
Answer: "Chronic pain syndrome" [...] - READER QUESTION ~ Knowing These Terms Can Correct Your Bronchitis Denials
Question: When I use 491.9, payers often deny the code and request additional information. How [...] - READER QUESTION ~ Charge for PPD Readings in Certain Situations
Question: We charge for a PPD placement but historically have not coded for reading the [...]