Internal Medicine Coding Alert
Medicare Says 11719 Is Routine
Question: A Medicare patient presented with a painful ingrown toenail. The internist trimmed the nail. Which code should I use? Also, since the patient didn't have a systemic condition, will Medicare cover the procedure? Answer: When an internist trims an ingrown nail, you should report CPT 11719 (Trimming of nondystrophic nails, any number). If the physician didn't document systemic findings, such as diabetes (250.xx), Medicare will not reimburse this service. The government payer considers 11719 routine foot care. -- Answers for You Be the Coder and Reader Questions were provided by Kathy Pride, CPC, CCS-P, a coding consultant for QuadraMed in Port St. Lucie, Fla.; and Bruce Rappoport, MD, CPC, a board-certified internist who works with physicians on compliance, documentation, coding and quality issues for RCH Healthcare Advisors LLC, a Fort Lauderdale, Fla.-based healthcare consulting company.
Alabama Subscriber
Internal Medicine Coding Alert
- Are You Losing $275 on Lesion Excision Coding? We Can Help
Why your 11400-11646 reporting may not measure up
When your internist excises a lesion (11400-11646), you [...] - Get the Pay You Deserve With Multiple Lesion Removals
Experts say you have to know which modifiers to use
If a patient presents to your [...] - You Be The Coder:
Concurrent Care With Pulmonologist
Question: In our multi-specialty group, an internist and pulmonologist wanted to bill for concurrent care [...] - Coding Quiz Bone Up on Your Lesion Excision Reporting
To ensure you know a lesion's pathology and size, test your coding knowledge of codes [...] - News You Can Use:
Say Goodbye to Your Coding Grace Periods
Tip: Review the Federal Register to update charge forms
CMS has scrapped the 90-day grace period [...] - Let the Right Answers Earn You $70 for Observation Care
Experts show when to choose 99218 instead of 99212
Reporting established patient codes (99212-99215) when your [...] - Coding Quiz Answers
Answer 1. False. Before supplying a procedure or ICD-9 code for lesion excision, you should [...] - Reader Question:
Report 99341-99345 for Home Visits
Question: How should we report home visits?
New Jersey Subscriber Answer: You should code home visits [...] - Reader Question:
Preventive Medicine = Carve-Out Coding
Question: A Medicare patient had a preventive visit (99397), E/M (99213-25), vaginal cancer screening (G0101) [...] - Reader Question:
Bill Established Patients Under Incident-To
Question: Do you have any tips for reporting a non-physician practitioner's service to Medicare when [...] - Reader Question:
Patient Presence Means E/M Payment
Question: The internist spent more than an hour with a family discussing an elderly patient's [...] - Reader Question:
Use 99385 for Sports Physicals
Question: Recently our internist performed a sports physical for an established patient's son. Should we [...] - Reader Question:
Get Specific With E Codes
Question: When should we use E codes? Do they help us receive reimbursement?
Arizona Subscriber
Answer: Although [...] - Reader Question:
No More Starred Procedures Means More Modifiers
Question: What's the practical significance of losing the starred designation in CPT 2004? For example, [...] - Reader Question:
Medicare Says 11719 Is Routine
Question: A Medicare patient presented with a painful ingrown toenail. The internist trimmed the nail. [...] - Get ABNs, or Risk Picking Up Patient Tabs
Without ABNs, unpaid Medicare bills may become your problem
If you aren't obtaining advance beneficiary notices [...] - ABNs:
What to Change, What to Leave Alone
Got an itch to make a switch on an ABN? Proceed with caution
When it [...] - You Be The Expert:
ABNs and Uncovered Medicare Services
Question: Our office obtains advance beneficiary notices each time there is some doubt about whether [...] - Reader Question:
Follow the CMS Definition of 'Deliver'
Question: Since the purpose of an ABN is to inform the patient about a service, [...]
