Neurology & Pain Management Coding Alert
Be Sure You Know Whats Involved Before Reporting Mental Status Exam
Although CPT includes a specific code for mental status examinations (96115, Neurobe... Read more
Although CPT includes a specific code for mental status examinations (96115, Neurobe... Read more
Get Your Fair Share When Reporting Concurrent Care
Insurers typically specify strict guidelines for payment of more than one service fo... Read more
Insurers typically specify strict guidelines for payment of more than one service fo... Read more
News Brief:
Look for Revised Place-of-Service Indicators in 2003
As part of CMS' proposed revisions to the 2003 Physician Fee Schedule, the agency ha... Read more
Look for Revised Place-of-Service Indicators in 2003
As part of CMS' proposed revisions to the 2003 Physician Fee Schedule, the agency ha... Read more
Correction:
Electroencephalogram
The November issue of Neurology Coding Alert (page 81) incorrectly stated that elect... Read more
Electroencephalogram
The November issue of Neurology Coding Alert (page 81) incorrectly stated that elect... Read more
Reader Questions:
Bilateral H-Reflex Testing
Question: The patient presented with a complaint of numbness and pain in the left ... Read more
Bilateral H-Reflex Testing
Question: The patient presented with a complaint of numbness and pain in the left ... Read more
Reader Questions:
Nursing Home Consult
Question: One of my physicians was asked to see a patient in a nursing home. We re... Read more
Nursing Home Consult
Question: One of my physicians was asked to see a patient in a nursing home. We re... Read more
Reader Questions:
In-Office Lumbar Puncture
Question: We've decided to provide lumbar punctures in the office instead of in ... Read more
In-Office Lumbar Puncture
Question: We've decided to provide lumbar punctures in the office instead of in ... Read more
Reader Questions:
Interpreting Test Results
Question: Our neurologist (on call for that week) ordered an MRI, MRA and CT scan fo... Read more
Interpreting Test Results
Question: Our neurologist (on call for that week) ordered an MRI, MRA and CT scan fo... Read more
Reader Questions:
Billing for Treatment to Relatives
Question: Recently, our neurology practice began treating an aunt of one of the group ... Read more
Billing for Treatment to Relatives
Question: Recently, our neurology practice began treating an aunt of one of the group ... Read more
Reader Questions:
Surface EMGs
Question: Is there a code for surface EMGs? Alaska Subscriber Answer: CPT provides... Read more
Surface EMGs
Question: Is there a code for surface EMGs? Alaska Subscriber Answer: CPT provides... Read more
You be the Coder:
Less Than 24-Hour Monitoring
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Less Than 24-Hour Monitoring
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Three Tips Unlock Optimum Reimbursement for EEG Monitoring
When reporting electroencephalographic (EEG) seizure monitoring... Read more
When reporting electroencephalographic (EEG) seizure monitoring... Read more
Three Guidelines Lead to Better Application of Modifier -25
Modifier -25 (Significant, separately identifiable evaluation and management service... Read more
Modifier -25 (Significant, separately identifiable evaluation and management service... Read more
Diagnostic Testing Is Not Exempt From Modifier -25 Requirement
In the fall of 2000, version 6.3 of the national Correct Coding Initiative (CCI) bun... Read more
In the fall of 2000, version 6.3 of the national Correct Coding Initiative (CCI) bun... Read more
CCI Update:
Version 8.3 Is Big but Not Bad for Neurology Practice
CMS, along with the National Technical Information Service (NTIS), has released vers... Read more
Version 8.3 Is Big but Not Bad for Neurology Practice
CMS, along with the National Technical Information Service (NTIS), has released vers... Read more
READER QUESTION:
Family Conference
Question: Should I charge an E/M service for a consultation with a family member... Read more
Family Conference
Question: Should I charge an E/M service for a consultation with a family member... Read more
READER QUESTION:
Cortical Mapping
Question: Can you explain proper reporting of 95961 and 95962? And how can we report... Read more
Cortical Mapping
Question: Can you explain proper reporting of 95961 and 95962? And how can we report... Read more
READER QUESTION:
Modifiers -GA and -GX
Question: I've heard that guidelines for Medicare modifiers -GA and -GX have changed... Read more
Modifiers -GA and -GX
Question: I've heard that guidelines for Medicare modifiers -GA and -GX have changed... Read more
You Be the Coder:
Botox Supplies
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Botox Supplies
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Know Your Limits:
Recognize Use and Frequency Guidelines for EDX Testing
When conducting electrodiagnostic (EDX) tests, neurologists must be cautious n... Read more
Recognize Use and Frequency Guidelines for EDX Testing
When conducting electrodiagnostic (EDX) tests, neurologists must be cautious n... Read more
Stop Overlooking CPO and Boost Your Bottom Line
Physicians supervising complex and multispecialty patient care can often recoup paym... Read more
Physicians supervising complex and multispecialty patient care can often recoup paym... Read more
Care Plan Oversight:
Medicare Does It Differently
Medicare payers do not follow CPT guidelines for care plan oversight (CPO) and will no... Read more
Medicare Does It Differently
Medicare payers do not follow CPT guidelines for care plan oversight (CPO) and will no... Read more
ICD-9 Update:
ICD-9 Update:
Prepare Now for 2003 Revisions Although the new year is still months away, some... Read more
ICD-9 Update:
Prepare Now for 2003 Revisions Although the new year is still months away, some... Read more
Reader Question:
Minimal EEG
Question: What is the correct code to report minimal EEG for a comatose patient? Neurol... Read more
Minimal EEG
Question: What is the correct code to report minimal EEG for a comatose patient? Neurol... Read more
Reader Question:
Neurophysiology Testing
Question: I have been receiving conflicting information on 95920. Can this code be u... Read more
Neurophysiology Testing
Question: I have been receiving conflicting information on 95920. Can this code be u... Read more
Reader Question:
Less Than 24-Hour Monitoring
Question: The neurologist monitored a patient for localization of cerebral seizures,... Read more
Less Than 24-Hour Monitoring
Question: The neurologist monitored a patient for localization of cerebral seizures,... Read more
Reader Question:
Defining Muscle Groups for Injections
Question: What constitutes a "muscle group" as defined by trigger point injection code... Read more
Defining Muscle Groups for Injections
Question: What constitutes a "muscle group" as defined by trigger point injection code... Read more
You Be the Coder:
Cranial Nerve EMG
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Cranial Nerve EMG
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Indicate Location to Enhance Specificity, Bolster Payment for Common Procedures
Many common neurological procedures, such as EMG testing, H-reflex studies and Botox i... Read more
Many common neurological procedures, such as EMG testing, H-reflex studies and Botox i... Read more
Part 3:
Prolonged Services: Reimbursement for t-PA Depends on E/M Service Codes
Because the Physician Fee Schedule assigns no physician work value to 37195 (Thrombo... Read more
Prolonged Services: Reimbursement for t-PA Depends on E/M Service Codes
Because the Physician Fee Schedule assigns no physician work value to 37195 (Thrombo... Read more
Myobloc Update:
Local Carriers Expand Coverage
Since CMS began accepting HCPCS code J0587 (Botulinum toxin type B, per 100 units)... Read more
Local Carriers Expand Coverage
Since CMS began accepting HCPCS code J0587 (Botulinum toxin type B, per 100 units)... Read more
News Brief:
No More E/M Documentation Guidelines?
Recently, the AMA announced on its Web site that on May 16, Health and Human Services ... Read more
No More E/M Documentation Guidelines?
Recently, the AMA announced on its Web site that on May 16, Health and Human Services ... Read more
Reader Question:
Care for LOPS Patients
Question: A recent Medicare program memo addressed the treatment and diagnosis... Read more
Care for LOPS Patients
Question: A recent Medicare program memo addressed the treatment and diagnosis... Read more
Reader Question:
Spinal Tap
Question: What is the proper code for a spinal tap? The service is usually coupled w... Read more
Spinal Tap
Question: What is the proper code for a spinal tap? The service is usually coupled w... Read more
Reader Question:
Concurrent Care
Question: A multiple sclerosis (340) patient's cardiologist admitted her to the hospit... Read more
Concurrent Care
Question: A multiple sclerosis (340) patient's cardiologist admitted her to the hospit... Read more
You Be the Coder:
Supervision Requirements
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Supervision Requirements
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Medical Necessity and Diagnostic Accuracy Make the Difference When Testing for Stroke
Although neurologists regularly face denials for diagnostic procedures to assess p... Read more
Although neurologists regularly face denials for diagnostic procedures to assess p... Read more
Correction:
RVU Increase for 95903
The June 2002 Neurology Coding Alert ("CMS Raises RVUs for NCS," page 46) incorrectl... Read more
RVU Increase for 95903
The June 2002 Neurology Coding Alert ("CMS Raises RVUs for NCS," page 46) incorrectl... Read more
Part 2:
Initial Inpatient and Consults Reimbursement for t-PA Depends on E/M Service Codes
Because the Physician Fee Schedule assigns no physician work value to 37195 (Thromboly... Read more
Initial Inpatient and Consults Reimbursement for t-PA Depends on E/M Service Codes
Because the Physician Fee Schedule assigns no physician work value to 37195 (Thromboly... Read more
News Brief:
Medicare Will No Longer Recognize sNCT
Neurology practices that use sensory nerve conduction threshold testing (sNCT) to diag... Read more
Medicare Will No Longer Recognize sNCT
Neurology practices that use sensory nerve conduction threshold testing (sNCT) to diag... Read more
CCI Update:
Version 8.2 Brings More Deletions Than Additions
National Technical Information Services (NTIS) has released version 8.2 of the nationa... Read more
Version 8.2 Brings More Deletions Than Additions
National Technical Information Services (NTIS) has released version 8.2 of the nationa... Read more
Reader Question:
Physical Therapy
Question: A physician comes to our office to perform trigger point injections for myof... Read more
Physical Therapy
Question: A physician comes to our office to perform trigger point injections for myof... Read more
Reader Question:
Consult Followed by Procedure
Question: We recently performed a consultation with findings that necessitated a spina... Read more
Consult Followed by Procedure
Question: We recently performed a consultation with findings that necessitated a spina... Read more
Reader Question:
Tackling Appeals
Question: Recently, our claims for multiple nerve conduction studies have been rejecte... Read more
Tackling Appeals
Question: Recently, our claims for multiple nerve conduction studies have been rejecte... Read more
Reader Question:
Day-After Visit
Question: Our group of neurologists evaluates a patient on day one. The following day ... Read more
Day-After Visit
Question: Our group of neurologists evaluates a patient on day one. The following day ... Read more
You Be the Coder:
Multiple Units of 95870
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Multiple Units of 95870
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Increase Reimbursement Potential When Reporting 92585-92586 and 95925-95930
A number of important limitations dictate proper reporting of evoked potential (EP... Read more
A number of important limitations dictate proper reporting of evoked potential (EP... Read more
EP Studies:
Indications Must Justify Testing
Payers are strict concerning medical justification for EP studies, but you can get... Read more
Indications Must Justify Testing
Payers are strict concerning medical justification for EP studies, but you can get... Read more
Part 1:
Critical Care Reimbursement for t-PA Depends on E/M Service Codes
Neurologists who report t-PA administration to stroke victims using only 37195 (Thro... Read more
Critical Care Reimbursement for t-PA Depends on E/M Service Codes
Neurologists who report t-PA administration to stroke victims using only 37195 (Thro... Read more
Complete ICD-9 Documentation Supports Higher E/M Services
Many factors determine the appropriate E/M service level for a given patient encounter... Read more
Many factors determine the appropriate E/M service level for a given patient encounter... Read more
Reader Question:
Botox and Full versus Limited Study
Question: What is the appropriate billing for Botox injection with EMG guidance? Spe... Read more
Botox and Full versus Limited Study
Question: What is the appropriate billing for Botox injection with EMG guidance? Spe... Read more
Reader Question:
Conscious Sedation
Question: Our neurologist bills for conscious sedation of children during MRIs, CT sca... Read more
Conscious Sedation
Question: Our neurologist bills for conscious sedation of children during MRIs, CT sca... Read more
Use New AMA Nerve List to Determine Billable NCS Units
Counting the number of separately billable nerve conduction studies (NCS) by determini... Read more
Counting the number of separately billable nerve conduction studies (NCS) by determini... Read more
CCI Update:
Version 8.1 Brings Minor Changes for Neurology
Version 8.1 of the national Correct Coding Initiative (CCI) is now available. The la... Read more
Version 8.1 Brings Minor Changes for Neurology
Version 8.1 of the national Correct Coding Initiative (CCI) is now available. The la... Read more
News Brief:
CMS Raises RVUs for NCS
CMS has announced a number of changes to the 2002 Physician Fee Schedule. Among them i... Read more
CMS Raises RVUs for NCS
CMS has announced a number of changes to the 2002 Physician Fee Schedule. Among them i... Read more
Reader Question:
Same Day,Multiple Services
Question: How should I report 62270 and 99233 when both are performed on the same da... Read more
Same Day,Multiple Services
Question: How should I report 62270 and 99233 when both are performed on the same da... Read more
You Be the Coder:
Multiple Evoked Potentials
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Multiple Evoked Potentials
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Reporting NCS Doesnt Have to Be Nerve-Wracking
Although nerve conduction studies (NCS) are among the procedures most common... Read more
Although nerve conduction studies (NCS) are among the procedures most common... Read more
Use the Internet to Research Carriers Policies
When in need of coverage information on NCS and other procedures, readers with Web acc... Read more
When in need of coverage information on NCS and other procedures, readers with Web acc... Read more
ICD-9 Coding Tips:
Signs,Symptoms Prove Medical Necessity for Diagnostic Testing
Diagnostic testing forms the core of neurology practice. Because such testing assumes ... Read more
Signs,Symptoms Prove Medical Necessity for Diagnostic Testing
Diagnostic testing forms the core of neurology practice. Because such testing assumes ... Read more
Reader Question:
EMGs in the Hospital
Question: Im having a problem with Medicares refusal to pay for EMGs performed by my doc... Read more
EMGs in the Hospital
Question: Im having a problem with Medicares refusal to pay for EMGs performed by my doc... Read more
Reader Question:
Observation Services
Question: What's the proper method for reporting hospital observation codes (99218-992... Read more
Observation Services
Question: What's the proper method for reporting hospital observation codes (99218-992... Read more
Reader Question:
Home Use of Biofeedback Machine
Question: May we charge for the use of biofeedback machines in the home? Florida Subscr... Read more
Home Use of Biofeedback Machine
Question: May we charge for the use of biofeedback machines in the home? Florida Subscr... Read more
Reader Question:
Quantitative Sensory Testing
Question: How should I bill for quantitative sensory testing? Maine Subscriber Answe... Read more
Quantitative Sensory Testing
Question: How should I bill for quantitative sensory testing? Maine Subscriber Answe... Read more
You Be the Coder:
Tensilon Test
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Tensilon Test
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Carpal Tunnel Syndrome:
Medical Record Must Outline Progressive Nature of Treatment for Payment
Carpal tunnel syndrome (CTS) is the most frequently diagnosed compression syndrome o... Read more
Medical Record Must Outline Progressive Nature of Treatment for Payment
Carpal tunnel syndrome (CTS) is the most frequently diagnosed compression syndrome o... Read more
Pediatric Neurology Exams:
Overcome E/M Requirement Shortcomings When Reporting
E/M documentation guidelines do not take into account the special circumstances associ... Read more
Overcome E/M Requirement Shortcomings When Reporting
E/M documentation guidelines do not take into account the special circumstances associ... Read more
Clarification:
Code 95816 With Intraoperative Monitoring
An example provided in the article on intraoperative monitoring in the January 2002 issu... Read more
Code 95816 With Intraoperative Monitoring
An example provided in the article on intraoperative monitoring in the January 2002 issu... Read more
Reader Question:
After-Hours Visit
Question: Due to a tight schedule, we agreed to see an established patient after our r... Read more
After-Hours Visit
Question: Due to a tight schedule, we agreed to see an established patient after our r... Read more
You Be the Coder:
Ischemic Limb Exercise Testing
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Ischemic Limb Exercise Testing
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Follow Four Steps to Pinpoint Payment for Botox Injections
When reporting botulinum toxin (Botox) injections, the challenges of choosing the corr... Read more
When reporting botulinum toxin (Botox) injections, the challenges of choosing the corr... Read more
Physician Fee Schedule Affects Coding Efficiency
Medicare's Physician Fee Schedule is a valuable resource but can be difficult to inte... Read more
Medicare's Physician Fee Schedule is a valuable resource but can be difficult to inte... Read more
News Brief:
Payment Conversion Factor Lowered for 2002
Owing to congressional mandates to decrease Medicare spending, the average national physic... Read more
Payment Conversion Factor Lowered for 2002
Owing to congressional mandates to decrease Medicare spending, the average national physic... Read more
Reader Question:
Digital EEG Analysis
Question: May we charge ambulatory EEG (95953) and digital analysis (95957) with 21-32 lea... Read more
Digital EEG Analysis
Question: May we charge ambulatory EEG (95953) and digital analysis (95957) with 21-32 lea... Read more
Reader Question:
M-Waves Versus F-Waves
Question: What's the difference between M-waves and F-waves? How are they coded?Californ... Read more
M-Waves Versus F-Waves
Question: What's the difference between M-waves and F-waves? How are they coded?Californ... Read more
Reader Question:
Autonomic Testing
Question: Some payers consider autonomic testing codes (95921, 95922 and 95923) to be mutu... Read more
Autonomic Testing
Question: Some payers consider autonomic testing codes (95921, 95922 and 95923) to be mutu... Read more
You Be the Coder:
Blink Reflex Testing
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Blink Reflex Testing
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Dont Be Shocked! Number of Muscles Tested, Area and Frequency Affect Payment for EMGs
Neurologists regularly provide electromyography (EMG) testing (95860-95872) to help di... Read more
Neurologists regularly provide electromyography (EMG) testing (95860-95872) to help di... Read more
CCI Version 8.0 Update:
Minimal Changes Affect Neurologists
Version 8.0 of the national Correct Coding Initiative (CCI) is available and went into eff... Read more
Minimal Changes Affect Neurologists
Version 8.0 of the national Correct Coding Initiative (CCI) is available and went into eff... Read more
News Brief:
A Kinder, Gentler CMS?
On Nov. 2, 2001, CMS posted to the Federal Register (Volume 66, Number 213) a proposal... Read more
A Kinder, Gentler CMS?
On Nov. 2, 2001, CMS posted to the Federal Register (Volume 66, Number 213) a proposal... Read more
Reader Question:
Multiple Trigger-Point Injections
Question: When reporting multiple trigger-point injections, I use 20550 and change the uni... Read more
Multiple Trigger-Point Injections
Question: When reporting multiple trigger-point injections, I use 20550 and change the uni... Read more
Reader Question:
Psychological Testing
Question: As a neurologist, may I provide and bill for psychological testing, 96100? If so... Read more
Psychological Testing
Question: As a neurologist, may I provide and bill for psychological testing, 96100? If so... Read more
Reader Question:
Same-Day Office Visit and Hospital Admission
Question: If I see a patient in the office and admit him or her to the hospital, I still... Read more
Same-Day Office Visit and Hospital Admission
Question: If I see a patient in the office and admit him or her to the hospital, I still... Read more
Reader Question:
Evoked Potentials
Question: Our carrier will only reimburse for visual evoked response testing if I cod... Read more
Evoked Potentials
Question: Our carrier will only reimburse for visual evoked response testing if I cod... Read more
Location, Location, Location! Reimbursement for Epidural Blocks Depends on Establishing Medical Necessity and Area
Epidural blocks provide effective pain management for patients with spine-related injuri... Read more
Epidural blocks provide effective pain management for patients with spine-related injuri... Read more
Intraoperative Monitoring:
Review Regulations To Render
Intraoperative neurophysiological testing monitors a patient for complications during ... Read more
Review Regulations To Render
Intraoperative neurophysiological testing monitors a patient for complications during ... Read more
Anthrax Coding Report Free on Web
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Approved Procedures for Intraoperative Surgeries
Specific procedures/surgeries are eligible for intraoperative monitoring. The following ... Read more
Specific procedures/surgeries are eligible for intraoperative monitoring. The following ... Read more
Correction:
Uni- or Bilateral CTS
The answer to Reader Question Uni- or Bilateral CTS on page 94 of the December 2001 issue ... Read more
Uni- or Bilateral CTS
The answer to Reader Question Uni- or Bilateral CTS on page 94 of the December 2001 issue ... Read more
Reader Question:
Neuropsych Evaluations
Question: Our practice includes a clinical psychiatrist (CP) who performs neuropsycholog... Read more
Neuropsych Evaluations
Question: Our practice includes a clinical psychiatrist (CP) who performs neuropsycholog... Read more
Reader Question:
Speech Therapy
Question: We would like to provide speech therapy for our patients. There is a hospital ... Read more
Speech Therapy
Question: We would like to provide speech therapy for our patients. There is a hospital ... Read more
Reader Question:
Upper Airway Resistance Syndrome
Question: What is the ICD-9 code for upper airway resistance syndrome (UARS)? ... Read more
Upper Airway Resistance Syndrome
Question: What is the ICD-9 code for upper airway resistance syndrome (UARS)? ... Read more
Reader Question:
Surface Electromyography
Question: Is there a code for surface electromyographies (EMGs) that are used for tremors ... Read more
Surface Electromyography
Question: Is there a code for surface electromyographies (EMGs) that are used for tremors ... Read more
You Be the Coder:
Bilateral Nerve Conduction Study
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Bilateral Nerve Conduction Study
Test your coding knowledge. Determine how you would code this situation before loo... Read more