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Neurology & Pain Management Coding Alert

Cover All Your Bases When Batting for Inflammatory Myopathies Using This Playlist
You no longer have to lump these two diseases under 359.89. Stumped by what code to use f... Read more
What's IBM? Identify Its Traits, Signs
IBM is one of a group of muscle diseases known as the inflammatory myopathies, which are c... Read more
Avonex Quick Facts
What is it: Avonex is the brand name of the drug form of Interferon beta-1a, which is use... Read more
5 Easy Steps Snag Every Avonex-Related Dollar
Your carrier-supply pay hinges on using Q, not J, code.  When coding for Avonex inject... Read more
Check Timeframe Before Turning to Sex Headache Dx
When sex gives patient a headache,use this all-encompassing code. Coding for sex-associat... Read more
READER QUESTIONS :
Hemisensory Deficit Requires 2 ICD-9 Codes
Question: In our rehab clinic, we saw patient with stroke (cerebrovascular accident [CVA... Read more
READER QUESTIONS :
ICD-9 2010 Alert: Temporal Sclerosis
Question: Our neurologists saw a case of temporal sclerosis. What code should I use for t... Read more
READER QUESTIONS :
Can a Sleep Study Code Describe an Awake Test?
Question: A sleep study was ordered for a patient diagnosed with hypersomnolence. The neu... Read more
READER QUESTIONS :
96110's Report Requires Recording Result
Question: Can you clarify what documentation needs to appear in the medical record when w... Read more
READER QUESTIONS :
ICD-9 2010 Alert: Update Your Dysarthria Code
Question: What ICD-9 code should I use for a patient being treated for dysarthria after a... Read more
READER QUESTIONS :
Coding for ENG? Strike Out 92270
Question: My neurologist wants to report 92270 for saccadic testing during an electronyst... Read more
READER QUESTIONS :
Pediatric Seizure: Ohtahara Syndrome
Question: A newborn was diagnosed with Ohtahara syndrome. Is there an ICD-9 code for this... Read more
READER QUESTIONS :
What's a Wada Test?
Question: What CPT code do I use for EEG performed in Wada testing? What is a Wada test? ... Read more
You Be the Coder :
95903, 95900-59? Verify Distinct Nerve
Question: We billed 95900 and 95903 for a motor nerve conduction study and an F-wave stud... Read more
ICD-9 2010:
Benefit From New Nervousness Codes Using This Guide
You'll have better symptom descriptions thanks to 5 new fifth-digit codes. ICD-9 2010 bri... Read more
Crack Botulinum Coding in 5 Steps
This rule let you capture extra 64614 unit. When your neurologist uses botulinum toxin to... Read more
ICD-9 Gives You More Choices for Brain Injury Coding
Check out V80.01 and V80.09 for special screenings. The newest edition of ICD-9 changes g... Read more
Consultation Pay Might Cause 2 Decreases -- One's a Timesaver
For Medicare, you'd use E/M codes instead. Your 99241-99255 revenue -- and your comp... Read more
READER QUESTIONS:
Choose Between Office and Admission Codes
Question: Our physician saw a patient in the office and decided to admit her to the hospi... Read more
READER QUESTIONS:
Want to Bill Prolonged Time? Read This First
Question: If my neurologist spends a prolonged amount of time with the patient during an ... Read more
READER QUESTIONS:
Confirm Spinal Block Location for Fluoro Code
Question: Can I report fluoroscopy in conjunction with pain management blocks? If so, wha... Read more
READER QUESTIONS:
Know Nuances Between Schwannoma, Neurofibroma
Question: What is the difference between a schwannoma and neurofibroma? Oregon Subscribe... Read more
READER QUESTIONS:
Note Differences Between 'Asleep' and 'Drowsy'
Question: My neurologist administered an EEG lasting for 20 minutes. Her documentation in... Read more
READER QUESTIONS:
Report Discontinued Procedure With Modifier
Question: During a lumbar puncture, a patient experienced leg numbness. Our physician ter... Read more
READER QUESTIONS:
Flat Fee Might Be Best for Visit Without Patient
Question: Does CPT include a code we can use when the physician sees the patient's family... Read more
You Be the Coder:
Double Nerve Study Requires Modifier
Question: I'm new to nerve conduction studies. We are billing 95900 in conjunction with 9... Read more
Catch Clues to Neurobehavioral/Neuropsychiatric Testing
Knowing and reporting the differences between tests protects your reimbursement. When you... Read more
Solve Carpal Tunnel Coding with 5 Guidelines
Dx, treatment options point the way to smooth CTS reporting. Think coding carpal tunnel s... Read more
Pain Management Corner:
Smash Payment Paybacks for Facet Joint Injections
Tighten up these pain codes for spotless claims every time. If your practice is like many... Read more
READER QUESTIONS:
Attach E Code to Coma for Specificity
Question: Can 780.01 be used for a drug-induced coma? Is there another code we can use th... Read more
READER QUESTIONS:
'In-House' EEG = Global Procedure
Question: My neurologist did the professional component of 95819 with equipment we own, h... Read more
READER QUESTIONS:
HPI + ROS Needed for 99232
Question: I have physician documentation stating that an inpatient "continues to have lef... Read more
READER QUESTIONS:
Add 59 for EEG With Polysomnography
Question: My neurologist completed an extended EEG and sleep staging polysomnography stud... Read more
READER QUESTIONS:
2 Ways to Code Complaint From Past Injury
Question: We have a patient with previous injury to the spine that is now causing neck pa... Read more
READER QUESTIONS:
TCD Needs Additional Risk Factors for Payment
Question: Our neurologist performed a transcranial Doppler study (TCD) on a patient who c... Read more
You Be the Coder:
Preconfigured Array Test
Question: My neurologist performed a neurodiagnostic test with a preconfigured electrode ... Read more
Crack NMJ Testing Challenges for Spotless Claims
Counting nerves correctly for 95937 = fewer repayments. Even though your neurologist may&... Read more
Determine New/Established Between Docs in Your Office
3 questions let you code transfers flawlessly and retain payment. You may find this scena... Read more
NEW! Pain Management Corner:
Lock Down Cluster, Tension Headache Dx Using These Clues
Bonus: This map makes ICD-10 prep a piece of cake. (Editor's note: Pain Management Corner... Read more
READER QUESTIONS:
Is E/M Included in 96116?
Question: My neurologist has recently begun doing neurobehavioral testing, and says he ca... Read more
READER QUESTIONS:
Yes or No: Modifiers for 64612-64613?
Question: When I report 64612 and 64613 to Medicare at the same time, I'm unsure what mod... Read more
READER QUESTIONS:
Both Extremities Treated -- Use Mod 50?
Question: My neurologist treated both extremities at the same 64616 session. Is it approp... Read more
READER QUESTIONS:
Established Patient Still Established With New Doc
Question: Our practice hired a new neurologist after another neurologist retired. The pat... Read more
READER QUESTIONS:
Choose Inpatient Code for Same-Day E/M
Question: My neurologist met an established patient at the hospital on Friday morning for... Read more
READER QUESTIONS:
Where Should You Count Forgetfulness?
Question: Is there a CPT code for performing a Mini Mental Status Exam (MMSE) during an o... Read more
READER QUESTIONS:
Avoid AQ Modifier If You're in Automated File
Question: I'm confused about whether to apply modifier AQ on my claims. If our ZIP code i... Read more
You Be the Coder :
Home Sleep Tests Must Meet Criteria
Question: My physician had a patient perform a home sleep test for obstructive sleep... Read more
Recognize Sepsis/UTI Neuro Interplay to Capture Consult Pay
Code neurological issues to avoid duplicating primary physicians diagnoses. ... Read more
Follow These Tips to Protect Typically Bundled NCS, EEG Pay
Your modifier 59 claims will pass muster thanks to this quick refresher. ... Read more
Find Out How to Code When
Coding symptoms can yield proper reimbursement. Where can you find ... Read more
READER QUESTIONS :
Code Studies by Date
Question: Our neurologist reads polysomnograms, sleep studies, and EEGs. Shoul... Read more
READER QUESTIONS :
7 Codes for ENG Machine Use
Question: Which codes are applicable to vestibular testing in an office settin... Read more
READER QUESTIONS :
Take Care With Bilateral Injections
Question: Medicare denied two bilateral Greater occipital nerve injections (64... Read more
READER QUESTIONS :
EMG Needle Charge
Question: What is the correct code for disposable sterile needles used for ele... Read more
READER QUESTIONS :
ED toYour Neuro: New Patient or Consult?
Question: When an emergency department (ED) physician calls and says he has a ... Read more
READER QUESTIONS :
Careful With CCI Edits for TTS
Question: My physician sees a Medicare patient and decides the patient needs a... Read more
READER QUESTIONS :
Payment for Switching Same-Day Pharmacy
Question: A patient who relocated to another state wants to pick up her Myoblo... Read more
READER QUESTIONS :
Same-Day, Different-Specialty E/M Services OK
Question: I had patients see two physicians on the same day. May I submit an E... Read more
READER QUESTIONS :
Extend Fever Dx to 5th Digit
Question: Medicare denied 780.6 as an invalid code for a patient who had a hig... Read more
You Be the Coder :
3 Rules for EEG Video Recording
Question: My neurologist performed a standard EEG (95819-26, Electroencephalog... Read more
Watch for OIG Regulations on Polysomnography and Sleep Studies
Not all tests during sleep are alike, and an audit might be waiting. Slee... Read more
Report MS-Related Dysphagia With Specificity, No Unbundling
Comprehensive treatment code is key to pay on  NMES, TENS, DPNS claims. ... Read more
Use Up to Level-4 E/M for Less Than Complete ROS
These FAQs answer your top recording and amount dilemmas. Ever heard a ch... Read more
Prepare for Sleep Test Audit by Focusing on Work-Up Notes
These clues help you distinguish between 95805-95807 and 95808-95811. ... Read more
Readers Questions:
Avenox: Still Under "Chemo" Rules
  Question: I was told by our Avonex representative that I should be billing the ... Read more
Readers Question:
New or Established? Always Count Years
Question: We had a patient seen for a consultation in a hospital, and our physician ... Read more
Reader Questions:
Botulinum: Bill Site, Not Injections
Question: Should I be billing CPT 96372 (Therapeutic, prophylactic, or diagnostic inje... Read more
Readers Questions:
It's Okay to Choose an Abnormal Dx
Question: My physician performed a physical exam on a patient that led to a conclusi... Read more
Reader Questions:
No NCCI Edits for These Nerve Tests
Question: My neurologist performed 95860, 95900, and 95904 on a patient. Shoul... Read more
You Be the Coder:
Some EMG Already Bilateral
Question: When performing electromyography (EMG) on cranial nerve supplied muscles v... Read more
Denial Woe:
Bust 95900 Bundles By Employing 3 Tactics
The AMA, modifier 59, and a highlighter can win NCS appeals. You can kiss your -without... Read more
Stop Lumping Multiple Tests Into 1 With NCS Exclusion Primer
You can separately bill a second NCS when you spot 3 circumstances. Don't let a CPT ins... Read more
Fully Code Distal Symmetric Polyneuropathy
Tests and diagnosis codes are at the center of your coding for DSP. Since distal symmet... Read more
Use Modifier 53 to Code Terminated Procedures
Improve lumbar puncture accuracy with these documentation tips. What steps should you t... Read more
READER QUESTIONS:
No Consult Charge for Transfer of Care
Question: A patient was seen in the emergency room for neck pain. The ER doctor asked my... Read more
READER QUESTIONS:
Use Time and Modifiers Carefully for EMGs
Question: My neurologist preformed EMGs in a hospital setting on four different patients... Read more
READER QUESTIONS:
Watch For CPT 2009 22 Error
Question: CPT 2009's inside cover states that the definition for modifier 22 is -Unusual... Read more
READER QUESTIONS:
3 Codes for PQRI E-Prescriptions
Question: My physician is going to begin electronic prescriptions following PQRI guideli... Read more
READER QUESTIONS:
Work With Hospitals to Determine TC
Question: Our neurologists sometime perform diagnostic studies on Medicare inpatients in... Read more
READER QUESTIONS:
What Code for Rare Neuro Disease?
Question: What is the correct diagnosis code for Segawa disease? Nevada Subscriber Ans... Read more
READER QUESTIONS:
Code 1 Channel + Both Sides as Bilateral With 95865
Question: My neurologist performed an electromyography (EMG) on the laryngeal muscles vi... Read more
You Be the Coder:
Sleep Apnea Can Be Symptom or Dx
Question: What is the difference between 327.23 and 780.57? Tennessee Subscriber Answe... Read more
4 Tips for Proper Peripheral Nerve Procedures Diagnosis Accuracy
Use caution when choosing between 350.1 and 729.2 or risk denials. Here's the scenario:... Read more
Take Care With New Prolonged Services Rules
Revisions to +99356, +99357 make Medicare payments easier to obtain. The deletion of mo... Read more
READER QUESTIONS:
Arm Yourself for Successful PQRI Reporting
Question: Reporting on PQRI measures seems complicated. I-m not sure my office has the t... Read more
READER QUESTIONS:
Mind CPT Deletions for Botox
Question: What is the correct way to report Botulinum toxin injections? Florida Subscri... Read more
READER QUESTIONS:
Use Caution Filing for Interpreter Service
Question: Which code should I use for using an interpreter with a Medicare patient? Tex... Read more
READER QUESTIONS:
Look to Audiologic Section for BAER
Question: How do we code for brainstem auditory evoked response (BAER) testing? New Jer... Read more
READER QUESTIONS:
Choose 96119 for Cognitive Function Tests
Question: One of our office RN staff performed a cognitive assessment on a patient consi... Read more
You Be the Coder:
When Is Modifier 59 Right for EMG?
Question: A patient had the following EMGs:95861 (Needle electromyography; 2 extremities... Read more
Overcome the Transcranial Doppler Testing Reimbursement Challenge
TCD is misunderstood by some payers -- help clear the fog. Proving medical necessi... Read more
3 Tips for Easily Solved Code Compliance Errors
Reduce denials for your practice by reading the fine print. There are always a few tric... Read more
Specify Neurologic Pain Diagnosis for Reimbursement
Be careful not to put words in your neurologist's mouth, or risk audit woes. Imagine yo... Read more
News You Can Use:
Compliance Alert: OIG Counts $20.4 Billion in Errors in 2008
Agency combed everything from injections to consulting agreements. The Office of the In... Read more
Reader Questions:
Global Period Determines Modifier 25 or 57
Question: What separates or determines the choice of modifiers 25 or 57? Maryland Subs... Read more
Reader Questions:
Stop Denials From Intraoperative Monitoring
Question: I am wondering if you have any information about coding and reimbursement for ... Read more
Reader Questions:
Consults In-Group = Established Patients?
Question: When my neurologist refers to another physician within our group, should I cod... Read more
Get the Most for Headache-Related Nerve Blocks in 3 Easy Steps
Tackle correct 64400 and 64405 coding head-on to ensure payment. If your neurology prac... Read more
Pop Quiz:
Test Yourself Against Tricky Coding Questions
Did you conquer the coding conundrums of 2008? Find out now. Before you set aside that ... Read more
Check Your Work:
Answers to the Quiz
Stay sharp on some of coding's more puzzling answers. How did you do? Check your answer... Read more
Reader Questions:
Does CMS Cover TIPs?
Question: Does Medicare still cover intradiscal electrothermal therapy (IDET)? South Da... Read more
Readers Questions:
Use 95928-95929 for Central Motor Tests
Question: My neurologist documented that she performed motor EP studies. How should I co... Read more
Reader Questions:
Watch for HIPAA Issues With E-Mail
Question: I sometimes e-mail patient records to consultants or other coders for help on ... Read more
Reader Questions:
Find Cervical Radiculopathy in ICD-9
" Question: I-m trying to find a diagnosis code for cervical radiculopathy, but I... Read more
You Be the Coder:
Don't Downcode E/M Service Modifier
Question: Another physician asked my neurologist to provide a consultation on a patient.... Read more
Prep for 2009 CPT Changes to New Plantar Nerve Codes and More
Epley maneuver and other new codes offer more places to get reimbursement. The time to ... Read more
Say Goodbye to Modifier 21
CPT wants you to take a shortcut by going straight to 99354-99359. If you-ve tried addi... Read more
Stay Out of Medicare Trouble When Coding Consults
Prevent denials by studying these 3 tips. If you-re confused about when and how to repo... Read more
News You Can Use:
Celebrate a Boost to Level-3 Office Visits
Check for changes in the 2009 fee schedule in 2 places. Figuring out where the 1.1 perc... Read more
Reader Questions:
Modifiers + Unlisted Code = Denial
Question: May I append the bilateral modifier 50 to unlisted procedure code 64999? Nebr... Read more
Reader Questions:
Use ICD-9 Dx for Injury-Related Cognitive Deficits
Question: Which diagnosis code should we report when a traumatic brain injury causes cog... Read more
Reader Questions:
2 of 3 Okay to Bill For 99215?
Question: To bill a 99215 visit, can I have a comprehensive history, comprehensive exam,... Read more
Reader Questions:
Get Reimbursement for MMSE With E/M Code
Question: I am having a difficult time obtaining reimbursement for the Mini Mental Statu... Read more
You Be the Coder:
95900 Needs a 59 Modifier
Question: My neurologist received payment from Medicare for the EMG and other nerve cond... Read more
Sleep Test or Polysomnography? How to Tell the Differenc
Coding these different procedures incorrectly could raise a red flag for auditors. They m... Read more
Get in Step With Facet Joint Coding to Avoid OIG Bull's-Eye
Most coders err with 64470 and 64475 -- here's how to buck the trend. The Office of Inspe... Read more
Begin Prepping for More Specific ICD-10 Today
Coming soon: Changes to seizure codes -- and everything else. If you think keeping up ... Read more
Reader Question:
Combo Nerve Injections Aren't Unlisted
Question: Should I use 64999 (Unlisted procedure, nervous system) to report a nerve block ... Read more
Reader Question:
Does Modifier 50 Apply to Injections on 2 Sides?
Question: When my neurologist injects trigger points in more than three muscles on each si... Read more
Reader Question:
Choose Appropriate E/M for Second-Opinion Visits
Question: Since CPT doesn't carry confirmatory consultation codes, how should I report the... Read more
Reader Question:
Coding Follow-Up Consults
Question: An ER doctor requested our neurologist's opinion on a Medicare patient. Our prov... Read more
Reader Question:
Use Hard Copy to Back Up Modifier 22 Claims
Question: Should I always file modifier 22 claims manually? Is there an easier and faster ... Read more
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