Neurology & Pain Management Coding Alert
Check That Diagnoses You Submit Are in ICD-9
Question: Our Blue Cross carrier denied our claim with diagnoses 847.0, 307.87 and 346.0; the carrier says we submitted an invalid, noncovered code. How else could I have reported the patient's neck pain? Massachusetts Subscriber Answer: When you report 847.0 (Sprains and strains of other and unspecified parts of back; neck), you should also include a date of injury and an E code to explain how the injury occurred (such as E813.x, Motor vehicle traffic accident involving collision with other vehicle). Code 346.00 (Classical migraine; without mention of intractable migraine) is a valid code, so you should be fine submitting it, but be aware that 346.0 needs a fifth digit. ICD-9 does not include diagnosis 307.87 but does include 307.81 (Tension headache); that might be the incorrect code the carrier referenced. Check the documentation because the incorrect diagnosis you submitted might be due to a simple keying error.
Neurology & Pain Management Coding Alert
- Red Flag:
Urinary or Sepsis Problems Can Lead to Neurological Coding Complications
Code neurological conditions based on diagnosis, not symptoms You might be an ace at coding [...] - You Be the Coder:
Multiple-Level EMGs
Question: Should we bill modifier 59 when our neurologist performs multiple levels of EMGs? For [...] - Procedure Basics:
You Can Report 96118, 96119 Separately -- if Details Fit
Watch these 2 areas to keep your claims legit If correctly reporting CPT 96118 and [...] - Compliance:
PHI Release Authorizations Aren't Always Forever
Make sure your authorization to disclose PHI hasn't expired One year ago, your patient signed [...] - Reader Questions:
Watch Documentation for tPA and Critical Care
Question: What is the appropriate way to bill for tPA? Can we bill for tPA [...] - Reader Question:
Consult Criteria May Differ by Payer
Question: I-ve seen information containing consultation definitions that differ from CPT. How do I know [...] - Reader Question:
95920 Can't Coincide With Office Visit
Question: One of our physicians says he can concurrently monitor intraoperative neurophysiology while conducting office [...] - Reader Question:
Reason for Fall Helps Guide Diagnosis
Question: What diagnosis should I report for a patient who falls frequently? New Jersey Subscriber [...] - Reader Question:
Check That Diagnoses You Submit Are in ICD-9
Question: Our Blue Cross carrier denied our claim with diagnoses 847.0, 307.87 and 346.0; the [...] - Reader Question:
Understanding Transitional Facility vs. Nonfacility
Question: What is the difference between a transitional nonfacility and a transitional facility? I-m not [...] - Reader Question:
Verify Details Before Using 95812
Question: Should we report 95812 or 95816 for an EEG obtained in the awake state [...] - Reader Question:
Observe PHI Rules for Patients and Staff
Question: How should a medical facility handle employees- access to their own medical records or [...]
