Neurology & Pain Management Coding Alert
Verify That ADHD Claim Goes to Correct Payer
Question: Our payer is denying any claims our pediatric neurologists submit for patients with ADHD if we include a diagnosis from the 290-319 series. Are there any alternative diagnoses? Ohio Subscriber Answer: The correct diagnosis for ADHD is 314.01 (Attention deficit disorder; with hyperactivity). If the payer denies your claims with this diagnosis, it might be because your physician is not a mental-health provider. Check to see if the patient has a separate address or carrier for mental-health claims; if so, submit your claim to that payer. V code question: Some coders say that if your physician follows up on medication to treat the patient's ADHD, your claim should include a V code with the ADHD diagnosis. You only use a V code, however, when no other ICD-9 code fits the situation. You shouldn't report a V code in your case because of 314.01.
Neurology & Pain Management Coding Alert
- CPT Makeover:
Learn How the 2008 Modifier Changes Will Affect Your Claims
Don't miss what an updated modifier 25 has in store for PAs and CRNPs CPT [...] - Coding 101:
59 Made Easy: Look for a Separate Location/Session
Be sure to check CCI for a -1- modifier indicator Properly applying modifier 59 is [...] - Audit Heads-Up:
Brace Yourself for RACs -- and What Their Visits Might Mean
Look for more intense scrutiny of Medicare payments in 2008 Billing Medicare as the primary [...] - Reader Questions:
Code Headache Separately From West Nile Fever
Question: What diagnoses apply to West Nile virus with encephalitis and post-encephalitis headache? The patient [...] - Reader Questions:
Verify That ADHD Claim Goes to Correct Payer
Question: Our payer is denying any claims our pediatric neurologists submit for patients with ADHD [...] - Reader Questions:
Remember Fifth Digit for Myasthenia Gravis Dx
Question: One of our technicians is training to perform repetitive nerve stimulation on patients with [...] - Reader Question:
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 [...] - Reader Questions:
Report 95806 for Off-Site Sleep Test Monitoring
Question: Our staff completed a portable sleep study in the patient's home (staged, with three [...] - Reader Questions:
Append 26 to Report Separate EEG Reading
Question: Our technologist often administers the EEG, and the physician reads the results later that [...] - Reader Questions:
Look to 354.1 for Anterior Interosseous Syndrome
Question: Our physician noted "anterior interosseous syndrome or focal nerve entrapment" on the patient's chart. [...] - Reader Questions:
Erase PHI Before You Click 'Send'
Question: I sometimes e-mail patient records to consultants or other coders for help on how [...] - Reader Questions:
Nerve Monitoring May Be Bell's Palsy Check
Question: I overheard a coworker discussing facial nerve monitoring testing for patients with Bell's palsy. [...] - Reader Questions:
Finally, You Can Look Up NPI Information
Question: Is the NPI database up yet? I can't figure out where to look for [...] - You Be the Coder:
Documenting a Nonresponsive Patient
Question: One of our patients is nonresponsive and unable to answer questions. The neurological exam [...]
