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Neurosurgery Coding Alert

HCPCS Level II 2020:
2020 HCPCS Level II Code Set Introduces New CES, Laminotomy Options
Hint: Code G9531 will see some revisions in 2020. The Centers for Medicare & Medicaid... Read more
CPT® 2020 Guidelines:
Master New CPT® 2020 Injection Guidelines for Somatic Nerves
Remember: Never report 64416 in conjunction with 01996. In 2020, CPT® will bring you num... Read more
Documentation:
Sharpen Medicare Signature Requirements Skills With This Quick Primer
Remember: You should only use a stamped signature as a very special exception. Ensuring y... Read more
Reader Question:
Solve Trial Occipital Stimulation Conundrum
Question: The surgeon placed a dual 8-electrode occipital stimulator subcutaneously for tr... Read more
Reader Question:
Patient Has Benign Tumor of Pineal Gland? Do This
Question: My surgeon diagnosed the patient with a benign tumor of the pineal gland. Which ... Read more
Reader Question:
Turn to This Dx Code for Multiple Sclerosis of Brain Stem
Question: The neurosurgeon confirmed a diagnosis of multiple sclerosis of the brain stem. ... Read more
Reader Question:
Report 64568 With Caution
Question: The neurosurgeon implants a neurostimulator electrode array on the vagus nerve a... Read more
You Be the Coder:
Dive Into This Laminectomy Scenario
Question: The surgeon removed the spinous process and both lamina, then he decompressed th... Read more
CPT® 2020 Guidelines:
How to Effectively Use New EEG, VEEG CPT® 2020 Guidelines
Hint: You will report 95700 for the long-term EEG setup service. As you learned in the ar... Read more
CPT®:
Know Spinal Region and Specific Imaging Used for Flawless Facet Joint Injection Claims
Remember: Don't report +64492 more than once per day. When you report paravertebral facet... Read more
Quiz:
Test Yourself on Prolonged Services Without Direct Patient Contact
Remember: Time is vital in determining whether to use a prolonged service code. In the ar... Read more
Reader Question:
Focus On These Laminectomy Codes
Question: To provide spinal cord and nerve decompression, the surgeon removed the spinous ... Read more
Reader Question:
Perfect Malignant Neoplasms Diagnosis With This Advice
Question: The physician documents that the patient has a malignant neoplasm of her right o... Read more
You Be the Coder:
Differentiate Between Decompression and Injection
Question: What is the difference between disc decompression and an injection for discograp... Read more
CPT® 2020 Updates, Part 1:
Check Out 23 New EEG and VEEG Codes Before Jan. 1 Rolls Around
These new EEG and VEEG codes specify certain times, so pay close attention when reporting ... Read more
CPT® 2020 Updates, Part 2:
CPT® 2020 Is Coming! Prep For Numerous Injection, Anesthetic Agent, and Steroid Revisions
You'll lose brain imaging code 78607 in 2020. CPT® 2020 will bring a lot of changes to y... Read more
Quiz:
Wondering if Your Parkinson's Disease Knowledge Would Make the Grade? Test Yourself
Hint: Secondary Parkinsonism is different than Parkinson's disease. Coding for Parkinson'... Read more
Reader Question:
Solve Injection Dilemma
Question: The provider injected a steroid into the space around the spinal nerves of the t... Read more
Reader Question:
Observe This Occipitocervical Fusion Scenario
Question: The neurosurgeon made a midline incision from the occipital protuberance down to... Read more
Reader Question:
Medical Necessity Crucial Component of Services Rendered
Question: Can you explain what definitions for medical necessity payers are working f... Read more
You Be the Coder:
Clarify Correct Dx for Type II Dens Fractures
Question: My surgeon documented an initial encounter for an anterior displaced type I... Read more
CPT®:
Conquer Occipital Nerve Block Claims By Identifying the Specific Nerve
If the surgeon performs GON nerve block, you should report 64405. You read in the medical... Read more
CPT®:
3 Tips Pinpoint Intracranial Aneurysm Location and Complexity
Report 61700 and 61702 for simple aneurysms. When you report intracranial (within the sku... Read more
Mythbuster:
Bust Typical Critical Care Myths to Ensure Clean E/M Coding
Don't separately report the services that are bundled into critical care. If your neurosu... Read more
Reader Question:
Don't Confuse 27096 and 20552
Question: The surgeon performed a steroid injection procedure for the patient's sacroiliac... Read more
Reader Question:
Look to These Dx Choices for Vascular Dementia
Question: A 75-year-old established patient is experiencing reduced memory and functioning... Read more
Reader Question:
Decipher This Intracranial Arterial Scenario
Question: The surgeon gained access through the right common femoral artery and advanced a... Read more
You Be the Coder:
Report Same Code for RSD, CRPS-I
Question: I'm so confused. I've seen the terms reflex sympathetic dystrophy (RSD) and comp... Read more
CPT®:
Strengthen Skull-Base Coding by Identifying Whether Surgeon Performed Approach, Definitive, or Repair/Reconstruction Procedure
Submit 61618 or 61619 for secondary repair/reconstruction of surgical defects of the skull... Read more
Coding Quiz:
Accelerate Kyphosis ICD-10 Skills With Quick Quiz
Always know underlying cause for the kyphosis. When your neurosurgeon diagnoses a patient... Read more
E/M:
3 Handy Tips Shore Up Prolonged Services Coding For Cleaner Claims
Hint: Don't forget that +99354-+99357 are add-on codes. If your neurosurgeon provides an ... Read more
Reader Question:
Report These Codes for Unspecified Bacterial Meningitis
Question: Which ICD-10 code should we report if the physician did not specify the bacteria... Read more
Reader Question:
Boost Cervical, Thoracic Epidural Knowledge
Question: The surgeon gave the patient a single-level cervical transforaminal epidural to ... Read more
Reader Question:
Advance Your Neuropsychological Test Skills
Question: The neurosurgeon spent an hour administering the Boston Naming Test for the pati... Read more
You Be the Coder:
Identify Correct EEG Code
Question: The physician saw a patient he operated on six months ago for a brain cyst. The ... Read more
ICD-10 Update:
New Neurostimulator Z-Code, Cervical Disc Disorder Revisions Top Neurosurgery ICD-10 Options
Presence of a sacral nerve neurostimulator will be included under code Z96.82. CMS recent... Read more
CPT®:
Navigate PLIF Claims By Remembering Additional Add-On Procedures
If surgeon instruments 3 or more segments, you should report segmental pedicle screw fixat... Read more
FAQs:
Answer Common Hydrocephalus FAQs to Identify Specific Type
Hint: Report Q03.9 for unspecified congenital hydrocephalus. Reporting hydrocephalus diag... Read more
Reader Question:
Dive Into Trigeminal Neuralgia Solution
Question: An established patient with trigeminal neuralgia reports to the neurosurgeo... Read more
Reader Question:
Always Know For Certain What Physician Documented
Question: We recently performed an internal audit and found that one coder was reporting 9... Read more
You Be the Coder:
Dig Into This Ventriculoperitoneal Shunt Tap Scenario
Question: According to the op report, the surgeon inserted a small 23-gauge butterfly... Read more
Spinal Dural Repair:
Dial Into Codes for Synthetic Spinal Dural Grafts, Delayed CSF Leak Repairs
Hint: Reporting 63707 or 63709 depends upon whether surgeon performed laminectomy. When t... Read more
ICD-10:
3 Tips Pinpoint Correct Multiple Sclerosis Dx Code
Hint: If the neurosurgeon confirms a diagnosis of MS, you would report G35. ICD-10 codes ... Read more
Modifier 62:
Append Modifier 62 Only When Each Physician Identifies as Co-Surgeon, Uses Same Dx Codes
Always mind the co-surgery indicators. Your neurosurgeon works together with another surg... Read more
Reader Question:
Check Location of Schmorl's Nodes
Question: What are Schmorl's nodes, and how should we report them? Florida Subscriber An... Read more
Reader Question:
Become a Pro at Observation Care
Question: I'm new to medical coding, and I've been struggling with some of the evaluation ... Read more
Reader Question:
Rely on These Dx Codes for Secondary Parkinsonism
Question: How does secondary Parkinsonism differ from Parkinson's disease, and what ICD-10... Read more
Reader Question:
Don't Forget to Append Modifier 53 In This Case
Question: While undergoing a lumbar spinal puncture to obtain a diagnostic sample of spina... Read more
You Be the Coder:
Put 61650 in Your Coding Toolkit
Question: The surgeon establishes access and advances the catheter into the right common c... Read more
Neuroendoscopy:
3 Tips Eliminate Neuroendoscopy Coding Challenges
Remember: Don't report the burr hole separately. In the medical documentation, you see th... Read more
Coding Quiz:
Brush up on Concussion Smarts With Quick Quiz
Hint: Make sure you know whether patient lost consciousness or not. When you're reporting... Read more
Modifiers:
Pave the Way to Modifier 59 Success With This Handy Guide
Remember: Always pay attention to the modifier indicator. Learning the ins and outs of CP... Read more
You Be the Code:
Dive Into This Spine CT Scenario
Question: The surgeon performed a computed tomography (CT) scan of a patient's spine. Ther... Read more
Reader Question:
Report Removal of Spinal Instrumentation Codes With Caution
Question: There is a debate in our office, and we were hoping you could help settle it. Is... Read more
Reader Question:
Demystify HPI for Cleaner E/M Coding
Question: We have a provider who believes that if she has an extended HPI, then she can re... Read more
Reader Question:
Rely on This ICD-10 Code for Congenital Aneurysm
Question: The physician documented that the patient has a congenital aneurysm associated w... Read more
Reader Question:
Read This Before Applying Modifier Q6 to NP Claims
Question: Can we report a nurse practitioner's (NP) services to Medicare with a locum tene... Read more
Reader Question:
Report This Dx Code for Intracranial Abscess
Question: The physician documented that the patient has an embolic cerebellar abscess. Whi... Read more
Reader Question:
Listen to CMS Podcast
Question: Can you tell me about CMS's new podcast that updates listeners to policy informa... Read more
CPT®:
Follow This Expert Advice for Smart EEG Billing
Check the documentation to see if the physician performed an extended EEG. Sometimes your... Read more
Coding Quiz:
Test Your Sciatica ICD-10 Skills With These Quick Questions
Hint: Always check the documentation to see if the physician documented sciatica with lumb... Read more
E/M:
3 Handy Tips Fortify Your ROS Skills for Solid E/M Coding
See who can appropriately record the ROS. When you report evaluation and management (E/M)... Read more
Reader Question:
Don't Append Modifier 52 in This Case
Question: I don't see any guidance on how to report an EEG where all 16 channels were not ... Read more
Reader Question:
Discover New Versus Established Patient Rules
Question: Our practice was recently audited, and an established patient visit was marked a... Read more
Reader Question:
Conquer Inpatient Initial Care Code Errors With Ease
Question: Can we report codes 99221-99223 more than once in the same day if a different ph... Read more
Reader Question:
Delve into 63047 Requirements
Question: Does 63047 require all three components, laminectomy, facetectomy, and foraminot... Read more
Reader Question:
Demystify Medicare's Conversion Factor
Question: What is Medicare's conversion factor and how will it impact our payments? Ohio ... Read more
You Be the Coder:
Discover Primary Laminotomy Codes
Question: I'm new to neurosurgery coding, and I'm confused about how to correctly report t... Read more
CMS:
Neurosurgery Procedures Logged Over $253 million in Improper Payments, Per CERT Report
Here are the claims that could be costing your practice well-deserved reimbursement. Your... Read more
ICD-10:
5 Tips Help You Navigate Common Neoplasm Dx and Avoid Denial Pileups
If the cerebral meninges tumor is benign, you would report D32.0. Whether they are malign... Read more
Quiz:
3 Quick Questions Test Your Understanding of Medicare Appeals Process
Hint: Don't mix up reopenings with appeals. Picture this scenario: You submit a claim to ... Read more
Reader Question:
Count Days, Not Number of Adhesions
Question: Can you explain the rules for 62263? Can you report this code for each adhe... Read more
Reader Question:
Know How to Handle Overpayments
Question: We recently realized that our practice has received overpayments from CMS. How s... Read more
Reader Question:
Differentiate Between Inpatient, Office Consult With This Advice
Question: Is there a difference between an office consultation and an inpatient consu... Read more
Reader Question:
Get Ready for LCD Updates
Question: One of my colleagues said that Medicare is changing LCDs to eliminate ICD-1... Read more
You Be the Coder:
Don't Miss the Modifier on This Claim
Question: In a patient with medically intractable epilepsy, the neurosurgeon replaced... Read more
CCI:
Focus on These Spinal Arthrodesis CCI Rules for Cleaner Claims
Report 63047 and +63048 with care. As you're reading the 2019 Correct Coding Initiative (... Read more
Coding Quiz:
Test Yourself on Common Cerebral Embolism Questions
Hint: Make sure you know specific site of the embolism. If you've ever report cerebral em... Read more
MPFS 2019:
2019 MPFS Concentrates on Lessening Practice Paperwork Burden
CMS emphasizing more time with patients, less with doing paperwork. CMS's “Patients Ove... Read more
Reader Question:
Dial into New Codes 95983 and +95984
Question: I am confused about the CPT® guidelines for new codes 95983 and +95984. Can you... Read more
Reader Question:
Let These Tips Guide Your Office's Self-Audit
Question: We would like to perform a self-audit of critical care claims in our practice to... Read more
Reader Question:
Always Accurately Code for E/M Procedures
Question: When coding evaluation and management (E/M) codes, how do we know where the “c... Read more
Reader Question:
Brush up on Critical Care Requirements
Question: What constitutes as critical care? Also, I once read that there is a specific li... Read more
You Be the Coder:
Hone in on EMG Procedure Codes
Question: In the medical documentation, I read that a patient who is recovering from a spi... Read more
CCI 25.0 Update:
Conquer New Implanted Neurostimulator CCI Edits
Remember: Always check the modifier indicator. You've learned about the 2019 CPT® code a... Read more
2019 Update:
Discover 3 Tips for Reporting Spinal Arthrodesis from CCI Edits Policy Manual
Know the rules when surgeon performs arthrodesis across multiple interspaces. The 2019 up... Read more
Modifiers:
Reporting Assistant Surgeons? Discover Which Modifiers You Can Append
Hint: Reserve modifier 82 for cases in a teaching hospital when a qualified resident is no... Read more
Reader Question:
Set This Critical Care Puzzle Straight
Question: During a recent critical care encounter, Dr. A spent 30 minutes with the patient... Read more
Reader Question:
Hone in on This Code for Removal of Previously Placed Spinal Catheter
Question: What CPT® code should we report if the neurosurgeon removed a previously placed... Read more
You Be the Coder:
Understand When to Correctly Append Modifier 24
Question: The surgeon completed a L5 laminectomy on a patient. Two months later, the patie... Read more
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