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Neurosurgery Coding Alert - 2021; Volume 22, Number 12
CPT® Coding:
A Look Back at 2021: E/Ms, Midyear Additions Highlight 2021 Changes
Check out the codes that CPT® dropped mid-July. By all accounts, 2021 was an action-pack...
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CPT® Coding:
Get Hip to What’s Coming in 2022 and Beyond
E/M section will be further altered in coming years. The last couple of years have seen m...
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Reader Questions:
Get all Info Before Diving Into E/M-CT Combo Encounter
Question: Notes indicate the provider performed an office evaluation and management ...
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Reader Questions:
Rely on Add-On for Second Hemilaminectomy
Question: Encounter notes indicate that the surgeon performed a hemilaminectomy at C1...
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Reader Questions:
Keep Up With 99211 Reporting Rules
Question: What are the minimum documentation requirements needed to bill 99211? What ...
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Reader Questions:
Drive Dx Decision With Provider Documentation
Question: One of our patients is a former opioid addict, and I am not sure what ICD-10 cod...
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Reader Questions:
Don’t Code Conditions Before They Happen
Question: Please settle this debate. One of our providers is saying that we should a...
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Reader Questions:
Use G43.6 for Various Syndrome Dxs
Question: Notes indicate that a patient suffered from Wallenberg syndrome. I'm not fa...
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Reader Questions:
Calculate MDM Risk for This Encounter
Question: Our provider recently spent some time discussing the risk factors for major...
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You Be the Coder:
Difficult Terminology in Op Notes
Question: Encounter notes indicate that the surgeon performed “DREZ laminectomy, thoraco...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 11
2022 E/M Coding:
CPT® Brings 99211 in Line With Other Office E/Ms
Here's the minor descriptor change that could have a major effect on coding. When CPT® r...
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CPT® Coding:
Set Up for Spinal Stenosis Success With Code Knowledge
Provider could use several methods to determine presence of condition. Patients reporting...
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E/M Coding:
Use Keen Eye, Coding Smarts to Tackle Observation Coding
Remember different codes for different payers, types of stays. Reporting observation se...
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Reader Questions:
Questions Persist on New Back Pain Codes
Question: How do I code acute or chronic lower back pain? Even with the new ICD-10 codes i...
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Reader Questions:
Get an Accurate Count of Nerve Conduction Tests
Question: Notes indicate that the provider performed sensory nerve conduction test using e...
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Reader Questions:
Px Status Crucial to E/M Code Choice
Question: Notes indicate that the provider performed an office evaluation and managem...
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Reader Questions:
Tumor Type Drives Craniectomy Code Choice
Question: What is the correct code for infratentorial craniectomy to excise a brain t...
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You Be the Coder:
Spinal X-Rays in 2 Areas
Question: Encounter notes indicate that the provider performed X-rays on two areas of a pa...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 10
CPT® 2022:
Get Up to Speed on New LITT, Laminectomy Codes
A new lesion therapy gets its own code in 2022 … and a lot more. Many years, the announ...
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CPT® 2022:
Revisions Revved Up for Next Year
Here's why you need to pay special attention to 2022 code revisions. When it rains, it...
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Modifier Madness:
Code Unrelated E/Ms With 24 … When Possible
Instead of relying on your clinic schedule for documentation proof, do this. Knowing the ...
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Reader Questions:
Use This Advice on High-Level Drug Therapy E/Ms
Question: What qualifies as “drug therapy requiring monitoring” in the high-risk ...
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Reader Questions:
Use Observation Codes for More Than Primary Dx
Question: Should we report the observation diagnosis codes (Z03-Z05) as primary diagnoses ...
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Reader Questions:
Knowing Circumstances Surrounding ECoG Vital to Code Choice
Question: When the surgeon performs an electrocorticogram (ECoG), how should I report the ...
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You Be the Coder:
MDM Coding: 1 Bullet or 2?
Question: I am still getting used to the new rules for office/outpatient evaluation and m...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 9
ICD-10- 2022:
See What ICD-10 2022 Will Look Like With New Codes
There will be a whole new set under the S06.0 heading. Don't be alarmed, but you're about...
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E/M Coding:
Catch Up With Still-Evolving Office/Outpatient E/M Rules
Here's why you should keep a lookout for more tweaks to rules. Autumn is almost upon us, ...
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Modifier Madness:
Prove Separate and Distinct Before Opting for Modifier 59
… and some payers might prefer the X{EPSU} modifier options. Payers never stop scrutini...
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Reader Questions:
Count Sutures, Then Choose Newborn Craniectomy Code
Question: Encounter notes indicate that the surgeon performed a craniectomy for craniosyno...
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Reader Questions:
Vascular Territory Important on Balloon Dilatations
Question: Encounter notes indicate that the surgeon performed three intracranial balloon d...
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Reader Questions:
Use Unlisted Code When Others Don’t Describe Procedure
Question: I've reported CPT® code 64999 for an erector spinae pain (ESP) block for years,...
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You Be the Coder:
Meet Threshold on New Prolonged Services Code
Question: Our provider performed an office evaluation and management (E/M) service for a n...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 8
ICD-10- 2022:
Dx Additions Include Expanded Options for Concussion, Back Pain
Here's why you should learn the new codes before the end of summer. When the calendar fli...
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E/M Coding:
Keep Up ED E/M Skills in 2021
These codes don't have the updated descriptors of 99202-99215. When your surgeon provides...
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Clinical Coding Corner:
Get Back to Basics on Disc Disorder Claims
Scenario illustrates the intricacies of cervical disorder treatments. Patients who have c...
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Reader Questions:
Table E/M Risk Concerns With MDM Smarts
Question: Both the Elements of Medical Decision Making (MDM) table in the 2021 CPT®&...
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Reader Questions:
Study Different Types of TIA Dx Codes
Question: I'm still pretty new to neurosurgery coding, and I'm curious about the different...
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Reader Questions:
Make the Most Correct Choice on E/M Level
Question: Notes indicate that the provider performed an office evaluation and managem...
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You Be the Coder:
Get Modifier Right on 2-Sided Surgeries
Question: Our neurosurgeon created a subdural burr hole in order to drain a hematoma....
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Neurosurgery Coding Alert - 2021; Volume 22, Number 7
Case Study Corner:
Use These Modifiers to Code Second Surgeries Successfully
Use 58 for a planned or staged procedure. Last month, we ran down the modifiers you shou...
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Studies:
Know Code Combos to Dodge EMG/NCS Coding Troubles
Do you know which NCS code you'll report with EMG of extremity? Patients reporting to you...
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Back to Basics:
Use Injection/Infusion Advice to Be a Hotshot Coder
Read this if you ever get confused about proper injection/infusion types. Coding for inje...
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Reader Questions:
Dig Deep for Answers to Craniotomy Questions
Question: After a level five outpatient evaluation and management (E/M) service for an est...
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Reader Questions:
Know Clamp Types to Lock Down on Aneurysm Repair Coding
Question: The surgeon performed surgery on an intracranial aneurysm via cervical approach....
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Reader Questions:
Report Prolonged Services With Telehealth E/M … Maybe
Question: Our provider performed an office evaluation and management (E/M) service over th...
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You Be the Coder:
Reporting Multiple TFESI Injections
Question: The physician documented transforaminal epidural steroid injections (TFESI) at l...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 6
2021 E/M Q&A:
New Reporting Rules Have Early Hits, Misses
Focusing on MDM has changed the calculus for coders, providers. When the AMA decided that...
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Surgery:
Head Down the Right Coding Path With Craniotomy/Craniectomy Skills
Use add-on code when surgeon removes skull portion. When your surgeon performs a craniot...
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Modifier Madness:
Get 58/76/78/79 Rules Straight Before Coding Surgery During Global
Do you know which modifier to use if the surgery is related to a previous procedure? Codi...
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Reader Questions:
Multiple Brachial Plexus Blocks = 1 Code
Question: The provider administered a brachial plexus block. He wants to bill this with 8 ...
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Reader Questions:
Get Back to Spinal Compression Fx Basics
Question: I'm a little unclear on spinal compression fractures. What exactly are they, and...
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Reader Questions:
Skull Base Lesion Tx Requires Multiple Surgeons
Question: When a patient receives treatment for a skull base lesion, how many differe...
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You Be the Coder:
Add-Ons and Vertebral Surgery Codes
Question: Our surgeon performed percutaneous lumbosacral vertebroplasty with biopsy, which...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 5
ICD-10 Coding:
Account for Secondary Conditions for Spinal Patients
Myelopathy, radiculopathy among conditions that can accompany primary issue. When a pati...
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E/M Coding:
2021 E/M Changes Get Some … Changes
Recent updates shed more light on the 2021 office/outpatient E/M revisions. If you missed...
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E/M Coding:
Keep Hospital Care Codes in Their Own Category
Use 1 set of codes for initial hospital care. There's been a ton of attention paid to the...
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Reader Questions:
Know When to Say When With Modifiers
Question: Encounter notes indicate that the neurosurgeon created a burr hole to implant el...
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Reader Questions:
Visualize Success by Mastering Spinal Cord Vocab
Question: I'm having trouble with some of the terminology when coding injection/drainage/a...
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Reader Questions:
Know HIPAA Rules Before Sending Patients Email
Question: Our patients frequently ask if we can send them appointment reminders or bills v...
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You Be the Coder:
Try to Get More Info on ‘Trigem. Nerve Disorder’ Note
Question: I have an operative report in front of me that is a bit confusing. Notes indicat...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 4
CPT®:
Here’s Why Time and Set Up Matter When Reporting Continuous EEG/VEEG Services
Hint: Report 95700 only once per recording period. You may be stumped if your physician r...
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ICD-10-CM:
5 Tips Hone Your Sciatica ICD-10-CM Reporting Skills
Remember: You must know the sciatica's exact location. When it comes to reporting ICD-10-...
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Modifiers:
Append Assistant Surgery Modifiers With Ease Using This Handy Guide
An indicator of “1” tells you that an assistant at surgery will never be paid. When y...
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You Be the Coder:
Look to Global for Modifier Success
Question: Notes indicate that after a level-four outpatient E/M service for an established...
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Reader Questions:
Report These S- ICD-10-CM Codes for Neck Sprain
Question: My surgeon treated a patient complaining of neck pain. The encounter notes indic...
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Reader Questions:
Distinguish Between EMRs and EHRs
Question: At our practice, we often use the terms EMR and EHR interchangeably, but our new...
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Reader Questions:
Bolster ABN Smarts With These Steps
Question: I'm new to coding. Can you please explain to me what an advance beneficiary not...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 3
CERT:
Medical Necessity Errors Result in Over $85 Million Projected Improper Payments for Neurosurgery, Per CERT Report
Cervical spinal fusion lands at the top of costliest medical necessity mistakes. You know...
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CPT®:
4 Tips Help Conquer Myelography Coding in Your Neurosurgery Practice
Hint: Check the documentation for the exact approach. If your neurosurgeon performs myel...
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Mythbuster:
Bust 5 Modifier 62 Myths to Solidify Your Claims
Make sure the ICD-10-CM codes match on both physicians' claims. A new subscriber recent...
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You Be the Coder:
Demystify This Fracture Repair Situation
Question: My physician performed closed treatment of a fracture of a vertebral process in ...
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Reader Questions:
Make Sure Your Mobile Devices Meet HIPAA Requirements
Question: How can we help secure our mobile devices, meet HIPAA requirements, and help saf...
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Reader Questions:
Approach Key for Pituitary Tumor Excision
Question: My neurosurgeon made an incision in the patient's scalp above the frontal area o...
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Reader Questions:
Decode What Medical Necessity Means
Question: I know medical necessity is vital to coding, but I'm not sure that I can define ...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 2
CPT®:
Sharpen Your Ventriculoperitoneal Shunt Tap Coding Skills With This Expert Advice
Remember: Don't mix up shunt tap with shunt irrigation. When your neurosurgeon performs a...
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Quiz:
7 Questions Guide Your Coding for Malignant Tumors in the Spinal Cord and Cauda Equina
Report C72.59 for malignant tumor in the Trochlear cranial nerve (IV). If you neurosurge...
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Policy:
Determine COVID-19 Vaccination Policy For Your Practice
Considering modeling your COVID-19 policy after your flu policy. Now that a COVID-19 vac...
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Reader Questions:
Follow This Advice for Medicare Appeals, Rebuttals
Question: Our practice just received a “demand letter” from our Medicare Administrativ...
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Reader Questions:
Conduct Self-Audit to Confirm Correct Medicare FFS Reimbursement
Question: What are some areas my office can perform a self-audit on or otherwise focu...
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Reader Questions:
Rely on This Code for Ankylosing Spondylitis of the Thoracic Region
Question: Which ICD-10-CM code should I report for ankylosing spondylitis of the thoracic ...
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Reader Questions:
Focus on Dx Code for Vascular Dementia Without Behavioral Disturbance
Question: Which ICD-10-CM code should I report for vascular dementia without behavioral di...
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You Be the Coder:
Focus on Number of Treatment Days for Adhesiolysis
Question: My neurosurgeon performed an epidural lysis of adhesions using hypertonic saline...
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Neurosurgery Coding Alert - 2021; Volume 22, Number 1
CPT®:
Differentiate from Implantation, Revision, and Removal Spinal Stimulator Codes to Achieve Cleaner Claims
Remember: Never report 95971 in conjunction with 95972. If your neurosurgeon performs a s...
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HCPCS Level II 2021:
2021 HCPCS Level II Welcomes New Clinical Indications for Head Imaging Codes
Hint: Code G9532 will be deleted in 2021. The Centers for Medicare & Medicaid Servic...
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Queries:
Always Submit Successful Provider Queries in Your Neurosurgery Practice
Remember: A query should never be used to question a provider's clinical judgement. Dur...
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You Be the Coder:
Use Modifier 22 With Caution
Question: My neurosurgeon planned to remove a patient's intraventricular colloid cyst usin...
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Reader Questions:
Learn How to Protect e-Signatures
Question: During a recent risk assessment at our practice, we found that the e-signatures ...
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Reader Questions:
Follow This Cranial Neurostimulator Removal Advice
Question: My neurosurgeon re-incised the skin over a direct cranial pulse generator in a s...
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Reader Questions:
File Claims With Care
Question: If we received an “unprocessable” claim from our MAC, can we appeal this? N...
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Reader Questions:
Inspect Cranioplasty Details in Medical Documentation
Question: My neurosurgeon repaired a 4cm skull bone defect by using bone tissue harvested ...
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