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Outpatient Facility Coding Alert

Reimbursement:
Watch for a Boost in Medicare Pay for 2013
  CMS final rule increases ASC payment rates, adds 25 procedures. Ambulatory su... Read more
Radiology Billing:
Coding for Multiple Locations? Clue in to the Latest on Proper Place of Service Assignments
  Latest Medicare info directs you to focus on where the beneficiary was at time ... Read more
Pain Management:
Tighten Up Your Dupuytren's Contracture Coding
  Here’s how: Narrow your choices by surgery, injection, or follow-up. Yo... Read more
Condition 101:
Dupuytren's Contracture Defined
In Dupuytren’s contracture (728.6, Contracture of palmar fascia), the patient expe... Read more
ICD-10:
Diagnosis Coding Gets More Specific for Barrett's Esophagus in 2014
  Tip: Dig into dysplastic changes to narrow your code choices. Barrett’s... Read more
Reader question:
Turn to 320 for Diagnostic Radiology Revenue Code
  Question: What is the appropriate revenue code for procedures our outpatie... Read more
Reader question:
You Can Bill Together For Tenotomy and Debridement
  Question: Is it true that we cannot bill 23405 (Tenotomy, shoulder area; s... Read more
Reader question:
Stick With J Codes for Chemo Pump Day 2 Follow-Up
  Question: A patient came to our facility for chemotherapy (day 1). She has... Read more
You Be the Coder:
Making the Choice for Rhytidectomy
  Question: One of the dermatologists at our center removed excess skin from... Read more
Modifier Watch:
Remember Timing Is Everything When Choosing Between Modifiers 73 and 74
Procedure documentation should point you in the right direction for cancellation coding.... Read more
Clip and Save:
Easy Reference Simplifies Your 73 or 74 Selection
Tip: Your choice hinges on anesthesia administration. The distinguishing factor between mo... Read more
CPT® Coding:
Unlock Your Spine Surgery Payment With These Documentation Keys
Payer rules keep changing, so keep up with what they want. Getting appropriate reimburseme... Read more
Reimbursement:
Keep a Check on Therapy Caps, or Risk Repeated Reviews
Get advanced approval if patient nears $3,700, or wait up to 60 days for CMS payment. ... Read more
ICD-10:
Start Thinking 'Digits' and 'Left/Right' for Success in Coding Hand Phalanges Fractures
Provider documentation will help you sort through 40-plus possible diagnoses. When ICD-10 ... Read more
Reader Question:
Safety and Timeframes Drive ASC and Non-ASC Lists
Question: I know that some procedures are on the "approved" list for performin... Read more
Reader Question:
Watch Medicare's List of Device Intensive Procedures
Question: What are device intensive procedures?Illinois Subscriber Answer: A device i... Read more
Reader Question:
Think 'Same-Day Global' for ASC Cases
Question: My friend who handles billing for one of our surgeons asked me how we handle glo... Read more
Reader Question:
Multiple Techniques Can Mean Multiple Codes for Polyp Removal
Question: During a colonoscopy, the gastroenterologist used a snare to remove two polyps (... Read more
Reader Question:
66985 Focuses on Secondary Implant
Question: We have a patient scheduled for a secondary IOL (intraocular lens) implant. How ... Read more
You Be the Coder:
Separating 19000 From 10021
Question: One of our surgeons documented, "Cyst aspiration ... clear yellow serous fluid&n... Read more
Pinpoint Correct Epidural Coding Following Instruction and Payment Changes
Be clear on difference between fluoroscopy and contrast. Code descriptors aren't the o... Read more
Reader Question:
Check the Situation Before Assuming 77003 Won't Be Paid
Question: One of our pain management specialists keeps adding 77003 to his billing sheet w... Read more
Reader Question:
Report Levator Resection Before Blepharoplasty
Question: The oculoplastic surgeon performed a levator resection and blepharoplasty on b... Read more
Reader Question:
27340 Could Be Best for Pretibial Bursectomy Code
Question: How should we code for a pretibial bursectomy? Illinois Subscriber Answer:... Read more
New Edits Focus on Transforaminal Injections, ECG Recording
Heads up: Some codes are Column 1 procedures for some pairs, but Column 2 procedures for... Read more
Reader Question:
Yes, You Can Report C1879 Along With 19125
Question: Our radiologist will be purchasing the needles and clips he'll use during stereo... Read more
Reader Question:
Avoid "Rule Outs" in Outpatient Settings
<strong>Question:</strong> <em>A new co-worker is having trouble under... Read more
Watch 3 Areas to Keep Your Endoscopic Sinus Surgery Claims on Track
Tip: Start with anatomy know-how. Endoscopic sinus surgeries pose multiple obstacles f... Read more
Reader Question:
Multiple Procedure Discounts Explained
Question: I've been away from ASC coding for a few years, so need to refresh some basics. ... Read more
Reader Question:
File L3260, But Don't Expect Extra Pay
Question: Do insurance companies pay for footwear in an ASC, such as surgical boots? A... Read more
Reader Question:
Initial vs. Recurrent Steers Inguinal Hernia Coding
Question: The surgeon performed laparoscopic preperitoneal repair of an incarcerated left ... Read more
Yes, You Can Report Modifier 52 in An ASC Sometimes
Modifier 52 (Reduced services) is primarily designed for physician use, but ASCs can repor... Read more
Reader Question:
Medicare Doesn't Expect Hospital and ER Doc Codes to Match
Question: Does Medicare require that the E/M CPT® codes submitted for payment by the h... Read more
Reader Question:
Pinpoint Which Services You Can Bill Separately
Question: I know that the facility fee includes many services we provide to patients in ... Read more
Reader Question:
Coding Clips and Needles with 19125 Depends on Payer
Question: When a physician performs sterostactic biposy (19125, Excision of breast lesion ... Read more
CCI Update:
New OPPS Edits Introduce Pairs for Fluoro with Tunneled Caths
CCI 18.1 changes went into effect April 1, with only 362 total additions and 6 deletions. ... Read more
Reader Questions:
Choose 28090 for Removing Ganglion Cyst from Foot
Question: The surgeon removed a ganglion cyst that was over the sinus tarsi area of the ... Read more
Reader Question:
Pass-Through Payments Explained
Question: Can you explain what "pass-through payments" are? Answer: Pass-through paymen... Read more
CMS Creates New Indicator M5 for ASC Quality Measures Reporting
April 2, 2102 will mark full implementation of a new payment indicator that contractors mu... Read more
Reader Question:
Payment Indicator Addendum Is Your Key to Understanding Procedure Reimbursement
Question: I'm new to ASC coding and am still learning the differences from being in a phys... Read more
Rehab Services:
Look Ahead to Using New Functional Status Codes in 2013
Tip: Start educating providers now on the codes and modifiers required by July. ... Read more
CPT® Errata:
Questioning Some of Next Year's Codes? Check the Errata List From AMA
CPT® 2013 just released, but you already need to note some changes. Now that the ... Read more
Dermatology:
Focus on Diagnosis and Documentation to Successfully Report AK Treatment
Choosing correctly from 15788-15793 is crucial to your claim. Chemical peels aren&rsq... Read more
ICD-10:
Report One Code for Pressure Ulcer in 2014 With Specific Location Choices
Heads up: You’ll move from 14 code possibilities to more than 150. Under the cu... Read more
Reader Question:
Edits Apply for Both Inpatient and Outpatient Surgeries
Question: Are CCI edits applied the same way when we’re coding professional servic... Read more
Reader Question:
No-Go for Reporting Electively Canceled Procedure
Question: I know we shouldn’t report modifier 73 for elective cancellation of a pr... Read more
Reader Question:
Report 29819 for Shoulder Implant Removal
Question: An orthopedic surgeon arthroscopically removed an implant from the patient&rsq... Read more
Reader Question:
Select New Code 0275T for MILD Procedure
Question: I could use some advice coding the following dictation: "Fluoroscopic a... Read more
Reader Question:
Ensure Claim Form Includes All Infusion Details
Question: Our ASC keeps getting denials for drug supply charges during injections and in... Read more
You Be the Coder:
Choosing a Diagnosis for Red Man Syndrome
Question: What is the correct diagnosis for red man syndrome? New Jersey Subscriber ... Read more
Reader Question:
Extensive Debridement Could Lead to 29823
Question: An orthopedic surgeon performed arthroscopic debridement and rotator cuff repair... Read more
Reader Question:
Double Check Before Submitting ICD-9 Codes for ASC
Question: We use CPT® codes in our ASC, but one of our insurers is requesting ICD-9 pr... Read more
Available Years:  2012