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Outpatient Facility Coding Alert

CMS Final Rule:
Break Down Key Components of the CMS OPPS, ASC Final Rule
See which of these changes may have an impact on your facility's bottom line. On November... Read more
ICD-10-CM Coding:
Use This Coding Clinic Guidance, Ease Your Excludes1 Note Worries
Plus, use some real-world examples to drive home what you've learned. This month, you'll ... Read more
NCCI Policy:
Adhere to These NCCI Policies on Your Endoscopic Surgery Claims
Think twice before coding separately for access routes. As a surgical coder, you're all t... Read more
Reader Question:
Note These Guidelines on Middle Turbinate, Endoscopic Sinus Services
Question: Can I report a middle turbinate resection in addition to an endoscopic polypecto... Read more
Reader Question:
Know When, When Not to, Return Report to Provider for Addendum
Question: A patient had an open reduction internal fixation (ORIF) hip surgery and returne... Read more
Reader Question:
Don't Worry About Legalization for Marijuana Use with Pregnancy
Question: I've been told that there is a new guideline on reporting for patients who are u... Read more
You Be the Coder:
Consider Cat III Add-Ons With Placement of Hypoglossal Nerve Stimulator
Question: What's the CPT® code for the placement of a hypoglossal nerve stimulator? I can... Read more
Case Studies:
Learn the Fundamentals of These 2 Multi-Faceted Spinal Injection Code Sets
Hone in on site, number of levels, and imaging guidance when selecting your code. In Volu... Read more
ICD-10-CM Guidelines:
Make Way for Brand New ICD-10-CM Guidelines on Sepsis Reporting
Consider this assortment of new and revised rule changes. The new coding year always brin... Read more
CPT® Coding:
Code Chemodenervation Claims Confidently With These Tips
Consider how some Dxs, HCPCS codes may vary by payer. Chemodenervation patients can prese... Read more
Reader Question:
Know What Supplies, Services Fall Under the ASC Global Payment
Question: Are we allowed to charge the patient for extra catheter supplies that we send th... Read more
Reader Question:
Differentiate Between Incision, Approach With Aural Glomus Tumor Excisions
Question: What CPT® code should I use to report a transcanal excision of an aural glomus ... Read more
Reader Question:
Stay Up to Date on Your G0297 Provider Attestation Requirements
Question: I'm looking for some authoritative guidelines pertaining to the proper reporting... Read more
You Be the Coder:
Check Status Indicators Before Billing Bilaterally
Question: Can you bill CPT® code 42808 bilaterally? Michigan Subscriber Answer: In orde... Read more
CPT® Coding:
Conquer Transforaminal Injections, Paravertebral Blocks With This Guide
If the process of coding pain management techniques involving the spine is leaving you in ... Read more
CPT® 2019:
Make Way for These 2019 Diagnostic, Interventional Rad CPT® Codes
Acclimate yourself with a plethora of new, revised, and deleted CPT® codes. If you code ... Read more
Case Studies:
Fine-Tune Your EGD Coding Skillset Using This Clinical Example
Pinpoint the differences between each code by using these pointers. When it comes to endo... Read more
Reader Question:
Make Proper mL/mg Conversion for J2550 Reporting
Question: We have a patient that was given a promethazine injection, via IV, for a total v... Read more
Reader Question:
Code CVA Tenderness, Flank Pain Interchangeably
Question: What is the diagnosis code for CVA tenderness? Florida Subscriber Answer: This... Read more
Reader Question:
Check NCCI Edit, Parenthetical Notes When Reporting 72275 With 62323
Question: Is it appropriate to code 62323 with 72275? Oklahoma Subscriber Answer: From a... Read more
You Be the Coder:
Note Separate Injection Sites for Greater, Lesser Occipital Nerve Blocks
Question: Can I code a lesser occipital nerve block in addition to a greater occipital ner... Read more
CPT® Case Study:
Use NCCI Policy to Code this Thyroidectomy, Parathyroidectomy Combo
Plus, know when and when not to consider reporting modifier 59. If you're in unfamiliar s... Read more
ICD-10-CM Guidelines:
Master the Art of Fracture Coding with this Comprehensive Instructional Guide
Aggregate all your chapter-specific fracture coding guidelines into one place. Most veter... Read more
CPT® Coding:
Code ERCP Services with Ease Using these Tips and Expert Advice
Break down each coding solution, from stone removal to ERCP. Depending on your ambulatory... Read more
Reader Question:
Refer to OPPS, ASC Addendums Before Billing Aspiration Drug Codes
Question: I am struggling to code this knee injection report. The physician documents “r... Read more
Reader Question:
Confirm Number of Views When Reporting Complete Scoliosis Series
Question: If the title of the report states “complete scoliosis series including supine ... Read more
You Be the Coder:
Check NCCI UOS Policy Before Coding Multiple Nerve Branch Injections
Question: The provider administered 2 ml of lidocaine 1% at the following locations: “th... Read more
CPT® Coding:
Note These 3 NCCI Exceptions Involving Extensive Shoulder Debridement
Streamline the billing and reimbursement process by following these rules. Most coders wi... Read more
Modifiers:
Adhere to these Facility-Specific Guidelines when Billing Bilateral Services
Note underlying differences between ASC, outpatient facility bilateral billing. At first ... Read more
E/M Coding:
Consider These Factors When Billing Modifier 57 With Minor Surgical Procedures
Don't let the plethora of conflicting guidelines overwhelm you. Most coders working in ph... Read more
Reader Question:
Identify Key Differences Between Salivary Duct, Gland Procedures
Question: I'm trying to code a report for a probe dilation of Stenson's duct due to obstru... Read more
Reader Question:
Use M43 Code Set to Report Congenital Spinal Fusion
Question: I've come across a report that states that the L5-S1 spine has fused together. I... Read more
Reader Question:
Refer to ICD-10-CM Index, Distinguish Between Unstageable, Unspecified Pressure Ulcers
Question: What's the difference between an unstageable pressure ulcer and a pressure ulcer... Read more
You Be the Coder:
Refer to Anatomical Criteria List When Coding 76770, 76775
Question: I am having trouble deciding between 76770 and 76775 on a report I am reading. T... Read more
2019 ICD-10-CM Codes:
Begin Prep Now for these Brand New 2019 ICD-10 Code Additions
Get a head start on these important changes coming down the pipeline. You should always p... Read more
CPT® Coding:
Nail Down the Concept of Corpectomy Thresholds with this Guide
Rely on percentage of vertebral removal to reach the most accurate code. If your ambulato... Read more
Case Studies:
Refine Your Prostatectomy Coding Skillset with these Scenarios
Know when to rely on a specific set of modifiers to help your cause. Prostatectomy proced... Read more
Reader Question:
Know What Terms Do, Do Not Constitute Myelography Radiographic Imaging
Question: A patient had a fluoroscopic guided lumbosacral myelogram. In the report, it doc... Read more
Reader Question:
Refrain from Modifier Use on Bilateral Indicator 2 Codes
Question: Should I use code G0279 to bill out a unilateral tomosynthesis with a 77065? If ... Read more
Reader Question:
Report Elevated B12 Levels Under Abnormal Blood Chemistry Codes
Question: How do I code a patient with an elevated B-12 level? Minnesota Subscriber Answ... Read more
Reader Question:
Bill Drug Codes to Facility Outpatient Hospital Setting
Question: Our physician performed a Myobloc injection in order to treat a patient with gas... Read more
You Be the Coder:
Refer to ICD-10-CM Guidelines for Monoplegia, Hemiplegia Coding
Question: Should I code a patient with monoplegia of the left arm as G83.22 or G83.20? De... Read more
CPT® Coding:
Boost your Colonoscopy/Sigmoidoscopy Coding Skill Set with these Examples
Identify important differences between biopsy and removal via technique. If colonoscopy a... Read more
ICD-10 Coding:
Learn the Basics of Hammer Toe Coding Using this Guide
Know rigid or flexible, acquired or congenital, for accurate Dx documentation. It's a com... Read more
CPT® Coding:
Nail Down the Fundamentals of this new Surgical Laparoscopy Code
The 38573 code encompasses washings, biopsies, and more. Prior to January 1, only an unli... Read more
CPT® Coding:
Boost your Colonoscopy/Sigmoidoscopy Coding Skill Set with these Examples
Identify important differences between biopsy and removal via technique. If colonoscopy a... Read more
ICD-10 Coding:
Learn the Basics of Hammer Toe Coding Using this Guide
Know rigid or flexible, acquired or congenital, for accurate Dx documentation. It's a com... Read more
CPT® Coding:
Nail Down the Fundamentals of this new Surgical Laparoscopy Code
The 38573 code encompasses washings, biopsies, and more. Prior to January 1, only an unli... Read more
Reader Question:
Check with Payer for Polypectomy Via Cold Forceps Approach
Question: How do I code a biopsy and removal of a colon polyp using a cold forceps techniq... Read more
Reader Question:
Know CPT® Guidelines on Reporting Moderate Sedation Administration
Question: I have two patients (over 5 years of age) receiving moderate sedation. One recei... Read more
Reader Question:
Assign Fracture Dx to Relevant Surgical Code, Only
Question: We have a patient who underwent an open reduction and internal fixation (ORIF) f... Read more
Reader Question:
Remember to Code Separately for PICC, Fluoroscopy
Question: How do I code for a peripherally inserted central venous catheter (PICC) line pl... Read more
Reader Question:
Check with Payer for Polypectomy Via Cold Forceps Approach
Question: How do I code a biopsy and removal of a colon polyp using a cold forceps techniq... Read more
Reader Question:
Know CPT® Guidelines on Reporting Moderate Sedation Administration
Question: I have two patients (over 5 years of age) receiving moderate sedation. One recei... Read more
Reader Question:
Assign Fracture Dx to Relevant Surgical Code, Only
Question: We have a patient who underwent an open reduction and internal fixation (ORIF) f... Read more
Reader Question:
Remember to Code Separately for PICC, Fluoroscopy
Question: How do I code for a peripherally inserted central venous catheter (PICC) line pl... Read more
You Be the Coder:
Confirm Bi-Compartmental Synovectomy Before Billing 29881, 29876
Question: I'm working on a claim where the provider performs a right knee chondroplasty, a... Read more
You Be the Coder:
Confirm Bi-Compartmental Synovectomy Before Billing 29881, 29876
Question: I'm working on a claim where the provider performs a right knee chondroplasty, a... Read more
CPT® Coding:
Discern Between Complications and Known Surgical Risks
Know when to use the ICD-10-CM index as a reference. When it comes to coding surgical pro... Read more
E/M Coding:
Know When, How to Justify Time Factor Over Key Components
Survey the visit, documentation to make the correct determination. Depending on your subs... Read more
ICD-10 Coding:
Minimize Pressure of Pressure Ulcer Coding, Use these 4 Pointers
Look for site, severity, and more. When your surgeon treats pressure ulcers, you'll need ... Read more
Reader Question:
Avoid Use of Multiple Codes for Aspiration, Injection of Same Joint
Question: How do I code a scenario in which the provider performs a knee aspiration and th... Read more
Reader Question:
Refer to CCI Edits for 2 Scopes
Question: Our surgeon performed a colonoscopy, removing one polyp, but he also documented ... Read more
Reader Question:
Understand Role of Measurement in Melanoma Excision Surgery
Question: An op report describes melanoma re-excision of a 1.9 cm lesion with 0.1 cm margi... Read more
You Be the Coder:
Rely on NCCI Guidelines for Pain Management Following RC Repair
Question: A patient returns two days following a rotator cuff repair (acute) complaining o... Read more
Compliance:
Zone in on these Diagnostic Imaging Order Form Guidelines
Plus, know when and how the interpreting provider can self-order. The rules surrounding h... Read more
CPT® Coding:
Concentrate on Essential Differences Between Complex Repair, ATT Codes
Rely on CPT® rules to outline the fundamentals behind both procedures. Sometimes, choosi... Read more
ICD-10 Coding:
Identify these Important Diagnostic Factors for Accurate Sequela Coding
Remember that order matters when it comes to sequela diagnoses. As an outpatient facility... Read more
Reader Question:
Stick to ICD-10 Index for Accurate TBI Coding
Question: What are the rules surrounding traumatic brain injury (TBI) coding? I can't figu... Read more
Reader Question:
Refer to ICD-10-CM Guidelines for S&S Coding
Question: We have a patient with diagnoses of chronic frontal sinusitis with ocular and bi... Read more
You Be the Coder:
Include Non-OR Complication Treatment in Global Surgery Payment
Question: We have a patient present to our office for an infected incision site 10 days fo... Read more
Wound Care:
Solidify Your Wound Care Claims with Expert Advice
Hint: Learn your LCDs to know which documentation details to include for wound care. When... Read more
ASCs:
Ensure Your ASC's Medical Staff Meets Medicare's Specific Conditions for Coverage
Hint: An RN must be in charge of nursing services in your ASC. CMS outlines very specific... Read more
ICD-10:
Handy Expert Tips Demystify Your Migraine Coding
Hint: Symptoms of partial or temporary paralysis may point to hemiplegic migraine dx. Rep... Read more
Reader Question:
Identify Correct Dx for Colobama Situation
Question: We have a patient diagnosed with colobama, but I'm not sure which ICD-10 code to... Read more
Reader Question:
Delve Into Nuances of CMPL
Question: What are some things we need to remember when offering complimentary items or se... Read more
Reader Question:
Billing 66982? Follow This Advice
Question: In our ASC, we are have seen some denials for our 66982 claims. Could you walk u... Read more
You Be the Coder:
Decipher This ESWL Code
Question: In the ASC, the surgeon performed a diagnostic bilateral ureteroscopy, then a le... Read more
CCI 24.0:
Did you Implement These New Vascular Surgery Edits? Find Out
Hint: Always pay close attention to the modifier indicator. You've had a little bit of ti... Read more
CCI 24.0:
Apply Wisdom From Our Experts, Tackle CCI 24.0 Edits With Confidence
Hint: Know your individual payers' policies. The new Correct Coding Initiative (CCI) 24.0... Read more
CDI:
Sharpen Your CDI Skills With These Handy Strategies
Hint: Check out these unique clinical documentation concepts. Every day, your providers t... Read more
Reader Question:
Distinguish Between Screening vs. Diagnostic Colonoscopy
Question: Can you explain the difference between a screening colonoscopy versus a diagnost... Read more
Reader Question:
Cosmetic Blepharoplasty Or Not? Find Out
Question: What ICD-10 codes will show that the patient's blepharo­plasty wasn't cosmetic?... Read more
You Be the Coder:
Mark Down These Dx Codes for TKAs
Question: Which ICD-10 codes support medical necessity for knee arthroplasties? Oregon Su... Read more
Compliance:
Marketing Your Surgery Center? Don't Stumble Over These Healthcare-Specific Statutes
Avoiding kickbacks, or just the appearance, a top concern when creating a marketing strat... Read more
Compliance:
Determine the Kickback Status of Your Marketing Plan
Are you marketing the physicians or the surgery center? The line between promoting your c... Read more
Avoid False Advertising and Comply With FTC Guidelines
When it comes to patient testimonials, honesty is always the best policy. Any advertising... Read more
CPT® 2018:
Find Out What's New For CPT® 2018 in Interventional Radiology
You'll have several fresh category III codes focusing on measurements of coronary FFR. If... Read more
Reader Question:
Get OON Billing Right Every Time
Question: What are some best practices we can follow for compliant out-of-network billing?... Read more
Reader Question:
Use Modifier 78 for Related, Unplanned Procedures
Question: A patient had surgery for an elongated second metatarsal at the ASC where the ph... Read more
Reader Question:
Conquer This Bunionectomy Scenario
Question: In the ASC, the surgeon performed a modified McBride bunionectomy on the patient... Read more
Reader Question:
Consider this Strabismus Scenario
Question: The surgeon performed a resection procedure on two horizontal muscles for strabi... Read more
Reader Question:
38571 or 38572? Find out
Question: Which group of lymph nodes constitutes a "total pelvic lymphadenectomy" with ref... Read more
You Be the Coder:
Decipher This Biopsy Scenario
Question: What CPT® code should I report for a "fine needle" prostate biopsy procedure? ... Read more
Available Years:  2018  2017  2016  2015  2014  2013  2012