Part B Insider (Multispecialty) Coding Alert

Determine how well you would answer these common questions

Dust off your thinking cap again.

Two weeks ago, you took our Part B challenge seriously. Many of you wrote in with questions for a future quiz, and today we-re putting you to the test with a few reader-submitted questions.

After you review these five test questions, turn the page to see how you fared.

Question 1: Why Can't We Code Probable Diagnoses?

Question: I-ve read in your publication that we should not report diagnosis codes that indicate uncertainty (such as -probable- or -rule out-). But I just came from a seminar where the speaker gave me a copy of coding guidelines that say that we can report probable diagnoses. Can you clarify this issue?

Question 2: Determine Which Infusion Is -Initial-

Question: A patient presented to our office for chemotherapy treatment. We performed a 30-minute antibiotic infusion and then a 115-minute chemotherapy infusion. Which infusion is considered -initial-?

Question 3: Determine When SNF Should Document Therapy

Question: I work in an SNF and have a question regarding our Medi-care Part B patients. How often are we expected to document therapy treatments? Do we need daily documentation, or is our daily treatment record enough? We use a daily treatment grid, so is it really necessary to write an actual note every day we see that patient?

Question 4: HIPAA May Be Out of the Spotlight, But Still on Minds

Question: I sometimes e-mail patient records to consultants or other coders for help on how to bill the claim correctly. How can I make sure I-m not committing a HIPAA violation?

Question 5: Which Modifier Applies to Dual Injections?

Question: Our physician re-cently treated a patient with olecranon bursitis in her right and left elbows. To treat the patient, he injected 10 mg of Depo-Medrol into each joint. Should I report 20605 twice with modifier 59 attached to the second code?