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Eli's Rehab Report

Survive NCCI 9.3:
Fluoroscopy Bundles Into Joint Injections
The latest version of the National Correct Coding Initiative (NCCI) perpetuates the trend ... Read more
5 Easy Ways to Improve EMG Reimbursement
If choosing from the numerous electromyography (EMG) codes feels like a tough workout, it'... Read more
Fight 'Hard-Copy' Requests From Payers
You should fight payer requests to provide so-called "hard-copy" results of electromyograp... Read more
Reporting E/M and EMG? Avoid These Pitfalls
If you're charging an E/M service every time the physiatrist conducts electromyographic (E... Read more
Negotiate With Payers for After-Hours Payment
After-hours codes are supposed to boost your reimbursement, but payment is not always auto... Read more
Reader Question:
Skilled Therapy Counts for Timed Codes
Question: Our physical therapist spent five minutes talking to a patient before she began ... Read more
Reader Question:
Co-Management May Warrant Consult
Question: Can I report a consultation if the physiatrist co-manages a patient's care?South... Read more
Reader Question:
Append -26 for NCS in Facilities
Question: If our physiatrist performs testing such as nerve conduction studies (NCS) and n... Read more
Reader Question:
Report Initial Hospital Care for Admits Only
Question: I was recently called into the hospital to take over the care of a stroke pati... Read more
You Be the Coder:
Report Two Units for ROM Testing?
Question: If we perform range-of-motion testing on two different extremities, can we repor... Read more
Prolotherapy:
You May Not Have to Eat the Cost
You can't benefit from reporting the trigger point injection codes to garner proloth... Read more
5 Tips to Speed Your Modifier -22 Payment
If you're submitting a claim for unusual procedural services without first determining how... Read more
Smart MDM Can Be Worth $35 A Pop
If you've been downcoding to a level-four office visit or lower just to play it safe, you ... Read more
Reader Question:
Break Multiple NCSs Onto Line Items
Question: When we perform nerve conduction studies (NCSs) on multiple units/nerves bilater... Read more
Reader Question:
Hypertension Contributes to Management
Question: When should I use a diagnosis of malignant hypertension? If a patient has a stro... Read more
Reader Question:
Report Ice, Heat as Same Code
Question: A patient came in with an injured foot, and the physiatrist gave him an ice pack... Read more
You Be the Coder:
Is Wound Care Part of E/M?
Question: How should we bill for a visit for simple wound care with no debridement? Our ph... Read more
Coding Case Study:
Billing Five or More Orthotics Codes? You May Have to Cut a Few
When it comes to fitting and dispensing orthotics, you should live by the "less is more" c... Read more
Want to Report 99205? Read This First
Many PM&R practices are stuck reporting low-level new patient E/M codes even though th... Read more
Find Your Place in History
The following chart outlines the various levels of history that you must document to repor... Read more
Reader Question:
NOS, NEC: There Are Differences
Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I... Read more
Reader Question:
Apply Phone Call to E/M Service
Question: A primary-care physician (PCP) called our physiatrist for consulting services fo... Read more
Reader Question:
Start Appending -GP and -GO to Claims
Question: Should we append modifiers -GP and -GO to our therapy codes?Pennsylvania Subscri... Read more
Reader Question:
On-Call Isn't Always New Patient Visit
Question: If our physiatrist is on-call for another group and he sees a patient for the fi... Read more
Reader Question:
Include Conferences in E/M Visit
Question: Our physiatrist treats a patient with fibromyalgia (729.1) who is in an inpatien... Read more
You Be the Coder:
Report -52 for a Halted Injection?
Question: One of our patients presented for a Botox injection. The physiatrist drew the me... Read more
5 Easy Steps to Fluoroscopy Reimbursement
According to CMS, physiatrists reported the fluoroscopic guidance code 76005 nearly 25 tim... Read more
Fluoroscopy Cheat Sheet:
Always Get Paid for Injections
Reporting fluoroscopic guidance with epidural injections is a challenge for even the most-... Read more
TPs Documenting E/M Exams? Read This First
Teaching physicians, take note: Don't rely on residents to complete your documentation for... Read more
Know Your Teaching Physician Requirements
The following excerpt from Medicare Transmittal 1780 (Nov. 22, 2002) can help you determin... Read more
Reader Question:
EMG Must Be Separate Procedure
Question: Is it appropriate to bill muscle testing (with supporting documentation) on the... Read more
Reader Question:
Report 99255 Just Once Daily
Question: If I report CPT 99255 more than once for the same patient on different days, ... Read more
Reader Question:
Report V15.81 for Drug Noncompliance
Question: We performed a nine-panel drug screen on a patient with a brain injury because ... Read more
Reader Question:
Look to 95868 for Bilateral Laryngeal EMG
Question: What is the appropriate code for bilateral EMG of the laryngeal muscle? Louisia... Read more
Reader Question:
NP Can Supervise Incident-To
Question: Our nurse practitioner (NP) normally sees our arthritis patients for follow-up ... Read more
You Be the Coder:
Who Performs the NCS?
Question: Can a nonphysician practitioner perform a nerve conduction study, or must the ph... Read more
Strengthen Your Muscle Weakness Coding With New ICD-9 Codes
PM&R practices will finally be able to specify muscle weakness diagnoses, thanks t... Read more
NCCI Serves Up New Edits for PM&R Practices
Thanks to version 9.2 of the National Correct Coding Initiative (NCCI), which took effec... Read more
3 Steps to Base Your E/M Visit On Time With Patient
Long E/M visits and time spent reassuring and counseling patients in the office does not ... Read more
Set Up a Template for Time Guidelines
If you are still unsure about whether your physician's documentation supports selecting... Read more
Good News! Carriers Wont Ask for Planned Refunds
Due to the delayed implementation of the 2003 Medicare Physician Fee Schedule , Medicare c... Read more
CMS Delays $1,590 Therapy Cap by 60 Days
Thanks to an eleventh-hour therapy-cap delay, you can continue treating your therapy patie... Read more
Reader Question:
Update Your TPI Coding
Question: Our physiatrist performed four trigger point injections in different muscle grou... Read more
Reader Question:
Report Symptoms in Absence of Dx
Question: When we see a patient for a new pain-related problem, I usually report the E/... Read more
Reader Question:
MD Must See Patient First for Incident-To
Question: Our nurse practitioner (NP) often sees patients and, if the physiatrist is in th... Read more
Reader Question:
Report Diskography RS&I Per Level
Question: If our physiatrist performs diskography injections at multiple levels (such as L... Read more
Reader Question:
Isaacs Syndrome: Motor Neuron Disease
Question: Is there a specific diagnosis code for Isaacs syndrome? Texas Subscriber ... Read more
Reader Question:
Report Botox Injections per Operative Session
Question: Our physiatrist administered three Botox injections to a patient's right arm,... Read more
You Be the Coder:
What is the Z-Joint?
Question: Our physiatrist documented a z-joint injection, but we couldnt find a code for t... Read more
Reporting 64405 for Third Occipital Nerve Blocks? Think Again
Physiatrists who administer third occipital nerve blocks should not automati... Read more
Take 3 Steps to Fewer Modifier -25 Denials
If you can prove that you've met specific documentation requirements, you can report both... Read more
News Brief:
Medicare Implements $1,590 Therapy Cap
Effective July 1, 2003, CMS will implement a $1,590 annual cap on Medicare B outpatient o... Read more
Reader Question:
Even Observation Patients Require H&P
Question: Our physiatrist admitted a patient as observation status. He handwrote a history... Read more
Reader Question:
Append -59 for Two Fluoros
Question: Our physician performed fluoroscopy for a transforaminal lumbar epidural steroid... Read more
Reader Question:
Medicare: Partners Are Same Physician
Question: One of our physiatrists administered a Botox injection (64614) to a patient with... Read more
Reader Question:
Report 2 Codes for Polyneuropathy, AIDS
Question: One of our patients has polyneuropathy of the extremities due to AIDS. The phys... Read more
Reader Question:
Modifier -50 Is Carrier-Specific
Question: When we perform bilateral procedures, should we bill the procedure code twice, w... Read more
Reader Question:
Diagnoses Dont Dictate Consults
Question: An internist requested a consult from our physiatrist for a patient with a confi... Read more
You Be the Coder:
Limited or Single-Extremity EMG?
Question: My physiatrist circled 95860 on an electromyography (EMG) report. His EMG dictat... Read more
Create Internal Guidelines for Acute, Chronic Neurogenic Pain Diagnoses
Carriers often require physiatrists to demonstrate whether a patient's neurogenic pain ... Read more
Assisted-Living Evaluations Require Precise Definitions
Physiatrists who evaluate patients in assisted-living facilities should stick to the code... Read more
Avoid IME Codes for Patient-Requested Evaluations
Physiatrists who evaluate workers compensation patients should report the 99455-99456 se... Read more
Correction:
EMG or NCS?
The May 2003 Physical Medicine and Rehab Coding Alert "You Be the Coder EMG or NCS?" sho... Read more
Reader Question:
Report 64620 Per Nerve
Question: Our physiatrist performed three cryodenervations of the 11th intercostal nerve ... Read more
Reader Question:
Append -25 for EMG With Consult
Question: If I perform a consultation on a new patient and feel that an EMG would help me... Read more
Reader Question:
CPT Deleted F-Wave Only Code
Question: How should we report an F-wave study only? New Mexico Subscriber Answer: Effect... Read more
Reader Question:
Submit Just One Fee for 95860
Question: We are considering establishing two different fees for our electromyography (E... Read more
Reader Question:
Selective Nerve Root Injections
Question: What is the correct code for a selective nerve root injection? Nebraska Subscri... Read more
Reader Question:
Report EMG Code Per Limb
Question: Our physiatrist performed a limited electromyography (EMG) study on two muscles... Read more
You Be the Coder:
Mortons Neuroma Injections
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
NCCI Update:
Reporting Pretherapy Injections Will No Longer Be Painless
Version 9.1 of the National Correct Coding Initiative (NCCI), which took effect April 1... Read more
Coding Case Study:
Select Correct Therapy Codes To Avoid Scrutiny
If your PM&R practice undercodes its therapy services to avoid setting off red... Read more
Modifier -25:
Its Not an E/M Cure-All, but Its Close
Although most coders believe that hospital admissions always include all of the E/M se... Read more
Therapy Coding:
Compare Your Billing Pattern to CMS Averages
To determine whether your practice reports therapy services more or le... Read more
Reader Question:
Report 64470 Range for Branch Blocks
Question: Which code should we report for a medial branch block? New Jersey Subscriber A... Read more
Reader Question:
Somatosensory Evoked Potentials: SSEPs
Question: Our physiatrist documented SSEP for back pain in a patient's chart. Is there a... Read more
Reader Question:
Stick With G Codes for sNCT
Question: Which codes should I report for sensory nerve conduction threshold tests (sNCT... Read more
Reader Question:
Report 95869 Once per Session
Question: Our physiatrist used electromyography (EMG) to test levels T3 and T4 of a pati... Read more
Reader Question:
Note Injection Substance to Select Code
Question: How do facet joint injections (64470-64476) differ from epidural blocks (62280... Read more
You Be the Coder:
EMG or NCS?
Test your coding knowledge. Determine how you would code this situation before looking ... Read more
For Aftercare, Report New V Codes Instead of Surgical Codes
If your rehab practice performs aftercare following surgery or fracture, do not re... Read more
Group Therapy:
Report 97150 Despite Patients Demands
You planned your group therapy (97150) session perfectly to accommodate three patients... Read more
News Brief:
2003 Conversion Factor Increased By 1.6 Percent
Although CMS cut the fully implemented nonfacility RVU for 20600* (Arthrocentesis, asp... Read more
Reader Question:
Same-Day SI and Facet Injections
Question: Which codes should we report for a sacroiliac (SI) injection on the same day ... Read more
Reader Question:
You Can Bill Suture Removal Sometimes
Question: Our physiatrist saw a patient in rehab following knee surgery and removed the ... Read more
Reader Question:
Tendon Injections Differ From TPIs
Question: What are the differences among the codes in the CPT 20550 -CPT 20553 seri... Read more
Reader Question:
Report 64999 for Hypogastric Block
Question: How should we code a hypogastric plexus nerve block? Tennessee Su... Read more
Reader Question:
Report 64620 for Cryoneurolysis
Question: Which codes should I report for cryoneu-rolysis of the thoracic intercostal ne... Read more
Reader Question:
Its OK to Report 95870 Per Extremity
Question: How many units of 95870 should we report if the physiatrist performs limited E... Read more
Reader Question:
Code ROM-Loss Symptoms
Question: If a patient has range-of-motion (ROM) loss, should we report 719.5x (Stiffnes... Read more
Reader Question:
Post-Op Pain Management Diagnoses Vary
Question: Medicare denied one of our rehab physician's postoperative pain management cla... Read more
Reader Question:
Report E/M for Oxygen Administration
Question: One of our patients suffered syncope and collapsed in the office. We administe... Read more
You Be the Coder:
Single or Continuous Epidural?
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Multiple Diagnoses, High Risk May Increase Inpatient Code Level
According to CMS data, physiatrists report 99231 more than any other CPT code, which ... Read more
Know CMS Guidelines for Subsequent Hospital Care
The following are CMS'documentation guidelines for the three subsequent hospital care c... Read more
High-Risk Patients May Warrant 99233
The following scenarios illustrate typical examples of when physiatrists use subsequent ... Read more
Bier Block Coding Can Be Painless
Although you should choose 01995 when administering Bier blocks for surgical anesthesia... Read more
Clarification:
Coding Late Effects of CVA
The February 2003 article "Use Just One Diagnosis Code for Late Effects of Stroke" advis... Read more
Reader Question:
Append -51 to Block With SI Injection
Question: Our physiatrist administered a caudal epidural block and a left sacroiliac (SI)... Read more
Reader Question:
Use 64622 for Nerve Destruction
Question: Our physiatrist performed a radiofrequency thermal coagulation (RFTC) to disab... Read more
Reader Question:
Mental Assessment Differs From MME
Question: One of our physiatrists performed a mental assessment on a patient who exhibi... Read more
Reader Question:
Dont Code Both Injection and Nurse Visit
Question: When our nurses administer injections, we usually report the codes for injecti... Read more
Reader Question:
Report New MNT Codes for Changes
Question: A dietitian comes to our rehab facility once a week to meet with some of our p... Read more
Reader Question:
Medicare Will Deny Prolotherapy
Question: We have been performing an increasing number of prolotherapy injections in ou... Read more
Reader Question:
Report 99271 Series for Second Opinions
Question: One of my former patients, whom I havent seen in more than a year, came to my o... Read more
You Be the Coder:
Use V67.09 for Annual Visit
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Use Just One Diagnosis Code for Late Effects of Stroke
Coding the late effects of a cerebrovascular accident (CVA, or stroke) differs fr... Read more
New CCI Edition Bundles 64416 into Most Orthopedic Codes
Version 9.0 of the Correct Coding Initiative (CCI), which took effect on Jan. 1, bundle... Read more
Rank Your CPT Code Use against National Averages
CMS doesn't have a crystal ball that reveals where your practice stands against other ... Read more
Make the Correct Code Comparison
Comparing your code use with CMS'statistics may not be completely accurate because the C... Read more
2003 Fee Schedule Update:
CMS Announces Pay Cut for Trigger Point Injections
To many physiatrists, CMS'2003 Physician Fee Schedule contained alarming news: The 4.4... Read more
Reader Question:
Split Codes When Billing WC,Medicare
Question: After the physiatrist evaluated a workers' compensation patient who had low ba... Read more
Reader Question:
CMS Will Probably Deny Procaine Injections
Question: We have been reporting J2690 (Injection, procainamide HCl, up to 1g) for proca... Read more
You Be the Coder:
Report 62361-62362 for Pain Pumps
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
No Need for Modifier -26 With New Dysphagia Evaluation Codes
Therapists and physiatrists who perform fiberoptic endoscopic swallowing evaluation... Read more
Report New Nerve Block Codes for Pain Management
When used correctly, the four somatic nerve block codes (64416, 64446-64448) that C... Read more
ICD-9 Coding Corner:
Osteoarthritis and Rheumatoid Arthritis Have Their Own Codes
Physiatrists should be extremely specific when reporting arthritis ICD-9 codes, beca... Read more
Therapists Bill the Evens, Physicians Report the Odds
CPT breaks down the new swallowing evaluation codes, so the therapists or speech-language... Read more
Reader Question:
Use 76003-26 for Physicians Role in Fluoro
Question: When I administer a finger joint injection (20600) with fluoroscopy, do I have... Read more
Reader Question:
Submit Modifier -GA When ABN Exists
Question: Do we have to report modifiers -GA and -GX for all claims that we know Medica... Read more
Reader Question:
Facet Joint Injection Has Global Period
Question: Our physiatrist performed a facet joint injection (64622, Destruction by neuro... Read more
Reader Question:
Appeal Downcoded Claims
Question: One of our carriers requested documentation when we billed 99215 to evaluate a... Read more
Reader Question:
Starred Procedures Are Not Global
Question: Our new office manager said we shouldn't bill a new patient visit ( CPT 9920... Read more
You Be the Coder:
Use 20610-59 for Multiple Sites
Test your coding knowledge. Determine how you would code this situation before looking ... Read more
Available Years:  2003  2002  2001  2000