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Eli's Rehab Report
Eli's Rehab Report
Eli's Rehab Report - 2004; Volume 5, Number 12
Debridement, Central Motor EP Highlight 2005 CPT Changes
EP codes eliminate the need for unlisted-procedure code and payment hassles If your ph...
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How to Improve Late Effects Coding
5 strategies keep complications out and reimbursement inOverlooking late effects ICD-9 cod...
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Put Your Late Effects Knowledge to the Test
2 coding scenarios challenge what you've learned Choosing late effects codes isn't always ...
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Don't Forget Pulse Generator CPT Changes
Minor alterations to 63685 and 64590 are still important CPT Codes 2005 makes minor c...
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Prepare for Time-Based Acupuncture Codes
More physician involvement could signal policy change Your physical medicine and rehab (P...
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Reader Question:
Solutions for Bilateral Occipital Nerves
Question: My physician prepared the suboccipital skin with isopropyl alcohol. He performed...
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Reader Question:
Capture Bilateral 62311
Question: When I use CPT 62311 how do I capture the "bilateral" portion? The descriptor st...
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Reader Question:
Use Alternative for Glossopharyngeal Nerve Code
Question: How should I code a glossopharyngeal nerve block? Montana Subscriber Answer: The...
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You Be the Coder:
Craniotomy-Incision Botox Injections
Question: How should I code for Botox injections along a craniotomy incision? My physiatri...
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Eli's Rehab Report - 2004; Volume 5, Number 11
NCCI 10.3 Update:
Count Whirlpool and Hubbard as Component Codes
Watch for diskography, spinal stimulators, inpatient codes bundleIf you continue to report...
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No Need to Hesitate With Spinal Infusion Pumps
Balance opioid therapy between patients and DEA When your physician provides long-term op...
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Don't Be Reluctant With Pain Meds, DEA says
Opioid therapy should include ongoing evaluations As long as your physiatrist regularly a...
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News You Can Use:
75 Percent Rule Gets Another Look
Tweaking criteria could throw a lifeline to threatened facilities Good news for rehab ...
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Change the Way You Code Chemodenervation and EMG
Use 95870 only with 64612-64614, 64640 You should no longer report chemodenervation...
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Reader Question:
Identify Diskography and IDET Location
Question: Can a physiatrist perform a diskography at the same time as intradiskal electrot...
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Reader Question:
No Need to Repeat PFSH for Well Patient
Question: What should a physiatrist on his daily rounds document for history when the pati...
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Reader Question:
Look to EMG for Quantitative Motor Unit Potential Analysis
Question: What is the CPT code for quantitative motor unit potential analysis? New Y...
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You Be the Coder
Multiple Epidurals During Same Session Question: Can I bill for multiple epidurals for the...
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Eli's Rehab Report - 2004; Volume 5, Number 10
Did You Know?You Can Use ESWT For Musculoskeletal Conditions
But what payers cover varies, so watch out Many physicians use extracorporeal s...
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Get It Straight:
Botulinum Type B Is Not Botox
5 botulinum questions and answers can make you $139 more Do you know the difference betwe...
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Know What to Expect From Medicare ESWT Policies
3 examples will save you a hassle in the long run When you report ESWT for patients with ...
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News You Can Use:
Obey the Rules of the Direct-Access Road
Your PT practice may not receive payment as easily When patients start to ache, they may h...
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Reader Questions:
Code Barbotage as Joint Injection
Question: Our physiatrist documented "barbotage of a calcific density in the supraspinatus...
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Reader Questions:
Same-Date E/M With Epidural Block Requires -25
Question: Can we charge an E/M service on the same day as an epidural block?North Carolina...
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Reader Questions:
Don't Expect Separate Payment for Telephone Calls
Question: Are any insurance companies paying for telephone consults (99371-99373)? What ab...
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Reader Questions:
You Won't Find a Code for an Intra-Articular Pars Injection
Question: What is the ICD-9 code for L5 pars fracture and the CPT code for an intra-arti...
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You Be the Coder:
You May Want to Report 726.39 for Bone Spur
Question: What is the correct diagnosis code for an olecranon bone spur? ICD-9 points to 7...
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Eli's Rehab Report - 2004; Volume 5, Number 9
5 Expert Answers to Your Aquatic Therapy Questions
From skill versus unskilled therapy to the use of public pools, our coding specialists g...
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Don't Settle for Unilateral Pay With Bilateral Procedures
Use modifier -50 to collect about $137 more for your facet injections You're not alone if...
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Part B Bundles Some Therapy Services Into SNF Payments
Physicians can report TENS and strapping in an SNF, but therapists can't If your therapist...
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News You Can Use:
New ICD-9 Edition Better Specifies Stroke and CVA
Code 436 no longer applies to every stroke chart As of Oct. 1, you should assign 434.91 (...
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Reader Question:
No Specific Timing Exists Between Acute, Chronic
Question: My physician documents "traumatic brain injury (TBI) with decreased activities ...
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Reader Question:
99301-99303 Do Not Reflect Level of Service
Question: We recently began referring patients to nursing facilities, and we also provide...
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Reader Question:
'And/Or' Makes the Difference for 64614
Question: My physician injected Botox into the trapezius muscle and splenius capitis mus...
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Reader Question:
Use 64999 for Achalasia Chemodenervation
Question: Can I report CPT 43236 for an esophagogastro-duodenoscopy (EGD) with botulinu...
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You Be the Coder:
How Should We Report Infraorbital Block?
Question: One of our physicians performed an infraorbital nerve block. What is the corre...
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Eli's Rehab Report - 2004; Volume 5, Number 8
New ICD-9 Codes Allow Site Specificity for Decubitus Ulcers
You have until Oct.1 to implement the new diagnosis code changes Coders, take notice: At...
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6 Easy Coding Tips for Amputation Rehabilitation
From wound care to aquatic therapy, keep amputee's rehab codes straight Do you know which...
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NCCI 10.2 Bundles Lidocaine Into Hundreds of Codes
If you bill J2001 with your injections, the latest edits will get your attention If your...
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News You Can Use:
Are You Reporting 64999 for IDEA? Think Again
Category III codes replace unlisted-procedure code July 1, 2004, has come and gone, w...
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Reader Question:
Treat a WC Patient, Use Office Visit Code
Question: Should I use work-related CPT 99455 each time my physiatrist sees a workers'c...
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Reader Question:
New Patient Not Based on Creating Medical Record
Question: When a patient presents to the office for the first time after our physician di...
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Reader Question:
Pair 64472 With 64470 for Additional Levels
Question: Our physiatrist performed an intra-articular joint injection in the cervical re...
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Reader Question:
Base 99313 and 99302 on Patient's New Medical Plan
Question: A physiatrist performs a history, evaluation and medical decision-making on a n...
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You Be the Coder:
Does CPT Include a Wound VAC Code?
Question: Our physiatrists have started using a "Wound VAC system" to expedite wound hea...
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Eli's Rehab Report - 2004; Volume 5, Number 7
Code Initial RSD Visits According to Symptoms
Use the 337.2x series only if the physiatrist definitively diagnoses RSD If your physiatr...
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Billing Debridement Codes for Dressing Changes?Think Again
Modifier -25 may be your key to bedsore pay for debridement,E/M visit If your physiatrist...
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Clip-and-Save Chart:
1 Sure Way to Nail Down the Correct RSD Codes
Use our handy chart to quickly identify your patient's RSD services Because reflex sympath...
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Modifiers -52 and -53:
Asking 1 Question Helps You Pick the Correct Modifier
Experts explain what to do when the physiatrist doesn't complete the procedure The physia...
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READER QUESTION:
Report Botox Once per Procedure
Question: My physiatrist performed a peripheral nerve branch chemodenervation with Botox ...
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READER QUESTION:
V Codes Describe Follow-up Total Hip/Knee Replacement Exams
Question: Our physiatrist often takes over the rehabilitation responsibilities for total ...
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You Be the Coder:
Do CVA Codes Refer to Brain or Body?
Question: For a late effect CVA (cerebrovascular accident), or stroke, patient, should I...
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Eli's Rehab Report - 2004; Volume 5, Number 6
NCCI 10.1 Edits Could Cost You More Than $120 Per Test
16 testing codes are now bundled into scores of spinal injection codes If your physiatris...
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Forget Separate Payment for Therapy Evals, Orthotics Codes
New NCCI edits bundle 97755 into 21 other codes If you're billing the new assistive tech...
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3 Tips Help You Choose Among Modifiers -59, -76 and -77
Hint: -76 and -77 signal repeats, while -59 refers to a different procedure You asp...
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Want to Make an Extra 15% Each Time You Report 99213?
5 requirements get you 100 percent nonphysician-practitioner reimbursement If a nonphysic...
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Reader Question:
Whirlpool Alone Is Justifiable for Wound Care
Question: We often use whirlpool to help cleanse patients' wounds. Our carrier recently to...
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Reader Question:
Appeal Modifier -25 Denials
Question: Whenever I use modifier -25 on an E/M service with a procedure code on the same ...
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Reader Question:
Maintenance Therapy Doesn't Pay
Question: Our office manager thinks that our therapist's gait training documentation refer...
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Reader Question:
Append -32, but Don't Expect More Money
Question: Our physiatrist spends a lot of time on confirmatory consultations that insurers...
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Reader Question:
Don't Let Patient's Age Drive Diabetes Diagnosis
Question: Our rehab physician recently saw a 16-year-old motor-vehicle accident patient wi...
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You Be The Coder:
Modifier -50 and 95900 Don't Mix
Question: Should we append modifier -50 to 95900 when we perform bilateral testing for car...
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Eli's Rehab Report - 2004; Volume 5, Number 5
4 Steps to Nerve Conduction Study Reimbursement
Identify the nerves tested to ease the path, experts sayIf you're confused when the physia...
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Performing Joint Injections Too Often? Prepare an ABN
Don't write off the $50-80 that Medicare allots for 20600-20610If you research payable dia...
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3 Answers to Your Consult Coding Questions
You can't 'boost' your MDM level, but you can improve your documentation ...
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Reader Question:
Report Trigger Point Code Once for 3 Sites
Question: Our physiatrist performed trigger point injections into the patient's back (rhom...
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Reader Question:
27096 Refers to SI Joint, Not Hip
Question: Our physiatrist performed a right hip joint injection under fluoroscopic guidanc...
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Reader Question:
Nurse Removes Stitches? Report 99211
Question: A motor-vehicle accident patient came to our office for therapy, and our nurse r...
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Reader Question:
Crutch Training Code Depends on Practitioner
Question: When we teach a patient how to use crutches, should we report CPT 99211 or a mo...
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You Be The Coder:
How to Report Botox for Blepharospasm
Question: How should I report Botox injections to control blepharospasm?Texas SubscriberAn...
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Eli's Rehab Report - 2004; Volume 5, Number 4
Select the Appropriate Injection Code in 4 Easy Steps
Hint: Look for these key words in the documentationMost PM&R practices submit injectio...
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Bill SNF Patients' Therapy Directly to Nursing Facility
Don't risk losing $80 or more per claim: follow consolidated billing rules When skilled nu...
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Report These Codes Directly to the SNF
Most diagnostic, therapy services are subject to consolidated billingMedicare includes hun...
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Debunk a 99211 Myth -- It's Not Just for Nurses
Learn 99211's requirements to determine whether your visits warrant itBecause PM&R pra...
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Reader Question:
Use New Patient Code After Covering
Question: When my physiatrist covers for another local private-practice rehab physician, I...
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Reader Question:
Base Dorsolateral Nerve Block on Injection Type
Question: What is the best CPT Code for a dorso-lateral sacral nerve branch block? Vi...
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Reader Question:
Consults Apply to New and Established Patients
Question: Should I report a consult for an established patient (whom we last saw two years...
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Reader Question:
Test Five Muscles to Report 95860-95864
Question: In your March 2004 article "Don't Forget EMG Guidance With Myobloc Injections," ...
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You Be The Coder:
Should We Append -52 to 95860?
Question: When we report EMG code 95860 without testing the paraspinals, should we attach ...
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Eli's Rehab Report - 2004; Volume 5, Number 3
Think J0585 Is a Catchall Botox Code? You May Be Throwing Away $340 Per Vial
Hint: Look for special Myobloc code, experts say If you report Botox type B (BTB) using ...
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Don't Forget EMG Guidance With Myobloc Injections
If you perform electromyographic (EMG) guidance to ensure Botox injection needle placement...
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How Does Your State Measure Up?
We've got the scoop on which states have the best BTB reimbursement Individual Medicare ...
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NCCI 10.0 Bundles Nerve Blocks With Most PM&R Codes
Medicare considers pretherapy injections nonreimbursable The latest version of the...
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News You Can Use:
Higher Conversion Factor Bolsters PM&R Practices' Pay
CMS finally released the long-awaited 2004 conversion factor. According to CMS' Dec. 24 tr...
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3 Tips Increase Your Discharge Reimbursement of $75-$100
Don't let poor documentation sink your 99238-99239 claims Physiatrists report hospital d...
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Reader Question:
Carriers Still Hashing Out 97755 Rules
Question: How many units of the new PM&R CPT 97755 can I report on the same date?Tenn...
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Reader Question:
Ask the Physician for Isaac's Syndrome Code
Question: Is there a specific diagnosis code for Isaac's syndrome? Texas Subscrib...
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You Be the Coder:
Is This Group Therapy?
Question: Our therapist often works with two patients simultaneously in a skilled nursing ...
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Eli's Rehab Report - 2004; Volume 5, Number 2
Secure Inpatient Pay Every Time With This ICD-9 Code Sequence
Primary DX should represent why you see the patient, not the underlying condition Physia...
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Stop Giving Away Your CPO Services for Free
Correct documentation could earn you an extra $80 Don't let carriers undervalue your phy...
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CPO Codes at a Glance
Use this quick reference to code your physician's CPO services If you frequently repo...
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Create a Foolproof System for Tracking CPO Services
As with other time-based codes, you must have thorough documentation to report CPO service...
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Fee Schedule Update:
Physicians Escape 4.5 Percent Cut for 2004
Medicare legislation raises conversion factor by 1.5 percent Congress offered physiatrist...
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Determine the Effect of the 2004 Fee Schedule on These Common Procedures
The following chart outlines a sampling of physician work RVU cuts for common PM&R pro...
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News You Can Use:
Congress Imposes 2-Year Moratorium on Therapy Cap
$1,590 cap no longer applies to therapy claims Good news for rehab providers: CMS' dreade...
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Reader Question:
Report 92950 for Resuscitation
Question: Our physiatrist was making rounds at the hospital today when he responded to a "...
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Reader Question:
Describe Wrist Aspiration With 20605
Question: I performed a consultation at the hospital, where I also aspirated the patient's...
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Reader Question:
Track E/M Components With New Category II Codes
Question: What is the new Category II section in CPT, and how should we use it? Flori...
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You Be the Coder:
One Diagnosis Code or Two?
Question: If a patient has knee pain and shoulder pain, should we report each diagnosis, o...
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Eli's Rehab Report - 2004; Volume 5, Number 1
CPT 2004 Clarifies Trigger Point Code
The AMA continues to tinker with the trigger point injection code descriptors, and CPT 200...
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CPT Clears Up Cloudy Starred Procedures
Don't let deleted 'stars' disrupt your private carrier payment The AMA ha...
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3 OIG Hot Spots and How to Steer Clear of Them
Want to avoid OIG scrutiny in 2004? Shore up modifiers, E/Ms Do you append modifi...
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Clarification:
Ask Your Payer About E/M With EMG
The November 2003 article "Reporting E/M and EMG? Avoid These Pitfalls" stated that in mos...
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Reader Question:
Prolonged Services Require Same Date
Question: Our group of physiatrists evaluates a patient on day one. The following day the...
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Reader Question:
No Anesthesia, No 15852
Question: One of our patients was in the rehab facility recovering from an automobile acc...
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Reader Question:
Show Payer the Time You Spend on E/M
Question: One of our insurers downcodes my E/M visits because the diagnoses don't support...
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Reader Question:
Report Intradiskal Injection by Site
Question: How should I code an intradiskal injection? Texas Subscriber Answer: Before you...
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Reader Question:
Report Hospital Admit or Outpatient E/M - Not Both
Question: When we admit a patient to the hospital directly from the office, should we bil...
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You Be the Coder:
How Should I Report NP's Services?
Question: Which code should I use for a nurse practitioner (NP) visit when the physiatrist...
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Available Years:
2004
2003
2002
2001
2000