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Primary Care Coding Alert

Nursing Facility Assessments Demand Careful Coding to Optimize Payment
Comprehensive nursing facility assessments (99301, 99302 and 99303) have been known to con... Read more
CPT and HCPCS Coding Changes for 2001 Affect Billing
The American Medical Association made its annual announcement about additions, deletions a... Read more
2001 Physician Fee Schedule Means Greater Reimbursement
HCFA announced on Nov. 1, 2000, that new Medicare payment rates to physicians will increas... Read more
Reader Question:
Incidental Services
Question: One of our doctors wants to know how to report services if a patient is seen for... Read more
Reader Question:
Stress Testing
Question: When billing for treadmills in the office, we use 93015. Is there a different co... Read more
Reader Question:
Injection Coding
Question: Is it allowable for us to bill 90782 (therapeutic, prophylactic or diagnostic in... Read more
Reader Question:
Groin Exploration
Question: If groin exploration is an unlisted procedure, which CPT code is appropriate? Ad... Read more
You Be the Coder:
I&D Global Periods
Question: A patient was seen for an incision and drainage of a cyst. She returned to the... Read more
Multiple Factors Help Determine Correct Code For Reimbursement for Lesion Removal
Removal of lesions or growths is among the procedures family physicians perform most frequ... Read more
Three Steps to Improve Diagnosis Coding of Repeat Pap Smears
When tests, exams or procedures need to be repeated, family practice coders are often conc... Read more
Reader Question:
Family Counseling
Question: What code is best to use for family counseling for a dying patient?Arizona Subsc... Read more
Reader Question:
Cancer Screening
Question: A new coder joined our staff and said that if we assigned the G0101 code during ... Read more
Reader Question:
Established vs. New Patient
Question: We are a multispecialty group with internists, family practitioners and pediatri... Read more
Reader Question:
Delestrogen
Question: I have a patient who receives Delestrogen, 40 mg. My understanding is that we sh... Read more
You Be the Coder:
Obstetric Care
Question: A family practitioner (FP) has provided obstetric care to a patient, including t... Read more
Bill the Injection and Provision of Antigens for Optimum Reimbursement of Allergy Therapy
Family practice coders turning to the allergen immunotherapy section of the CPT manual oft... Read more
Bill CPT & HCPCS Codes for Full-service Synvisc Payment
Coders have reported an increase in the use of a new therapy called Synvisc (hyaluronic ac... Read more
HCFA Releases Draft E/M Documentation Guidelines
The Health Care Financing Administration (HCFA) unveiled proposed documentation guidelines... Read more
Reader Question:
Urinalysis
Question: One of our payers is handling the following three urinalysis codes differently: ... Read more
Reader Question:
Place of Service
Question: I have several questions regarding a situation where one doctor visits another p... Read more
Reader Question:
Nurse Visit
Question: If a patient presents to the office for a procedure not requiring a visit with t... Read more
You Be the Coder:
Coding With an EKG
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Many Variables Impact Proper Reimbursement for Observation Status
Many factors affect coding when patients are admitted to the hospital for observation. Co... Read more
Proposed Changes Would Lower Observation Reimbursement
In the July 17, 2000, edition of the Federal Register, the Health Care Financing Administr... Read more
The Art of Diagnosis Coding:
Understand the ICD-9 System and Decrease Claims Rejections
Correct use of diagnosis codes is crucial to any family practice offices reimbursement. Ac... Read more
Reader Question:
Colonoscopies
Question: A physician has asked me how to bill for colonoscopies using multiple snare or ... Read more
Reader Question:
Basal Cell Lesions
Question: A patient had destruction of five basal cell lesions that were .5 cm in size and... Read more
Reader Question:
Pap Smears
Question: In the February issue of Family Practice Coding Alert, you said it was not acc... Read more
You Be the Coder:
Unscheduled Visit
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Correct Reporting of Endoscopic Exams Gains Ultimate Ethical Reimbursement
Family practice coders charged with assigning codes for endoscopic examinations of the low... Read more
How to Code Complex Deliveries And Speed Reimbursement
Delivering babies may represent a significant portion of a family practices business. In m... Read more
Reader Question:
Dictated Records
Question: At a seminar I attended, the speaker stated that a physician should never put di... Read more
Reader Question:
School Physicals
Question: This is the time of year when our office sees a lot of school, camp and bus driv... Read more
Reader Question:
Diabetic Educator
Question: We have a certified diabetic educator who sees some of our patients, and I have ... Read more
You Be the Coder:
Skin Nodule
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Poisoning vs. Adverse Reaction:
Receive Optimum Pay Up for Treatment of Ill Effects from Medication
Nugget: Code the treatment of ill effects from a medication after determining whether the ... Read more
Special HCPCS Codes Get Optimal Pay Up for Gyn Exams
Nugget: Family practices will get the reimbursement to which they are ethically entitled b... Read more
Optimize Reimbursement for Nurse-only Visits
Nugget: To properly use 99211, the nurse must know when to involve the physician, or the p... Read more
Reader Questions:
Cerumen Removal
Question: A patient came into our office with complaints of ear pain and Herpes simplex. T... Read more
Reader Questions:
Motor Vehicle Accident Injuries
Question: A patient comes into the office to see the physician for injuries resulting from... Read more
Reader Questions:
ERCP Stent Change
Question: One of our physicians changes the stent in his patients and wants to bill using ... Read more
You Be the Coder:
E/M Services
Question: A patient came into our office for a scheduled visit. We sent the patient direct... Read more
Optimize Medicare Reimbursement for Prostate Cancer Screening Exams
Thanks to changes in Medicare policy as of Jan. 1, 2000, family physicians now have the op... Read more
Maximize Payment for Critical Care Services
Coding professionals who monitor critical care service codes noticed several significant c... Read more
Reader Question:
Medicare Payments
Question: We are having difficulty getting paid by Medicare in two areas. First, Medicare ... Read more
Reader Question:
Marcaine Coding
Question: What J code should we assign to indicate the use of Marcaine, 0.5 solution?Allan... Read more
Reader Question:
Preventive Services vs. E/M
Question: I am new to coding and confused about the distinctions between a preventive serv... Read more
Reader Question:
Nurse Visits
Question: One of our patients has complained that he needs to make an appointment for a ch... Read more
You Be the Coder:
Laceration Repair
Question: A patient was seen at our office for the repair of a laceration. We filed code 1... Read more
Optimize Medicare Payment by Billing Evaluation and Management in Addition to FOBT
Only 9 percent of eligible fee-for-service Medicare beneficiaries get their annual fecal o... Read more
Five Tips for Improving E/M Reimbursement
No codes are more common for family practices than those for office/outpatient evaluation ... Read more
How to Bill Annual Physical And E/M on the Same Day
Family physicians (FPs) and coders often debate whether a patient visit is billed approp... Read more
Compliance Plans:
Compliance Plan Will Help FPs Through Medicare Audits
A central focus of Medicares campaign in the upcoming year will be compliance within solo ... Read more
Yo Be the Coder:
B-12 Injections
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Reader Question:
Remicade Infusions
Question: The practitioner in our office is billing for Remicade infusions for the first t... Read more
Reader Question:
Pre-surgical Physical
Question: What is the correct method to bill a pre-surgical physical 99244 (office consult... Read more
Getting Payers to Reimburse For The Bethesda System
Although the Bethesda System (TBS) of reporting Pap smears is widely practiced, it is not ... Read more
Correctly Defining the Patient as New or Established Gets Optimum Reimbursement
Although CPT defines new and established patients under Definitions of Commonly Used Terms... Read more
Receive Optimum Payment by Avoiding Undercoding
CPT outlines the three key components for choosing an E/M levelhistory, examination and m... Read more
Reader Question:
Treating a Hospice Patient
Question: What code do I use when the patient is under hospice care (at home) and the phys... Read more
Reader Question:
Billing for Resuturing
Question: A patient comes in with a benign lesion which requires excision and sutures. The... Read more
You Be the Coder:
Diagnostic Code for Prostate Exam
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Correct Reporting of Flu Visits and Vaccinations Optimizes Reimbursement
Family practice offices recently have been beset by a rash of flu cases and people seeking... Read more
Time Is Key Element in Getting Payment for Prolonged Service
Documentation of physician time is critical in charging for prolonged services, which are ... Read more
Separate Coding of Lab Tests Will Bring Appropriate Payment
Coding lab tests can be a challenge when lab panels dont include all of the tests that wer... Read more
Reader Question:
Intravenous Injection and Administration of Fluids
Question: A patient presents with nausea, vomiting and dehydration. How do you code for th... Read more
Reader Question:
Coding When Resident Sees Patient
Question: A family practitioner (FP) and resident go to see a patient in a nursing home du... Read more
You Be the Coder:
New Administrative Codes
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Knowing What is Included in the Global Surgery Package Avoids Coding Errors
Although family practitioners (FPs) rarely perform major surgery, they do conduct minor s... Read more
Correct Coding for Level of Maternity Care Provided
Depending on whether a family practitioner provides antepartum care only, delivers the bab... Read more
Reader Question:
Levels of Preventive Care
Question: How do we designate different levels of preventive care? Maybe someone only need... Read more
Reader Question:
Correctly Coding Pap Smears
Question: If a patient comes in for a Pap smear, can we charge for an office visit along w... Read more
You Be the Coder:
Ear Wash--E/M Code or Not?
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Correctly Code to Get Paid for Immunizations
To get reimbursed for giving a patient a vaccination, either on its own or as part of a pr... Read more
Optimize Pay Ups for School, Camp, and Work Physicals
Its an annoying but real fact of life for billers for family practices: patients or parent... Read more
Yo Be the Coder:
Joint Injections
Test your coding knowledge. See if you can come up with the answer, and then check yourse... Read more
Capturing Patients Appropriate History Is a Necessity for Work-related Injuries
Since coding for work-related injuries is dictated by each state, there are no national st... Read more
Reader Question:
Preventive Screening
Question: I am a nurse practitioner and work with some older adults under Medicare. I am ... Read more
Available Years:  2000  1999