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Primary Care Coding Alert

Follow the Rules for Full Flu Shot Reimbursement
It's that time of year again turkey roasting in the oven, holiday gift shopping, ... Read more
Dont Get Shortchanged on Visits to Nursing Homes
When your FP visits a long-term-care facility, pay close attention to the language in ... Read more
Look to CMS for Rules on Assisted-Living Centers
A 2001 Medicare transmittal offers a clear answer to a question that has been plaguing... Read more
Reader Questions:
Digital Rectal Exam Payment
Question: I know CMS has released bulletins saying G0102 (Prostate cancer screening; d... Read more
Reader Questions:
Holter Monitor Removed Early
Question: How should I bill for a Holter monitor if the device is not left in place fo... Read more
Reader Questions:
Critical Care or Prolonged Service?
Question: A patient suffered syncope and collapsed in the office, so our FP administer... Read more
Reader Questions:
Medicare Waivers
Question: We almost always have our Medicare patients sign an advance beneficiary noti... Read more
Reader Questions:
ICD-9 Grace Period
Question: Our software system has not yet been updated for the new ICD-9 codes that CM... Read more
Reader Questions:
Allergy Injection and Nurse Visit
Question: May I bill 99211 (Office or other outpatient visit for the evaluation and mana... Read more
You be the Coder:
Billing for Treatment of Relatives
Test your coding knowledge. Determine how you would code this situation before l... Read more
Injection Codes, Observation Care Codes Among Big CCI Changes
The new Correct Coding Initiative edits are in, and family practice coders will ... Read more
Six Steps to Preventive/Problem Payment
Although getting paid for a preventive exam and a problem E/M service on the same vi... Read more
Listen Up:
Coding the Otitis Media Diagnosis
With more than 24 codes to choose from (381.00-382.9), coding an otitis medi... Read more
READER QUESTION:
Circumcision Repair
Question: A pediatrician performed a circumcision a newborn in the morning, and th... Read more
READER QUESTION:
Wart Removal With E/M
Question: I know that if an established patient makes an appointment to have a wart ... Read more
READER QUESTION:
Nail Avulsion and Excision Distinction
Question: I am confused as to when to code for avulsion of a toenail and when to code ... Read more
READER QUESTION:
Venipuncture and Specimen Handling
Question: When an FP performs a blood draw at a patient's home and then transfers ... Read more
You Be the Coder:
Urgent Care Hours
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Cast Away Denials With Casting and Strapping Rules
There are no bones about it: Coding for casts and strapping instead of fractur... Read more
Modifier Madness:
Clear Up Confusion Over Modifiers -51 and -59
Modifiers -59 (Distinct procedural service) and -51 (Multiple procedures) ha... Read more
Test Your Knowledge:
Coding Modifiers -51 and -59 Case by Case
Test your modifier knowledge. Determine how you would append this situat... Read more
Reader Question:
Cerumen Removal With E/M
Question: A patient came in complaining of congestion in his ear. After examining ... Read more
Reader Question:
Injection and Nurse Visit
Question: When a patient comes in for a Depo-Provera injection, one of our physicians ... Read more
Reader Question:
Lesion Excision Global
Question: Three days after having a lesion removed, a patient came in with an infe... Read more
Reader Question:
Extra Emergency Time
Question: A new patient came into the office with a laceration of her forearm. The... Read more
You Be the Coder:
Coumadin Coding
Test your coding knowledge. Determine how you would code this situation before... Read more
Upcoming ICD-9 Changes Affect Family Practices
From abnormal Pap smears to fracture follow-ups many of the upcoming ICD-9 change... Read more
ICD-9 Joins the 21st Century
Stumped about how to code that paintball injury or scooter fall? The ICD-9 revisions h... Read more
Quench Your Thirst With IV Hydration Coding
You may think intravenous (IV) hydration coding is just a matter of reporting 9078... Read more
Shoot for Dollars With Trigger Point Coding
The challenge of coding trigger point injections is two-fold: calculating the number... Read more
Reader Question:
Anaphylactic Reaction
Question: After a patient receives an allergy injection, she has an anaphylactic react... Read more
Reader Question:
ED Visit to Determine Patient Admission
Question: How can our FP get paid for an emergency department visit when he is cal... Read more
Reader Question:
Tummy Trouble
Question: An established patient presented with mid-abdominal pain. He told the FP it ... Read more
You Be the Coder:
Pap-Only Visit
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
New CMS Coverage:
Cash In on ABPM
Family physicians who provide ambulatory blood pressure monitoring (ABPM) can now re... Read more
Use 796.2 for White-Coat Hypertension
An estimated 20 percent of patients have white-coat hypertension, so coders will likel... Read more
Zero In on Dollars With Asthma Code Revision
ICD-9 2002 implemented a key change in asthma diagnosis coding that family physician... Read more
CCI Version 8.2:
FP Coders Get a Breather
The new Correct Coding Initiative (CCI) edits version 8.2 that took effect July 1 co... Read more
Reader Question:
Hospice Patient
Question: We referred a patient to hospice for lung cancer, but we are still treating ... Read more
Reader Question:
Fracture Follow-Up
Question: Our FP saw a patient in the emergency department (ED) and applied a splint. ... Read more
Reader Question:
Incision/Removal Code Includes Repair
Question: Our FP removed glass from a patient's temporal area and sutured the wound. W... Read more
Reader Question:
Reciprocal Billing Versus Locum Tenens
Question: Our family physician is taking a month-long vacation. Another physician wi... Read more
Reader Question:
Meds Management
Question: Can I use 90862 for follow-up visits of patients on anti-depressant medica... Read more
Reader Question:
Phone Call Conundrum
Question: Although our physicians sometimes spend a lot of time managing patients ov... Read more
Reader Question:
Multiple Lesion Modifiers
Question: Our physician removed and destroyed multiple lesions on a Medicare patient... Read more
You Be the Coder:
Counseling a Family Member
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Code 16000 Series Is Cool for Burn Treatment
When a patient seeks treatment from the family physician for a minor burn, m... Read more
Diagnosis Directs Payment for Concurrent Care Coding
When family physicians (FPs) along with other specialists treat patients in the h... Read more
Reader Question:
Two Office Visits on One Day
Question: Early in the morning, the physician diagnosed a woman with acute bronchitis ... Read more
Reader Question:
Physician Office Injury
Question: We recently saw a young child with chicken pox. While the patient, his mothe... Read more
Reader Question:
TB Skin Tests
Question: What is the proper way to bill for TB skin testing? Is it appropriate to rep... Read more
Reader Question:
Rape Codes
Question: Would you please advise us on how to code for a rape exam? Arizona Subscrib... Read more
Reader Question:
Cardiovascular Exam
Question: How should we report V72.81? One interpretation is to assign it only if the ... Read more
You Be the Coder:
Payment for Visiting Patients
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Capture Correct Reimbursement:
Patients Chronic Condition Determines Antepartum Care Code
Many family physicians (FPs) provide antepartum care for pregnant patients with chroni... Read more
News Brief:
Medicare Issues Guidelines for MNT Codes
Medicare recently issued its national coverage decision on medical nutrition therapy... Read more
CCI Update:
New CCI Edits Affect Vaccination and Wound Care
The new Correct Coding Initiative (CCI) edits version 8.1 went into affect A... Read more
Reader Question:
Penis Wart Destruction
Question: When our doctor destroys warts on male patients' genitals we d... Read more
Reader Question:
Prothrombin Time Test Follow-Up
Question: A 65-year-old patient is on Coumadin for his cardiac arrhythmia. He came in ... Read more
Reader Question:
History Versus Continuing Treatment
Question: A patient presented with an ankle sprain, and the physician told him to rest... Read more
Reader Question:
Mini-Mental Status Exam
Question: We had a 78-year-old patient present with dizziness. The patient's son accom... Read more
Reader Question:
Adverse Reaction to Medication
Question: A diabetes patient who just started using insulin presented with blurred vis... Read more
Reader Question:
Xylocaine Injection and Excision Bundled?
Question: The physician removed six papillomas from a patient and administered three d... Read more
Reader Question:
Dual Hospital Visits
Question: Dr. A admits a patient to the hospital and bills this as a level-one hospita... Read more
Reader Question:
Venipuncture Coding
Question: When a family physician performs venipunctures in the office, which is the... Read more
Reader Question:
Medication Evaluation
Question: Under which key component should we count physician review of a patients medic... Read more
You Be the Coder:
Two Lesions,One Global Period
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Report Foot Care Based on Disease,Symptoms
Family practitioners (FPs) cut or pare keratotic lesions on feet and treat toenails ... Read more
Use Prolonged Services to Capture Extra E/M Time
Many coders are confused about when to code for time and when to use the prolonged ser... Read more
Reader Question:
Dissatisfied Patient
Question: A patient sees one physician in the practice and is unhappy with that provider... Read more
Reader Question:
Red Tide
Question: Recently, we have had patients present with reactions to red tide. They come i... Read more
Reader Question:
Oxygen Therapy
Question: Our family physician gave a patient with cluster headaches 20 minutes of oxyge... Read more
Reader Question:
ADHD Absent Definitive Diagnosis
Question: How should I code for a patient being evaluated for attention deficit diso... Read more
Reader Question:
Supplied Serum
Question: How should I code when our physician gives an injection of allergen immunother... Read more
Reader Question:
Diagnosis of Substance Abuse
Question: A patient presents with depression and feelings of nervousness. During the s... Read more
You Be the Coder:
BP Check
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Coding for Hearing Tests:
92551 versus 92552
Reviewed on May 22, 2015 The difference between pure tone hearing tests and threshold ... Read more
A No-Risk Plan for Coding Initial and Repeat Pap Smears
Pap smears are covered every two years for low-risk Medicare patients and annually for h... Read more
Medicare Now Covers IVIg for Specific Skin Diseases
Family practices can now receive reimbursement for intravenous immune globulin treatme... Read more
Reader Question:
Preoperative Testing
Question: Our doctor does preoperative testing on patients. Usually the pre-op includes an... Read more
Reader Question:
Disability Paperwork
Question: Can we charge the insurance company for having the physician complete disability... Read more
Reader Question:
Two Doctors Performing Critical Care
Question: Our FP was paged to the emergency room (ER) at 1 a.m. to treat one of his patien... Read more
Reader Question:
Podophyllin Treatment of Warts
Question: How should I code for podophyllin treatment of four vaginal warts? We are u... Read more
Reader Question:
Sick-Building Syndrome
Question: Which code should we use for sick-building syndrome? Nevada Subscriber  An... Read more
You Be the Coder:
Preventive Exam with Vision Screening
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Straightforward Coding Guidance for
Family physicians (FPs) perform proctosigmoidoscopies (proctos) and flexible sigmoidoscopi... Read more
New Rules Beckon Proper Use of Medical Nutrition Codes
Family physicians have a new option for providing nutrition counseling to Medicare patie... Read more
Breathe Easily:
Tips for Coding PFTs Correctly
Family physicians (FPs) often perform spirometry (94010) and bronchospasm (94060) tests on... Read more
Reader Question:
Fracture Care Coding
Question: The physician fixed a patients fracture of the distal finger by placing the fing... Read more
Reader Question:
Sports Physical and Checkup
Question: When a child comes to the office for a sports physical and a well visit at the s... Read more
Reader Question:
Diagnosis Code for Immunizations
Question: A patient came in complaining of back pain and said he was leaving the country a... Read more
Reader Question:
Destruction of Plantar Wart
Question: Which code should I use for cryotherapy treatment of a common or plantar wart on... Read more
Reader Question:
Teaching Visits as Nurse Visits
Question: Patients who are new to insulin come to our office for teaching visits. A nurse ... Read more
You Be the Coder:
Excision of Benign Lesions
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Code E/M Visit, Procedure Separately for Minor Dermatological Problem
Often a patient comes in for a regular office visit, and the family physician (FP) dis... Read more
Patients Health Is Key Factor in Coding for Counseling
When doctors counsel patients on disease care or preventive health, they should be paid ... Read more
Assisting Surgeons Use Same Code as Primary Surgeons
About one of every four family physicians serves as an assistant at surgery, according t... Read more
New CCI Edits Have Few Changes for Family Practices
CMS released the national Correct Coding Initiative (CCI) edits version 8.0 effective Jan.... Read more
Reader Question:
Hospital Admission
Question: A patient presents to the office, and the physician determines she needs to be a... Read more
Reader Question:
Nursing Home
Question: Our physician sees patients in a nursing home, and while he is making rounds, pa... Read more
Reader Question:
Bicillin
Question: When a patient comes in for an office visit and is given an injection of Bicil... Read more
You Be the Coder:
Glass Removal
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
CMS Clarifies When To Code Diagnostic Tests Based on the Results
CMS' recent program memorandum (transmittal AB-01-144) reminded Medicare carriers of t... Read more
Avoid Modifier Missteps To Reduce Denials
Modifiers remain a mystery to many coders who think they know how and when to append... Read more
Anthrax Coding Report Free on Web
Physicians and other healthcare professionals who provide services to any patients with ac... Read more
Reader Question:
Is This Visit Preventive or Problem-Oriented?
Question: An established patient scheduled an annual physical, but when he came in he comp... Read more
Reader Question:
Lunelle Injection
Question: Our practice is receiving many requests for the new contraceptive injection Lune... Read more
Reader Question:
Bone-Density Screening Requirements
Question: A 35-year-old woman presents with osteoarthritis of the knee and a pituitary a... Read more
You Be the Coder:
Daughter Seeking Advice for Mother
Test your coding knowledge.  Determine how you would code this situation before l... Read more
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