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Primary Care Coding Alert

Prepare for Denials if You Report 2 Nursing Facility Codes on a Single Claim
No modifier can separate the new edits bundling codes in the 99304-99316 rangeThe new edit... Read more
Break Bad Coding Habits With Fracture Care Answers
Does fracture care have a time limit? The answer may surprise you If your family physicia... Read more
Important Fracture Care Coding Terminology at Your Fingertips
Know these keywords to select the right ICD-9 code every timeWhen you review your fracture... Read more
Reader Question:
Consider Sending Documentation for 69205
Question: Our family physician documented the following note: -An impacted foreign body (F... Read more
Reader Question:
Medicare Allows Initial Screening ECG
Question: Do Welcome-to-Medicare patients qualify for a screening ECG? Which codes should ... Read more
Reader Question:
Count the Minutes When You Bill PT Modalities
Question: We recently hired a physical therapist. He saw a 65-year-old male with multiple ... Read more
Reader Question:
Check Out ICD-9's Signs and Symptoms Codes
Question: A patient recently presented with pain in her hands that kept her awake at night... Read more
Reader Question:
Ask for Specifics With Chronic Pain Syndrome
Question: What is the best diagnosis code for chronic pain syndrome?Indiana Subscriber An... Read more
You Be the Coder:
Will Waterpik Satisfy 69210 Requirement?
Question: Our physician removed cerumen using a Waterpik. He says that this is an -instrum... Read more
Combat Confusion Surrounding the 2006 Digital Rectal Exam/FOBT Codes
The code creators explain the differences between 82270, 82272 and G0107Coding for digital... Read more
Coding Quiz:
Take 5 Minutes to Determine Your NPP Coding Know-How
Can you bill incident-to in the hospital?  The answer may surprise youYou might think... Read more
Steer Clear of 3 Diagnosis Coding Snags
Our guidelines spell out the requirements for aftercare, V codesWhat should you do when yo... Read more
READER QUESTIONS:
Emphysema Visit May Require Multiple CPT Codes
Question: Which CPT Code should we report when an established patient with emphysema (49... Read more
READER QUESTIONS:
Stop Guessing When Coding MMR Titer Draw
Question: A patient needs proof that she was vaccinated against MMR, but she cannot find h... Read more
READER QUESTIONS:
Remember Modifiers for Hospice Visits
Question: When our FP (who is a non-hospice provider) performs a medical visit at a hospic... Read more
READER QUESTIONS:
Rely on E Codes for WC Patients
Question: Some of our insurers require E codes following an accident, but others do not. W... Read more
You Be the Coder:
How Should We Bill Patient-Generated 2nd Opinions?
Question: I know that CPT deleted the confirmatory consult codes for billing second opinio... Read more
Alert Your Staff to These 4 CMS-Issued Changes
Feel free to report stress tests and E/Ms without modifier 25CMS has issued a number of ch... Read more
Take These Simple Steps To Soothe Burn Coding Confusion
Tip: The burn's location is crucial to choosing the right ICD-9 codeWhen you-re faced... Read more
Coding Coffee Break:
Can You Code the Story of Your Life?
Try to find the diagnoses that match up to these milestonesIt seems that there's an ICD-9 ... Read more
READER QUESTIONS:
CMS Adds New Diabetes--Related Coverage to FQHCs
Question: Are DSMT and MNT services covered benefits in an FQHC?Washington Subscriber Ans... Read more
READER QUESTIONS:
Leave ECG Diagnosis to Physician
Question: If the family physician hasn't indicated the ECG results in his final diagnosis,... Read more
READER QUESTIONS:
Count 'No Fever' in ROS
Question: I have found information and heard at seminars conflicting information regarding... Read more
READER QUESTIONS:
Determine Payer for Dermabond Repair
Question: When an FP closes a wound using Dermabond, should we report a simple laceration ... Read more
READER QUESTIONS:
Marshfield Auditor's Sheet In Not a CMS Tool
Question: What exactly is the Marshfield Clinic Auditor's worksheet? I have heard that it ... Read more
READER QUESTIONS:
Classify 'Spitting Up' as a Feeding Problem
Question: A mother presents with her newborn baby and says she is concerned about the baby... Read more
You Be the Coder:
Lock Down Td Product Code With This Component
Question: When an adult patient receives a DECAVAC injection, should I use 90714 or 90718?... Read more
These Tips Help You Decide if Destruction, I&D Visits Also Warrant E/M Service
Improve your procedure-related coding with solid understanding of modifier 25 Two ast... Read more
Test Yourself:
Do These Common FP Procedures Also Warrant an E/M Service?
See how you rationale stacks up to these experts' opinionsYou should be able to bill for a... Read more
Quick Tips:
How to Keep Well-Woman Exam Claims Squeaky-Clean
Say goodbye to your confusion over screening guidelinesTo code a well-woman exam correctly... Read more
READER QUESTIONS:
Obtain Alternative V20.2 Age Guideline in Writing
Question: BlueCross National Capital Area (NCA) started applying claims containing V20.2 a... Read more
READER QUESTIONS:
Code Flu Shots Separate From Global Ob
Question: A patient came in for an obstetric revisit and received a flu shot. What is the ... Read more
READER QUESTIONS:
Avoid This No-Credit-History Statement
Question: If a family physician marks a Medicare patient's history element as -noncontribu... Read more
READER QUESTIONS:
Does Developmental Questioning Warrant Reporting
Question: At a 24-month established patient preventive medicine service, a mother describe... Read more
You Be the Coder:
Quickly Unravel 99354-99355's Time Requirements
Question: A family physician saw a Medicare patient with an extremely complicated history ... Read more
Clear Lab-Test-Trio Reimbursement Hurdles With This Insider Info
Hint: You need more than modifier QW to secure adequate payment Sales representatives- co... Read more
Take the Guesswork Out of Qualifying Tests for PT, H. Pylori and Flu
Now you can keep track of the more than 30 tests that you can report with 85610, 86318 and... Read more
6 Things to Consider When Reviewing Billed Service Levels
Teach physicians to create iron-clad MDM notes You can't get inside your FP's head to kno... Read more
Which Elements Stack Up to Moderate Complexity? Find Out Here
Clip and save your MDM breakdown guide You can easily calculate the right number of eleme... Read more
Reader Questions:
Modifier 59 Doesn't Override Payment Reduction
Question: When I remove one lesion and biopsy another with an uncertain nature, Medicare p... Read more
Reader Questions:
Give Credit for These Asked-About Conditions
Question: The history of present illness (HPI) section of the 1997 guidelines states that ... Read more
Reader Questions:
Strategy Improves Your Modifier 25 Appeals Case
Question: In our office, we usually use one note to describe a procedure and an E/M. Why d... Read more
You be the coder:
Does Your Definition of 'Comprehensive' Need Updating?
Question: A patient comes in for a school physical, but the patient's insurance does not c... Read more
Plug in a New ICD-9 Series to Support Visits Outside Ob Global
Your fall superbill should include these new pain diagnosesGood news: Beginning Oct. 1, yo... Read more
Avoid Autumn Aftercare Denials With Expanded V58 Series
ICD-9 2007 introduces new pediatric BMI codesYou can dodge truncated-V58.3 denials as long... Read more
Your Peers Report:
Medicare Says No to Intergroup Newbies
Use this ammunition to challenge 99201-99205 multispecialty denialsGovernment payers may t... Read more
READER QUESTIONS:
ECG Claims Will Soon Require 1 Fewer Step
Question: As an HPSA, must we submit component codes when we provide a complete ECG?Tennes... Read more
READER QUESTIONS:
Take Your ROS up a Notch
Question: What is the difference between review of systems (ROS) levels?California Subscri... Read more
READER QUESTIONS:
Find Out How a BP, Weight Check Measure Up
Question: A medical assistant (MA) gives a patient an allergy shot, checks his blood press... Read more
READER QUESTIONS:
Collect Sports Exam Pay 2 Ways
Question: Our practice has so much trouble getting reimbursed for sports physicals. Could ... Read more
READER QUESTIONS:
Are You Making This PSA Reporting Error?
Question: Why doesn't Medicare cover a prostate specific antigen (PSA) test for my patient... Read more
You Be the Coder:
Should You Count Isolated Visit as CPO?
Question: A family physician met with the family members of an assisted living facility pa... Read more
Capture Asthma, Diabetes Education a Whole New Way
Your practice could benefit from new patient self-management codes Because your plate... Read more
Take an Extra Step for Infusions Involving Multiple Substances
Warning:  Don't report hydration therapy for drug administration fluidYou can avoid s... Read more
Tried-and-True Tips Turn Denials Into 9921x + 69210 Payments
Experts reveal the diagnoses and modifiers insurers want on cerumen removal, E/M service c... Read more
READER QUESTIONS:
Treat Weight-Loss Referrals as Incident-To
Question: Our clinic's services include a Medifast weight-loss program. One of our PA-Cs s... Read more
READER QUESTIONS:
Check Diagnosis for I&D for Testicular Pain
Question: Our physician completed a detailed history and exam on an established patient wh... Read more
READER QUESTIONS:
Get Details for Compromised Immune System Dx
Question: Our physician is treating a patient following a splenectomy due to MVA in the pa... Read more
READER QUESTIONS:
Dealing With an H&O Turned Acute Admit
Question: How should I code a stay when the patient is admitted one day for H&O and is... Read more
READER QUESTIONS:
Only Charge the Visit for BP Monitoring
Question: How should I bill Medicare for monitoring a patient's blood pressure for 24 hour... Read more
READER QUESTIONS:
Garner Specifics for Chronic Pain Diagnosis
Question: Which diagnosis should I report for chronic pain?California Subscriber Answer: ... Read more
READER QUESTIONS:
Charging for PPD Reading Varies by Situation
Question: We charge for a PPD placement but historically have not billed for reading the t... Read more
READER QUESTIONS:
Don't Combine All Hospitalists' Time
Question: We have a group of hospitalists making rounds at different times throughout the ... Read more
You Be the Coder:
Determining Who an 'Appropriate Source' Is
Question: Parents brought their child to our office to discuss the possibility of ADD. Con... Read more
Make 3 Changes to Your Nebulizer Coding And Slash Your Denials
Key: Incorporate the HCPCS Codes 2006 DuoNeb supply code You can keep payment rolling ... Read more
Learn 6 Must-Know Principles Of Moderate Sedation Coding
CPT 2006 replaces 99141-99142 with provider-, age- and time-specific codes With recent CP... Read more
Capture Diabetes Counseling Services With This Action Plan
Medicare will cover MNT and DSMT--but you must meet these requirements With the number of... Read more
Identify These Characteristics to Differentiate Among 99143-99150
  Clip and post your quick reference guide to moderate sedation coding You can e... Read more
Reader Questions:
Use Current State of Asthma to Assign 5th Digit
Question: When reporting an asthma diagnosis, do I need a fifth digit?Virginia Subscriber ... Read more
Reader Questions:
Append 52 for Minor Puncture Wounds
Question: A patient presented with a puncture wound in the palm of her hand after falling ... Read more
Reader Questions:
Capture HPSA Bonus With Exact Visit Location
Question: Our practice is in a rural area, but we don't always receive an HPSA bonus when ... Read more
You Be the Coder:
Avoid Biopsy Terminology Trip-Ups
Question: How should I code for an -excisional biopsy-? The family physician performed thi... Read more
Stop Leaving Injection Money on the Table With These Tips for Reporting 90772
Action: Code multiple 90772s the same way you coded 90782s The financial health of many f... Read more
Take This Test to Determine How Well You Know Your FOBT Terms
Tip: Zero in on collection number and insurer when choosing among 82270, 82272 and G0107 ... Read more
Use This Checklist to Master 82270, 82272 and G0107 Reporting Rules
10 do's and don-ts put your FOBT coding on the path to payment Eliminate the confusio... Read more
Reader Questions:
Satisfy New Consult Criteria With a Fax
Question: To use a consultation code, a coworker thinks we should make sure the requesting... Read more
Reader Questions:
Use Signs to Substantiate 99050-99051 Services
Question: What documentation do the special services after-hour codes require?South Caroli... Read more
Reader Questions:
Anticipate Rate Reversal, Retroactive Payment
Question: Will I need to resubmit the claims I have submitted in 2006 to claim the correct... Read more
Reader Questions:
Identify These Terms to Combat Bronchitis Denials
Question: When I use 491.9, payers often deny the code and request additional information.... Read more
You Be the Coder:
Match New Infusion Codes to Outdated Ones
Question: I heard that CMS infusion codes G0345-G0350 are only valid for dates of service ... Read more
Adopt Simple Strategies to Protect Modifier 25 And 59 Payments
OIG finds numerous claims include procedure, not separate E/M documentationGet ready: Carr... Read more
3 Cases Reveal the New Infusion Coding Method's Secrets
Resolve to break down IV infusion therapy based on the bag's contents, not insurerYou can ... Read more
READER QUESTIONS:
Review Insurer's Modifier Policies
Question: A mother brings her son in for a non-healing spot on his hand. The family physic... Read more
READER QUESTIONS:
Take 3 Steps for Flu Immunizations
Question: I have trouble keeping all the flu vaccine coding combinations straight. Do you ... Read more
READER QUESTIONS:
Check Payer's 99211 Supervision Rules
Question: Does CPT's note following 90772 mean that I may report 99211 for a family-physic... Read more
You Be the Coder:
Report FP's Portion of DXA
Question: At our clinic, x-ray technicians perform DXA scans and the family physicians int... Read more
Implement This Action Plan for Flawless FOBT Coding In 2006
CPT introduces 82272 for analysis of in-office single-specimen collectionBeginning Ja... Read more
Check If New Special Service Codes Apply to Your Practice
99051 reflects medicine's trend toward longer office hoursYour office always remains open ... Read more
Are Special Services a Time-Eater or a Money-Maker? Find Out Here
New and revised codes may result in greater coverageAlthough Medicare doesn't reimburse sp... Read more
Guaranteed Strategies For Workers' Comp Claim Success
Presented by Marvel J. Hammer, RN, BS, CPC, CCS-P, CHCOThe following supplement to Family ... Read more
READER QUESTIONS:
Counting Chronic Conditions
Question: The 1997 audit guidelines state that I can reach an extended history by updating... Read more
READER QUESTIONS:
Consider Specialty When Determining Patient Status
Question: Our group uses the same tax identification number for a family practice clinic a... Read more
READER QUESTIONS:
Assign 9921x Rather Than 90862
Question: For a Ritalin follow-up visit for a child who has attention deficit disorder (AD... Read more
READER QUESTIONS:
Use Modifer 25 on E/M Code With 90772
Question: A family physician performs a significant, separately identifiable E/M service f... Read more
You Be the Coder:
Is a Modifier 51-59 Submission Kosher?
Question: A family physician excises a benign skin lesion with an excised diameter over 4.... Read more
Take 5 Simple Steps to Solidify B-12 Payments In 2006
Understand the basics of reporting the new streamlined injection codes Code 90782 ranks in... Read more
Learn 3 Vital New Nursing Facility Coding Principles
Welcome an annual assessment replacement code and expanded subsequent care levels in CPT 2... Read more
Measure the New Nursing Facility Code Requirements Against the Old
Clip and post this quick reference to 99304-99318's service levelsQuickly adjust to the nu... Read more
READER QUESTIONS:
Attach Modifier 59 by Code Designations
Question: Should I always append modifier 59 to the lower-valued code of an NCCI bundle?Wa... Read more
READER QUESTIONS:
Research Insurers' Meet-and-Greet Policies
Question: When a pregnant woman wants to interview a family physician prior to selecting t... Read more
READER QUESTIONS:
Submit Separate Service With Re-Pap
Question: Should I report an office visit in addition to a repeat Pap smear?Massachusetts ... Read more
READER QUESTIONS:
Make Top-4 CPT Revisions to Your Superbill
Question: I-ve heard that numerous CPT changes are in store for family physicians in 2006.... Read more
You Be the Coder:
Prepare to Code New Fluarix
Question: Our office is expecting a shipment of the Fluarix TIV influenza vaccine. When a ... Read more
Available Years:  2006  2005  2004  2003  2002  2001  2000  1999