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Primary Care Coding Alert

Make Chronic Condition Coding Easier With These Tips
Remember: If the condition has no bearing on treatment, leave it off your claim Just b... Read more
Track the Most Common Chronic Conditions
Remember, physician presence not always needed for checkup Records show that 87 perce... Read more
Follow-Up Visits Might Mark Fracture Treatment
Ethically add $$ to claim by reporting fracture care codes instead of E/M Wondering w... Read more
Reader Question:
Figure Diagnostic Decision Into E/M Code Choice
Question: An established patient reports with a severe headache and blurred vision. Duri... Read more
Reader Question:
Check Balanced Budget Act for Supervision Rules
Question: If a nurse practitioner (NP) or physician assistant (PA) performs a diagnostic... Read more
Reader Question:
Wheezing ICD-9 Code Doesn't Represent 'WARI'
Question: Concerning the coding of acute bronchospasm (519.11), when is it appropriate t... Read more
Reader Question:
Medication Might Not Indicate Diagnosis
Question: Can we code a condition or disease if the FP notes in the documentation that t... Read more
Reader Question:
Avoid Paybacks for Cloned Documentation
Question: I often use previous electronic medical record (EMR) charts with the same chie... Read more
Reader Question:
Complete ROS Requires Double-Digit Reviews
Question: What is the difference between problem-pertinent, extended and complete review... Read more
You Be The Coder:
ICD-9 Coding When Doctor Doesn't Diagnose Depression
Question: When a patient exhibits signs of depression, but the FP does not diagnose depr... Read more
Check That Nosebleed Encounter:
It May Be Only an E/M
 CPT-approved nosebleed treatments involve certain methods, tools When a patient... Read more
Annual Assessment Vital to Childhood Obesity Fight
Diet/weight problem offers E/M service coding opportunity Childhood obesity is still ... Read more
Reader Question:
Separate Dates OK for Allergy Prep, Admin Codes
 Question: Our practice started offering allergen immunotherapy. The nurse explained,... Read more
Reader Question:
Wait on Test to Confirm Emphysema
Question: A new patient reports to the FP complaining of wheezing and breathlessness. The ... Read more
Reader Question:
Code for Extra E/M if Exam Exceeds 'Incidental'
 Question: An established patient with gamekeeper's thumb reports to the FP. The oper... Read more
Reader Question:
99173 Gains Credence via Fee Schedule
 Question: A consultant suggested we use modifier 25 to overcome denials for 99173 an... Read more
Reader Question:
Use Modifier 76 to Steer Clear of Repeat Denials
 Question: How should I report a service that the physician performs more than once i... Read more
Reader Question:
Report V Codes for Patient's Long-Term Meds
 Question: A new patient reported to the FP and received a level-two E/M service. The... Read more
You Be the Coder:
Get Up to Speed on Different Meniscus Tear Types
 Question: An established patient reports to the FP complaining of pain and swelling ... Read more
Master Reporting Guidelines When You Perform Multiple Injections
Break out modifiers if you want to collect your rightful payYou can set yourself up for cl... Read more
Know Frequency Rules, Risk Categories for Medicare Colonoscopy Screenings
Medicare has frequency requirements for average- and high-risk patientsMedicare patients w... Read more
READER QUESTIONS:
J7620 Eases Compound Drug Coding
Question: Our nurse practitioner (NP) administered a nebulizer treatment recently, and I a... Read more
READER QUESTIONS:
Be Wary of Suspect Injury Explanations
Question: A 6-year-old girl with a black eye reported to the FP. The physician's notes ref... Read more
READER QUESTIONS:
Use This Diagnosis for Asthma Wtih Croup
Question: An established  patient with a history of asthma who is now taking Albutero... Read more
READER QUESTIONS:
If Same Problem Prompts Both Services, Consider Same Diagnosis
Question: Our physician treated a new patient with a pressure ulcer on the back of her hea... Read more
READER QUESTIONS:
Is 82247 Test Approved for the Office?
Question: May I perform the total bilirubin test in  the office?Florida Subscriber&nb... Read more
READER QUESTIONS:
Tick Removal--FBR or E/M Code?
Question: A patient with a tick embedded in his shoulder came to our office. The FP remove... Read more
READER QUESTIONS:
Modifier May Unlock 94760 Payment
Question: Is there any secret to getting payment for pulse oximetry test code 94760? Our i... Read more
READER QUESTIONS:
Use 99241-99245 When Pre-Op Meets 3 Criteria
Question: What is the CPT code for a pre-op exam?New Jersey Subscriber Answer: No CPT cod... Read more
READER QUESTIONS:
'Middle-of-the-Road' Coding Won't Prevent Scrutiny
Question: I heard that if I bill mostly 99213s and keep my E/M billing within the middle-o... Read more
READER QUESTIONS:
Check ICD-9 Table of Drugs for Insulin OD Diagnosis
Question: Our patient injected too much insulin and experienced dizziness and blurred visi... Read more
You Be the Coder:
Learn These Terms to Correct Bronchitis Denials
Question: When I use 491.9, payers often deny the code and request additional information.... Read more
Make Sure You Recognize Incident-to -- or You Could Be Losing Reimbursement
You can't report incident-to unless FP authored care planWhen one of your nonphysician pra... Read more
Time Matters on Multi-Substance Infusion Sessions
You must meet the 16-minute mark to code for infusionsWhen your family practitioner perfor... Read more
News You Can Use:
ICD-9 Beefs Up Dysphagia Diagnosis Code Set
Final list will appear in early summerIn the fall, you will have some new ICD-9 codes to g... Read more
READER QUESTIONS:
You May Need Modifier 24 on E/Ms During Globals
Question: The physician performed incision and drainage on a patient's complicated forearm... Read more
READER QUESTIONS:
Modifier 59 Can Unbundle Biopsy, Wart Detruction
Question: A patient with three plantar warts on his right foot and a lesion with benign pa... Read more
READER QUESTIONS:
Use E/M Code for Ear Wick Insert
Question: One of our physicians inserted an ear wick saturated with an antibiotic into an ... Read more
READER QUESTIONS:
Get to Know the New Inhalation Codes
Question: I know that CPT introduced two new bronchodilator codes this year. How should I ... Read more
READER QUESTIONS:
Foot FBRs Differ From Soft-Tissue FBRs
Question: Our physician performed simple foreign- body removal (FBR) on a patient with a w... Read more
READER QUESTIONS:
Fake Complaint Requires Real Diagnosis Code
Question: Our FP saw a patient who complained of migraine pain. After examining the patien... Read more
You Be the Coder:
Finding the Right FB Sensation Diagnosis
Question: A new patient complaining of throat pain reports to the FP. The FP makes a dia... Read more
Choose FOBT Code Based on Test Type -- Here's How
Location of FOBT is critical to correct coding When a patient reports to your FP for a fe... Read more
News You Can Use:
New CCI Edits Bundle Burn/Debridement Code Combo
Watch out: Latest burn edits allow possibility of unbundling  The latest version... Read more
Missing Moderate Sedation Codes Could Cost You
Coders say some insurers are paying for sedation Do you report moderate (or conscious... Read more
Reader Questions:
Call on Biopsy Code for Diagnostic Removal
Question: The physician saw an established patient with a patch of rough skin on his forea... Read more
Reader Questions:
Dermabond/Suture Combo Calls for
Question: An established Medicare patient reports to the FP after falling from the stairs ... Read more
Reader Questions:
Report E/M Code When FP Removes ED Sutures
Question: An established patient with three scalp sutures reports to the FP for suture rem... Read more
Reader Questions:
Separate E/M Possible on Some 'Re-Paps'
Question: Should I report an office visit in addition to a repeat Pap smear?Massachusetts ... Read more
You Be the Coder:
Acing Your Bandage Coding Encounters
Question: A patient reports with a swollen right index finger that she injured while catch... Read more
Coding Standard E/Ms When FP Performs Observations Could Cost You
These 2 scenarios can help you get observation coding right each time If you-re not cued ... Read more
News You Can Use:
No Fooling: New NCCI Bundles Several Vaccine Codes
April 1 edits also tighten up hemoglobin coding The latest version of the National Correc... Read more
Here's Why 69210 Isn't the Answer for Every Cerumen Removal Claim
Choose an E/M instead if the cerumen is not impacted When the FP performs cerumen (earwax... Read more
Reader Questions:
Check 'Artificial Menopause' for Estrogen Withdrawal Dx
Question: An established patient who had a hysterectomy six months ago came to the FP for ... Read more
Reader Questions:
E/M Levels Vary for Migraine Patients
Question: What level of E/M service should I report when a new patient reports to the FP f... Read more
Reader Questions:
Hydration Encounter Often Includes Separate E/M Service
Question: A patient who is complaining of diarrhea and extreme thirst reports to the FP. S... Read more
Reader Questions:
Use 250.8x to Represent Diabetic Hypoglycemia
Question: Our physician saw a hypoglycemic patient, but we aren't sure which hypoglycemia ... Read more
Reader Questions:
Extra Documentation May Be Necessary for Unlisted J Code Payment
Question: The FP performs an IV infusion of diltiazem HCl, also known as Cardizem or Tiaza... Read more
You Be the Coder:
Stress-Test Code Depends on Physician Equipment, Involvement
Question: A morbidly obese patient who was having chest pains reported to the office for t... Read more
Check for Proof of Incision Before Reporting FBR Code
Here's why you-ll use E/M codes for some foreign-body removal encounters Patients wh... Read more
Measure Excised Lesion Size, Then Send the Sample to Pathologist
If you wait until after pathology, lesion (and payment) will be smaller When your FP ... Read more
Reader Question:
Opt for E/M Code When FP Checks Meds, Provides Psychotherapy
Question: Our family physician recently saw a 12-year-old established patient with att... Read more
Reader Question:
Base PT Code Choice on Modality
Question: If the FP administers 25 minutes of electrical stimulation physical therapy (P... Read more
Reader Question:
Include BMI V Code on Weight-Related Encounters
Question: An established patient who gained 20 pounds over the holidays reported to the ... Read more
Reader Question:
If It's Not Relevant to Encounter, Omit Chronic-Condition Dx
Question: An established patient with type II diabetes reported to the FP complaining of... Read more
Reader Question:
Follow 'Rule of Nines' for Burn Diagnosis Coding
Question: I have not been coding for very long, and I have a question about burn diagnos... Read more
You Be The Coder:
Method Drives Your Lesion Destruction Coding
Question: How should I report destruction of anal lesions? Our FP destroyed two anal les... Read more
Prove Patient's 'Critical' Condition When Reporting 99291
Remember: CPT considers many services part of the critical care package When deciding whe... Read more
Follow This Advice When Deciding Flu Test Status
If test differentiates between influenza A&B, report 2 units of 87804 When your famil... Read more
Don't Rule Out Reporting an E/M Visit Along With a Monthly Synagis Shot
Most physicians want to conduct separate E/M when patient gets injection If your family p... Read more
READER QUESTION ~ Cellulitis Presence Drives Tissue Infection Diagnosis Coding
Question: Our physician treated a soft-tissue infection on a patient's finger. Which diagn... Read more
READER QUESTION ~ Observe '3-Year Rule' When You're Considering Patient Status
Question: A child's parents stopped her treatment with our office two years ago. Last week... Read more
READER QUESTION ~ Incomplete Screens Require Modifier Help
Question: When a physician spends time attempting a hearing and vision screen on a child b... Read more
READER QUESTION ~ Code Asthma-Attack Portion of Visit Separately
Question: During a recent encounter, the physician provided a preventive medicine service ... Read more
READER QUESTION ~ Cerumen Removal Claim Could Include Procedure, E/M Code
Question: Our physician saw an established patient for an ear infection, but she had such ... Read more
YOU BE THE CODER ~ Multiple Inhalation Claims
Question: Our physician performed a pair of inhalation treatments on a patient recent... Read more
Stay Ahead of the NCCI Curve With This Nursing Facility Coding Primer
Plus: The latest NCCI edits target the new vent management codes With more than 9,000 cha... Read more
Your Physician's Notes Can Do the Diagnosis Coding for You
You just have to know where to look to find the right ICD-9 codes Don't let an incomplete... Read more
TEST YOURSELF:
Can You Choose the Right ICD-9 Code for This Lesion?
Read the physician's documentation and put your skills to the test Now that you-re... Read more
ICD-9 PRIMER:
Nail Down Lung Diagnoses With These Tips
Focus on acute conditions and exacerbations to select the right code Your key to correctl... Read more
READER QUESTION:
Don't Expect G0102 Payment
Question: I know that CMS has released bulletins saying G0102 (Prostate cancer screening; ... Read more
READER QUESTION:
No Need to Fear the Unclassified J Code
Question: Which codes should I report when the physician performs an IV infusion of diltia... Read more
READER QUESTION:
Include Fluorescein in E/M
Question: Our physician performed a fluorescein staining for detecting a corneal abrasion.... Read more
READER QUESTION:
Consider STD Exposure Before You Select Dx
Question: If an asymptomatic patient reports a concern that she might have a sexually tran... Read more
READER QUESTION:
Nail Down Supervision Levels
Question: Our carrier asked us to verify that our nurse performed a patient's stress test ... Read more
READER QUESTION:
Stop Using 17000 for Plantar Wart Destruction
Question: The January 2007 Family Practice Coding Alert stated that codes 17000 and 17004 ... Read more
YOU BE THE CODER:
Check Dx Codes for Lab Work
Question: When the family physician collects blood samples and sends them to an outside la... Read more
Trying to Use the 'Loophole' to Bill All Visits As 99215? This Mistake Could Cost You
Surprise! CPT and CMS require medical necessity for all E/M visits If you are a victim of... Read more
Discover 8 Fresh Ideas for Finding Untapped Revenue
Turn a negative into a positive with these quick steps Keeping your physicians from takin... Read more
Don't Miss This Official Routine X-Ray Coding Clarification
See what the guidelines advise You should never bypass any chance to review official guid... Read more
ICD-9 QUIZ ~ Code the Story of Your Patient's Life
Can you find the diagnosis codes in this patient's history? Sometimes it may seem ... Read more
6 Steps Promise Diabetes Coding Success
Complications need special attention Diabetes refers to diabetes mellitus or, less often... Read more
YOU BE THE CODER ~ How Should We Report Rhinorrhea?
Question: Which diagnosis should I use when a patient has rhinorrhea? New York Subscr... Read more
READER QUESTION ~ Who Says You Can't Go 'Home'?
Question: One of my family medicine physicians wants to make house calls for a select few ... Read more
READER QUESTION ~ Use 2 Codes for HPV Inoculation
Question: How should I bill the administration of the second and third shot of Gardasil? S... Read more
READER QUESTION ~ Confirm Diagnosis Before You Report It
Question: If the physician hasn't indicated ECG results in his final diagnosis, should I c... Read more
READER QUESTION ~ G0375 Covers Smoking Cessation Counseling
Question: We-re not having much success getting payment for smoking cessation counseling w... Read more
READER QUESTION ~ Look at 20552 Range for TPIs
Question: How should I bill for trigger point injections with Xylocaine? Rhode Island Subs... Read more
CPT 2007 SNEAK PEAK:
CPT Brings New Ventilation Management, Warfarin Codes
Get ready for the new edition, effective Jan. 1 If you-ve been wondering how you should r... Read more
Medicare Retires G0107 for Fecal-Occult Blood Testing
Look to 82270 for FOBT coding Family medicine coders may feel as if they just got up to s... Read more
Mycotic Nail Debridement Coding Can Be as Easy as 1-2-3
Check carrier frequency limitations for 11720 and 11721 If you can count on a denial f... Read more
Master Correct 'Q' Modifier Use
Many carriers require physicians to append a modifier from the Q7-Q9 range when billing ro... Read more
READER QUESTION:
Consider Size for Benign Lesion Excision
Question: Which ICD-9 code should I report if the doctor documented -benign cyst: anterior... Read more
READER QUESTION:
Bill Secondary for Patients With Part A Only
Question: Our physician saw a patient in the hospital. The patient had only Part A Medicar... Read more
READER QUESTION:
New Guidance for Nerve Block With Circumcision
Question: If we bill 54150 for a circumcision, can we also report 64450 for the accompanyi... Read more
READER QUESTION:
Use V Codes for Screening Tests
Question: Is there a diagnosis code we can report for medication monitoring? We need this ... Read more
READER QUESTION:
Get to Know Acronyms
Question: Our physician documented -ITB friction syndrome of knee,- but we are unable to f... Read more
YOU BE THE CODER:
Which Codes Apply to Bronchitis?
Question: When I use 491.9 to describe a patient's bronchitis, payers often deny the code ... Read more
Available Years:  2007  2006  2005  2004  2003  2002  2001  2000  1999