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Primary Care Coding Alert
Primary Care Coding Alert
Family Practice Coding Alert - 2008; Volume 10, Number 12
Halt Knee-Related Injection Rejections With 3 Critical Details
Code 20610 might always need a modifier for Medicare pay If denials for trigger point a...
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Clean Up Maternity Confirmatory Visit Claims With Quick Quiz
Don't miss out on E/M fees by initiating the maternity record too soon When your FP sim...
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Pediatric Coding Corner:
Protect Time-Based Pay in 2 Easy, But Critical, Steps
Omitting this detail could cut a 99214 to a 99213 If time-selected E/M documentation do...
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Reader Questions:
9924X Allowed Source Depends on Guideline
Question: May a provider bill insurance for a consultation that a school nurse or teache...
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Reader Questions:
Look for Site-Specific I&D Code
Question: Our physician assistant (PA) did an incision and drainage (I&D) (10060) fo...
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Reader Questions:
2 Hospital Visits: 1 E/M or 2?
Question: A private payer representative informed my doctors that they can bill for more...
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Reader Questions:
Consider MMSE Part of E/M
Question: An FP saw a 72-year-old woman because she had been feeling light-headed and di...
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Reader Questions:
Consider 90465, 90471 Mutually Exclusive Codes
Question: Regarding the counseling code for vaccines administered to patients less than ...
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You Be the Coder:
Align 'Well' Cervical Pap Diagnoses
Question: An FP performs a preventive medicine service and collects a Pap smear for cerv...
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Family Practice Coding Alert - 2008; Volume 10, Number 11
Use Inside Info to Prevent HPI Rule Hunt
In CMS's eyes, this element is your FP's duty Although support staff might want to ligh...
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Risk Audit by Coding Same-Date E/M, Critical Care
Heed this warning: Medicare mentions -discretionary reviews- on 99291 claims You-ll nee...
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Clean Up 99291 Claims by Keeping Up With Transmittals
Medicare now excludes critical care and an ED E/M on same date CMS has released a flurr...
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Pediatric Coding Corner:
Using 2 ICD-9 Tips to Get Paid for 95930 and E/M
Careful: Sometimes a well-check diagnosis isn't the way to go You-ll get paid the first...
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Reader Questions:
Include Anesthesia in 1 Circ Type
Question: When an FP performs a neonatal circumcision without anesthesia, a consultant s...
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Reader Questions:
Code Differently for 'Alterations' and 'Blackouts'
Question: A 25-year-old new patient reports to the FP for his initial visit. He says tha...
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Reader Questions:
ICD-9 Code Choice Depends on Apnea's Cause
Question: The physician performs a level-two E/M on a new patient with sleep issues. The...
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Reader Questions:
Freeze at 327.XX ICD-9 Section for Sleep Paralysis
Question: An established patient reports to the FP reporting that shortly after waking u...
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Reader Questions:
If Physician Makes No Incision, Opt for E/M
Question: A patient presents to the FP with shards of glass from a shattered light bulb ...
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You Be the Coder:
Complex or Simple Nosebleed Treatment?
Question: An established patient reports to the FP with a bleeding left nostril. She tel...
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Family Practice Coding Alert - 2008; Volume 10, Number 10
Heed New Transmittal When Compiling Critical Care Time or Face Denials
Medicare release clears up family counseling, concurrent care rules If you can spot cr...
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Protect Incident-to Pay With This Added Phrase
Hassle-free option: NPP can report the service directly without having to satisfy criter...
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ICD-9 2009 Update:
Prepare to Expand Fever Diagnosis so Fall Claims Will Sail Through With Ease
Your 780.6 entry soon will require four more lines To report a fever of unknown origin ...
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Reader Questions:
Use Modifier 51 on Some Surgery Encounters
Question: A patient reports to the FP with two cuts on his right forearm: a deep 6-cm la...
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Reader Questions:
Get Your MIA CPT Codes Here
Question: I read that the CPT Codes 2008 manual doesn't contain three new vaccine codes...
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Reader Questions:
It's Not too Late to Participate in PQRI
Question: Our family medicine practice did not begin the Physician Quality Reporting Ini...
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Reader Questions:
Choose Code After Checking for Preservatives
Question: The FP's physician assistant (PA) administered a preservative-free intramuscul...
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Reader Questions:
Patient Actions Guide Insulin OD Code Choice
Question: Encounter notes indicate that a patient with uncontrolled type II diabetes had...
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You Be the Coder:
How to Code Admit to Hospitalist
Question: An FP sees an established patient in the office for high fever and dehydration...
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Family Practice Coding Alert - 2008; Volume 10, Number 9
Revert to 'Crossed-Out' for Your Inhalation Solution Drugs
Albuterol, levalbuterol pay depends on returning to more specific J codes Although you ...
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On the Cutting Edge:
Use 2 Questions to Pin Down J7611-J7614 Inhalation Coding
You can crosswalk brands, deleted code with this flowchart A year and a half has passed...
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ICD-9 2009 Update:
Use New Codes for Diabetes Caused by Another Problem
Changes also make blood-in-urine, pressure-ulcer coding more specific You can head off ...
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ICD-9 2009 Update:
Focus on Headache Details to Master Diagnosis Subsets
These terms help you sort through post-traumatic, cluster, tension categories Although ...
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Reader Questions:
Apply Universal New-Patient Definition
Question: A physician in our group provides an E/M service to a hospital inpatient. If t...
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Reader Questions:
How to Report Hearing Loss Unfounded
Question: A 12-year-old patient comes to us after failing a school hearing screen but pa...
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Reader Questions:
E/M Not Possible When Session Is for Training Only
Question: An established patient with acute bronchitis reports to the FP's office for a ...
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Reader Questions:
Wait for Cards Before Reporting Take-Home FOBT
Question: An established patient receives a level-two E/M service from the FP, who then ...
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You Be the Coder:
E/M or Nosebleed?
Question: An established patient reports to the FP with a nosebleed that he could not st...
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Family Practice Coding Alert - 2008; Volume 10, Number 8
Update Your IVIG Codes Today to Avoid a Pile of Denials
Medicare still pays for immune globulin shots -- under new guidelines If you haven't no...
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Follow These Coding Do's on Inhalation Service Claims
Code 94664 describes 4 devices, but that's not a complete list Stop missing opportuniti...
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Pediatric Coding Corner:
Avoid Undercoding ADD/ADHD Sessions by Using This Continuum
Ethically boost assessment visits when you find this documentation You can capture the ...
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Reader Questions:
Consider Flu Nasal-Wash Options
Question: Is there an appropriate "collection code" to report for performing the flu nas...
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Reader Questions:
You'll Code Differently for Blood Draws, Lab
Question: We saw a patient for a blood draw and sent it to an outside lab for testing. T...
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Reader Questions:
Differentiate Between Different COPD Diagnoses
Question: The FP performs a level-four E/M for an established patient. The notes indicat...
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Reader Questions:
Leg Pain at Well Check Means 2 Codes
Question: An established 2-year-old patient presented for a well child checkup. The pati...
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Reader Questions:
Zoom In on Fluorescein Use
Question: Our FP performed a fluorescein staining for detecting a corneal abrasion. When...
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You Be the Coder:
Reporting E/M-Urinalysis Claims
Question: The FP performs a level-two E/M for a new patient. The results of the evaluati...
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Family Practice Coding Alert - 2008; Volume 10, Number 7
CCI 14.1 Update:
Break Bundles to Prevent Payment Loss on 90760, 90772
New edits put focus on separate, significant E/Ms The next time a patient requires hydr...
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CCI 14.1 Update:
Code Nebulizer Treatment Only With 94640 or 94644
Prepare for edits to strapping, nebulizer services -- and more Find out when and how t...
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Pediatric Coding Corner:
Use This Guide to Net All 'Bright Futures' Services
Are you forgetting to code any -extras- during well checks? If you-re not clear on the ...
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Reader Questions:
Squirmy Child Stops Screen
Question: We tried to do an audiogram with a 7-year-old patient, but we were unable to o...
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Reader Questions:
Learn 2008 Conversion Factor -- for Now
Question: What is the conversion factor for 2008? North Carolina Subscriber Answer: Th...
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Reader Questions:
Photoscreening Gets Category I Code
Question: I-m questioning our practice's use of 92015 for photoscreening. The procedure ...
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Reader Questions:
Beware Bundles on 99477 Claims
Question: What services are included in the new neonatal initial hospital intensive care...
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You Be the Coder:
Coding Multi-Day Hospital Stays
Question: An FP admits a patient to observation on Feb. 22. The physician writes orders ...
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Family Practice Coding Alert - 2008; Volume 10, Number 6
Expert Advice:
Count Hours to Arrive at Proper Observation Code Choice
8-hour mark is crucial for Medicare patients When your FP performs observation services...
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Pediatric Coding Corner:
Test Results Tell You Whether to Report Lead Poisoning Dx
Better way: A high-risk V code can remedy payment woes You-re going to have to use an e...
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Reader Questions:
Percentages Provide Clues on Obesity Dx
Question: What distinguishes "obesity" from "morbid obesity"? North Carolina Subscriber...
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Reader Questions:
Is Parents-Only Conference Billable?
Question: An established patient's parents came in without their teenage son to discuss ...
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Reader Questions:
Get the Lowdown on 'Missing' CPT 2008 Codes
Question: I read that the CPT 2008 manual doesn't contain three new vaccine codes. Would...
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Reader Questions:
Stick With 075 for EBV
Question: Should I code Epstein-Barr with new 2008 code 058.89 (Other human herpesvirus ...
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Reader Questions:
Use Notes to ID Fracture Treatment Type
Question: The FP performs closed treatment on a patient's ulnar shaft fracture. There ar...
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Reader Questions:
Prepare for 'UHC Meets CCI'
Question: I-ve heard that I-m going to have to start changing some of the codes that I b...
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You Be The Coder:
Be Precise With Jaw-Injury Diagnoses
Question: The FP treated a patient who had been in a minor motorcycle accident (the pati...
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Family Practice Coding Alert - 2008; Volume 10, Number 5
Gain $8 per Visit by Recognizing All 69210 Coding Opportunities
Careful: That cerumen removal encounter might be an E/M When your FP removes cerumen, z...
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Search Out Separate E/M Evidence on Cerumen Claims
...
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Pediatric Coding Corner:
Know the Facts Before Buying SureSight
Report SureSight services with 99173, not 92015 If you-re considering replacing technic...
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Reader Questions:
Beware the Burn Coding Bundles
Question: A patient came in with first- and second-degree burns on her hand. The physici...
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Reader Questions:
Draw Complete ROS Picture With System Reviews
Question: There are three review of systems (ROS) levels: problem-pertinent, extended an...
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Reader Questions:
Omit Laceration Repair Code on Bandage Fixes
Question: An established patient who had an accident during a bicycle race reports to th...
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Reader Questions:
Use This Bladder Aspiration Code in 2008
Question: The FP performs a suprapubic aspiration to obtain a clean urine specimen from ...
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Reader Questions:
Leave Modifier 51 Off Vaccination Claims
Question: Can you settle a dispute our office is having? Do we need to use modifier 51 w...
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Reader Questions:
Keep Coding Even if Payment Doesn't Come
Question: When an insurance carrier does not pay for a code, should we still report it? ...
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You Be The Coder:
Multiple Laceration Repairs
Question: An established patient reports to the FP with a facial laceration just below t...
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Family Practice Coding Alert - 2008; Volume 10, Number 4
Use These Tips to Avoid an E/M Denial With 95115, 95117
Medicare starts paying for same-day E/M service and allergy injection When the FP perfo...
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CPT Update:
Use 99477 to Capture Care Beyond 99223
Newborn care continuum now has a middle tier You can confidently use a new tool in your...
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Gain $173 for Increased Newborn Care Work
4 vignettes pin down when to report 99477 Initial newborn care codes pay from a high of...
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Reader Questions:
Knock Out Sedation Denials With New Policy
Question: When our physician provides moderate sedation in addition to a procedure, some...
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Reader Questions:
Look to Type I Codes First for Diabetic Ketoacidosis
Question: A new patient with diabetes reports to the FP for an initial evaluation. The p...
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Reader Questions:
Location Matters When Coding Ultrasound Service
Question: Our FP took a biopsy using ultrasound to guide needle placement in the office ...
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Reader Questions:
Code Well Portion, Asthma Treatment Separately
Question: After receiving a preventive medicine service, an established patient has an a...
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Reader Questions:
Include I&D in Excision
Question: A patient with a simple pilonidal cyst reports to the ED. The physician decide...
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You Be The Coder:
Coding Hydration in 2008
Answer: You could have reported the hydration with 90760 (Intravenous infusion, hydratio...
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Family Practice Coding Alert - 2008; Volume 10, Number 3
Mind Your G's and Q's, or Medicare Might Deny Well-Woman Exams
Use separate codes for breast/pelvic exam and Pap smear When your FP provides a well-wo...
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Use This E/M Guide to Stay Out of Auditor's Crosshairs
Study the claim element-by-element to determine correct history level You don't have to...
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Reader Questions:
Code Sub Physician's Work With Proper Modifier
Question: One of our FPs is taking December and January off (an extended holiday). We ha...
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Reader Questions:
Report Biopsy Code Per Lesion
Question: A new patient reports to the FP for an initial E/M. During the course of a lev...
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Reader Questions:
When Should You Charge for PPD Readings?
Question: We charge for a PPD placement but historically have not coded for reading the ...
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Reader Questions:
J Code Eases Compound Drug Coding Headaches
...
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Reader Questions:
Exceed Inherent E/M Before Coding It Separately
Question: One of our nurse practitioners (NPs) recently saw a 65-year-old established pa...
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Reader Questions:
Fifth Digit Can Be Vital for Claim Acceptance
Question: A patient with extrinsic asthma reports to the hospital in the throes of a sev...
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You Be The Coder:
Reporting Diabetic Manifestations
Question: An established patient with type II uncontrolled diabetes reports to the FP fo...
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Family Practice Coding Alert - 2008; Volume 10, Number 2
CPT Update:
Revised Nursing Codes Put Time on Your Side
CPT 2008 reworks definitions for 99304-99310 Good news for coders: CPT has revised the ...
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CPT Update:
Check Panel Type Before Choosing Test Code
Metabolic panels now broken into different types This winter you-ll need to discern the...
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CPT Update:
Let Nurses Conduct Your Team Conferences
New codes coming for ADHD school meetings, vent management and more Don't have time to ...
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Reader Questions:
Remember T Modifiers on Toenail Trims
Question: An established patient complaining of pain in toes on both feet reports to the...
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Reader Questions:
E Code Helps Explain Insulin Overdose
Question: An established patient with uncontrolled type II diabetes who is on insulin an...
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Reader Questions:
TB Test Should Not Include Injection Code
Question: When a patient reports to the physician for a tuberculosis (TB) skin test, can...
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Reader Questions:
Fifth Digit Can Be Vital for Claim Acceptance
Question: A patient with extrinsic asthma reports to the hospital in the throes of a sev...
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You Be The Coder:
Observing Global Surgical Periods
Question: An established patient had an accident while on vacation, and another physicia...
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Family Practice Coding Alert - 2008; Volume 10, Number 1
Get Ready to Say 'Hello' to New Telephone Call Codes for 2008
Smoking cessation counseling to get CPT codes Has the imprecise matching of simple, int...
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Use 'E Visits' to Save Time, Fatten Bottom Line
Caution: Don't discuss sensitive medical matters via unencrypted e-mails When your FP p...
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Pediatric Coding Corner:
Avoid Losing Out on Vaccine Dollars With These Tips
Remember: Dose code differs for children under 3 If your practice is losing money on fl...
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Reader Question:
6 New Vaccine Codes Coming Next Year
Question: Will there be any new vaccine codes for coders in 2008? Tennessee Subscriber ...
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Reader Question:
Report Entire 1st Visit With New Patient Codes
Question: Could you clarify how to code a new patient visit during which the patient com...
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Reader Question:
Can You Use V Codes as Primary Diagnoses?
Question: When the FP performs diabetes screenings for our patients, which ICD-9 code sh...
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Reader Question:
Medicare to Allow More Moderate Sedation Pay
Question: What are Medicare's payment policies for the new moderate (conscious) sedation...
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Reader Question:
Include V Code on Toy-Related Lead Screenings
Question: What V code should we use for lead screenings that parents request for their c...
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You Be The Coder:
Coding a Catch-Up Shot Session
Question: At an 18-month preventive medicine service, the FP noted that the toddler had ...
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