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Primary Care Coding Alert

Track Missed Immunizations and Well Newborn Visits Using This Trio of V Codes
Your lab coding just got more specific thanks to V72.6's expansion. Avoid denials for bir... Read more
Ensure Reimbursement for H1N1 Vaccine Administration by Getting Payers' Regs
Be prepared to use G9141, 90470, or 90465-+90474 when vaccines become available this fall... Read more
Short List of V Code Changes to ICD-9 2010
• V15.83 -- Personal history of underimmunization status • V20.31 -- H... Read more
Help Your Doc Code Dementia E/M Encounters for More Accurate Claims
Determine HPI or ROS during assessment for geriatric patients. Your family physician is a... Read more
READER QUESTIONS:
What's in a Name With Sex Headache Diagnosis?
Question: Our family physician saw a male patient who is suffering from throbbing headach... Read more
READER QUESTIONS:
Consider 99211, Not 90465-+90474, for PPD Test
Question: We bill an injection fee for immunizations. Can we include an injection fee for... Read more
READER QUESTIONS:
Not All Chest Pains Are Heartaches
Question: A patient has been complaining of chest pain. Our FP has ruled out a heart cond... Read more
READER QUESTIONS:
Apply CPT 9920x Vs. 9921x Rules in an FQHC
Question: For physicians in a federally qualified health center (FQHC), are there differe... Read more
READER QUESTIONS:
Asthma Always Trumps Wheezing
Question: We had an established patient with prior history of asthma who came into the cl... Read more
READER QUESTIONS:
Probable H1N1 Is Not the Same as Diagnosis
Question: Our physician is currently handling a probable case of H1N1. He wants me to use... Read more
You Be the Coder :
Plethysmography to Compute BMI
Question: When measuring the BMI using an electronic scale, can we use 93720 (Plethysmogr... Read more
Pediatric Coding Corner:
4 Tips Ensure Success in Coding Feeding Problems for 2010
Use expanded 779.3x to describe newborn issues. Come Oct. 1, your newborn problem ICD-9 c... Read more
Indicate Gout Stage Thanks to ICD-9 Code Newbies
This denial averting chart links acute, chronic, tophus to required fifth digits. Thwart ... Read more
Check Out This Formula for a Winning Sports Physicals' Plan
These useful strategies assure revenue despite scant insurer coverage. Very soon, a ru... Read more
Dual 87804 Results:
AMA Issues Modifier Directive
Question: When reporting 87804 to describe testing for rapid influenza virus A&B, sho... Read more
Reader Questions:
Monofilament Test: Procedure or PE?
Question: We have a diabetic patient who gets a monofilament test once a year. Can we cha... Read more
Reader Questions:
3 Criteria You Need for White Coat Hypertension
Question: We have a patient who was diagnosed with white coat hypertension. Is there an I... Read more
Reader Questions:
Finding the Meaning Behind Ramsay Hunt Syndrome
Question: I can't find the ICD-9 code for Ramsay Hunt syndrome? Is there an ICD-9 diagnos... Read more
Reader Questions:
Finding the Meaning Behind Ramsay Hunt Syndrome
Question: I can't find the ICD-9 code for Ramsay Hunt syndrome? Is there an ICD-9 diagnos... Read more
Reader Questions:
Code Cervical Vaccine against HPV Virus
Question: A patient comes in to the office for Gardasil injection. What diagnosis should... Read more
Reader Questions:
Screen for Risky Behavior
Question: The family physician orders a screening Pap smear, as he suspects his patient m... Read more
Reader Questions:
Watch Carrier Rules for 94760 + E/M
Question: Can I get paid by Medicare carriers for 94760 with any E/M code? Maine Subscrib... Read more
You Be The Coder:
Is Post-Op Infection Part of Global Period?
Question: A patient comes in to the clinic nine days after an I&D performed by his fa... Read more
Play the Lesion Excision Waiting Game Unless Carrier Directs You Otherwise
Pathology report can unlock $57 more for 11620. If recent guidance made you question the ... Read more
Generate More Revenue For E/M With Injection Code When You Spot 2 Clues
There's always something more than injections when patients and doctors meet. Here's how ... Read more
Solve Multiple E/M Dilemmas by Focusing on the Problem, Specialty
Don't lose sleep worrying over denials for multiple same-day office visits with guarantee... Read more
Reader Questions:
Know the Right Conditions for Vitamin D Screening
Question: Is anyone using 268.9 in coding for screening tests for vitamin D deficiencies?... Read more
Reader Questions:
Quit Your Smoking Cessation Coding Woes
Question: I am getting denials when I bill V15.82 with 94406. What would be the more app... Read more
Reader Questions:
What You Need to Know About Dysplastic Nevus
Question: The pathology report mentions dysplastic nevus. Is there an ICD-9 code for this... Read more
Reader Questions:
Manifestations Need Extra Codes
Question: For patients being treated for diabetic neuropathy, is it necessary to code sep... Read more
Reader Questions:
Don't Get Fuzzy Over Urine Drug Screening
Question: Is there an ICD-9 diagnosis we can use to code for urine drug screening? New Yo... Read more
You Be the Coder:
Rest Home Service Versus CPO
Question: A new patient in an assisted living facility was treated for hypertension by th... Read more
Break ECG, Catheter Surgical Package Inclusions When Appropriate
Your 93000, 51701 pay hinges on employing this tool. If you missed the Correct Coding Ini... Read more
15% More Pay Awaits Coders Who Can Max Out NPP Benefit
Correctly code NPP's hospital services, or you'll sell the practice short. If you don't t... Read more
Pediatric Coding Corner:
2 Cases Simplify Your Well-Check V Code Selection
Denials possible without separate ICD-9s for immunization admin, supply. Do diagnosis cod... Read more
READER QUESTIONS:
Easy Steps to Bill for PPD Tests
Question: Is anyone billing an office visit (99211) with the PPD (TB test) code (86580)? ... Read more
READER QUESTIONS:
Finding the Right Code for Flushing
Question: What is the ICD-9 code for "hot flushes?" New York Subscriber Answer: The code ... Read more
READER QUESTIONS:
Maximize Billing for Oxygen Therapy in the Office
Question: Can we bill for oxygen therapy given to patients in the office during an E/M se... Read more
READER QUESTIONS:
Why the Equipment Matters When Billing for ABI
Question: Can I bill separately for ankle brachial index (ABI) on top of the E/M service ... Read more
READER QUESTIONS:
Distinguish Between the Different Types of Asthma
Question: What is the ICD-9 code for mild, intermittent asthma? Kansas Subscriber Answer:... Read more
READER QUESTIONS:
Belching Equals Eructation in ICD-9
Question: Is there an ICD- 9 code for belching? Arkansas Subscriber Answer: Yes, belching... Read more
You Be the Coder:
Is There an ICD-9 Code for Swine Flu?
Question: A college student traveling through Texas two days prior returned home with fev... Read more
Max Out Burn Claims When You Find 16000, Separate E/M Evidence
Net 16000 pay when treatment occurs. A sunburn can qualify as a bur... Read more
Focus on Pre-Op E/M's Purpose to Keep Claims Correct
File claims for non-consult services, but make sure patient knows some preop E... Read more
Steer Clear of Denials by Coding for Consults on Case-By-Case Basis
This guide streamlines payers diagnoses order variations. When your... Read more
Look for Pre-Headache 'Warning Signs' and Avoid Migraine Miscodes
Aura, migrainosus info fills 4th and 5th ICD-9 digits. ICD-9 2009 f... Read more
READER QUESTIONS :
Be Aware of Surroundings on US Claims
Question: The FP meets a 27-year-old patient who is 16 weeks pregnant at the l... Read more
READER QUESTIONS :
Rely on Combo Codes for Some COPD Patients
Question: An established patient with chronic obstructive pulmonary disorder (... Read more
READER QUESTIONS :
Shelve Excision Codes When It's Just a Shave
Question: A patient with superficial lesions on his right hand reports to the ... Read more
READER QUESTIONS :
Choose Inpatient Code for Some 1-Day E/Ms
Question: The FP meets an established patient at the hospital on Monday mornin... Read more
You Be the Coder :
Completely Coding Tetanus Shot Encounters
Question: An established 17-year-old patient reports to the FP after stepping ... Read more
Green-Light Higher-Paying FBR Procedure by Honing Your Incision Vocab
Restricting 10120 to scalpel incisions could be costing your practice $80. ... Read more
Get the Answer to FBR's Most Common FAQ
Youve nailed down a charts soft-tissue foreign body removal (FBR) support, and... Read more
ID All HPI Elements for Most Accurate E/M Coding
Not accurately counting history of present illness (HPI) elements can land you... Read more
News You Can Use:
Prevent Denials by Knowing CIGNA's New Rules Now
One more private insurer has kissed confusing code bundles goodbye and welcome... Read more
READER QUESTIONS :
Double Up for Pinpoint Pressure Ulcer Coding
Question: An established 75-year-old Medicare patient reports to the FP for in... Read more
READER QUESTIONS:
Consider Online Aids for Counseling Template
Question: We have been trying to report the new smoking cessation counseling c... Read more
READER QUESTIONS :
Supervision Situation Alters Xolair Admin Coding
Question: An established 19-year-old patient with allergic asthma reports to t... Read more
READER QUESTIONS :
CTI + E/M Possible With Unscheduled Injections
Question: An established patient with a plan of care in place for carpal tunne... Read more
READER QUESTIONS :
Separate FBRs From Rust Ring Removals
Question: Operative notes indicate that a patient complaining of left eye pain... Read more
You Be the Coder :
Does a Single Cut Lead to Excision Exception?
Question: An FP performs a level-two E/M on a new patient, during which she di... Read more
Tally TPI Targets or Risk Miscoding Claim
4-step FAQ can make you a top TPI gun. FP coders who want to perfec... Read more
Top-Notch Dx Coding Keys Concurrent Care Claims
$$$ can fly out the door if ICD-9 overlap afflicts claim. Getting t... Read more
Follow 3 Steps to Burn Through Dx Coding Duties
Start at 940.x and work your way up on burn ICD-9s. When your FP pe... Read more
READER QUESTIONS:
Count Minutes on 'Counseling Exception' Claims
Question: A new patient with juvenile diabetes meets with the FP for managemen... Read more
READER QUESTIONS:
Get Specific With New Hematuria ICD-9s
Question: A 28-year-old established patient reports to the FP complaining of b... Read more
READER QUESTIONS:
Method Provides Coding Clues on Ear FBR
Question: A father brings his 2-year-old son in to the FP with an injury to hi... Read more
READER QUESTIONS:
Coding Doesn't Change When Unna Boot Does
Question: An established patient with a diagnosis of superficial thrombrophleb... Read more
READER QUESTIONS:
Coders Disagree on Foot FBR Specifics
Question: A 43-year-old established patient meets the FP at the hospital with ... Read more
READER QUESTIONS:
Dermabond = Laceration Repair, Usually
Question: The FP treats an established 18-year-old patient who has a long,but ... Read more
You Be the Coder :
ID Different Cyst I&D Types
Question: An established patient reports to the FP with a tender mass at the a... Read more
Bust 3 Myths That Could Be Holding Up Your Smoking Cessation Reporting
This truth plan reveals 99406, 99407 minimum requirements to avoid overwork. With Amer... Read more
Before You Mark 99211, Check Off These Items
Your nurse visits will withstand scrutiny safeguarding almost $20 per claim. With inciden... Read more
Stop Assuming 99000 Is Just for Messenger Fee
The AMA changed its mind -- and you should change your policy. If you reserve 99000 ... Read more
Correction:
Do Not Code G0245 + 99213-25
Edits, not diagnosis, trigger case study denial. If your FP provides an office visit a... Read more
READER QUESTIONS:
Diagnostic Level I Code Replaces G0394
Question: HCPCS 2009 shows Medicare deleted G0394 (Blood occult test [e.g., guaiac], fec... Read more
READER QUESTIONS:
Check Location to Code Lesion Destruction
Question: Using electrocautery, I removed lesions from a patient's cervix. Should I use ... Read more
READER QUESTIONS:
CNS = NP = PA for CPT, But Check Law
Question: Does a certified nurse specialist (CNS) count as a nurse practitioner (NP) for... Read more
READER QUESTIONS:
Equate Modifier 76 With Repeat Procedure
Question: A patient has pressure sores that were 20 sq cm on his right ankle and right h... Read more
READER QUESTIONS:
Where Do You Count Forgetfulness?
Question: A patient comes in with a chief complaint of -increasing forgetfulness.- How c... Read more
READER QUESTIONS:
Look for Comorbidity to Expect Pre-Op Pay
Question: Ophthalmologists always request our opinion on whether patients scheduled for ... Read more
You Be the Coder:
Check This Before Using 90465
Question: A 15-year-old has a preventive medicine visit with the FP. The physician counsel... Read more
3 Steps Ethically Add $36 to This Excision Claim
Measurement, report, location ensures coding accuracy. Patience is a virtue, particular... Read more
CPT 2009:
FAQ Answers Halt Giving Away Well Check Related Services
New language makes challenging screening bundles easier. If you-ve been lumping immuni... Read more
Are You Counting All Prolonged Service Time? There's a New Way in 2009
Include unit/floor time in 99356-99357 unless payer instructs otherwise A minor word ch... Read more
Get Out of Your Head When Reading UTI, DM, HTN Note
Perceiving -due to,- -benign- could land you with incorrect dx. Be careful that your sep... Read more
Reader Questions:
E-Scribe Bonus Basics
Question: I heard that physicians may receive bonuses for e-prescribing. What codes woul... Read more
Reader Questions:
Note Organization Is Preferred
Question: The doctor dictates a detail in his "plan" that he doesn't mention in his revi... Read more
Reader Questions:
90772 Edits Continue Anew
Question: A family physician admitted a patient to the hospital and ordered a Penicillin... Read more
Reader Questions:
Sick Visit + Work Injury: How Many E/Ms?
Question: A patient came in for medical illness diagnosis and had also hurt his finger. ... Read more
Reader Questions:
Stick With 51701 for Non-Indwelling Cath
Question: A charge ticket indicates the FP performed an "in & out cath." Diagnosis i... Read more
You Be the Coder:
Is 99211 + 95117 OK?
Question: When a patient comes in for allergy injections -- and that's all the nurse ... Read more
CPT 2009:
Sidestep Newborn Care Denials With This 6-Step Update Plan
Massive changes bring children's E/M coding system together. Overhauling your total new... Read more
Spot the Newborn Code You Need in a Snap
This crosswalk helps you navigate CPT's 2009 newborn E/M section The work of overhaulin... Read more
Medicare Update:
Say 'Good Riddance' to 2 IPPE Requirements in 2009
-Happy retirement- no longer comes with unwelcome present. Just-turned 65-year-olds ha... Read more
CPT 2009:
Follow 5 Do's to Unstick Injection Coding Errors
This tactic will pre-empt losing $21 for B12 shot. If you-re not up on the latest do's ... Read more
Reader Questions:
Am I Missing $15 in Nebulizer Education?
Question: Should we use 94664 when a nurse provides education/demonstration/monitoring t... Read more
Reader Questions:
99406, 99407 Coverage Hinges on Condition
Question: What diagnoses does Medicare cover for smoking cessation? For instance, will the... Read more
Reader Questions:
Does Back Pain E/M + TPI Warrant E/M-25?
Question: An established patient came in for continuing lower back pain. The FP took an ... Read more
Reader Questions:
Code H&P That Nonsurgeon Performs
Question: An FP performs a pre-op clearance that an out-of-state surgeon requests on a p... Read more
You Be the Coder:
Shave Duplicative Denials
Question: An FP shaved three epidermal lesions that the patient chose not to have submit... Read more
3 Tips Ratchet Up Your FBR Pay
Gain $54-225+ when you identify these items. Automatically accepting an E/M code or r... Read more
ICD-9 2009:
Ensure Wart, Disruption Specificity by Taking Quick Quiz
Avoiding this Pap smear pitfall will prevent -outdated- code denials. If you-re linki... Read more
CPT 2009:
Skip Modifier 21 -- Go Straight to 99354-99359
You-ll have only the more specific way to report prolonged services. Have you tried add... Read more
Reader Questions:
Exam, MDM Sway Chest Pain E/M Selection
Question: When a patient comes into the office complaining of chest pain, we often order... Read more
Reader Questions:
Find Syndrome for Hair Around Digit
Question: A 3-month-old had hair wrapped around her toe that was constricting blood flow... Read more
Reader Questions:
How to Code Online BP Med Check
Question: A 52-year-old female patient (non-Medicare) suffering from hypertension is tak... Read more
Reader Questions:
Limit 36410 to MD Required Draw
Question: Because our office does not have a nurse, the physician always draws blood. Ca... Read more
Reader Questions:
Are You Undercoding Condition Checks?
Question: We see a lot of patients who come in with a shopping list of problems that are... Read more
You Be the Coder:
Splint Placement: 3 Codes Are Possible
Splint Placement: 3 Codes Are Possible Question: I placed a finger splint on a patient ... Read more
Avert Foot Exam Denials in 1, 2, 3 Steps
Swift payment might be as easy as switching your diabetes fourth digit To get diabetic... Read more
Pediatric Coding Corner:
Simplify Well-Child Exam Coding With Single V Code
Beware: Payers may force you to use -acceptable- dx If you-ve been unsure when to use V... Read more
News You Can Use:
Put an End to Pelvic Exam Requirement Myth
You can use G0101 even when FP doesn't perform breast exam Despite rumors otherwise, yo... Read more
Rectify Common Hypertension Coding Errors With Quick Quiz
These questions will stop you from reading too much into your FP's 401.x notes You can ... Read more
Reader Questions:
Tackle This Modifier 25 and EKG Scenario
Question: We-ve received letters from CMS regarding modifier 25. We use this modifier on... Read more
Reader Questions:
Can You Link Ritalin Use to OV?
Question: Is V58.69 a secondary code? Texas Subscriber Answer: Yes. ICD-9 considers ... Read more
Reader Questions:
Connect Saturday Code to Hours, Not Dx
Question: Our office is open on Saturdays. What ICD-9 codes would the claim require to u... Read more
Reader Questions:
Keep Track of Refills for E/M
Question: May we bill an insurance carrier for a prescription refill outside the global ... Read more
Reader Questions:
Correct Order Combats FluMist Denials
Question: We have begun administering Flumist along with well checks and other immunizat... Read more
You Be the Coder:
Coumadin checks:99363 Versus 85610
Question: When overseeing patients taking Warifin/Coumadin, should our practice use 9936... Read more
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