Primary Care Coding Alert
Code Changes:
CPT® 2012 Includes Intradermal Flu Vaccine Option With 90654
Don't miss revisions to other vaccine, E/M codes. CPT® 2012 goes into effect in a ma... Read more
CPT® 2012 Includes Intradermal Flu Vaccine Option With 90654
Don't miss revisions to other vaccine, E/M codes. CPT® 2012 goes into effect in a ma... Read more
Rural Care:
Protect Your Bottom Line: Implement These Revalidation Letter Requirements
Here's the lowdown on how these CMS changes apply to your practice.If you're a rural healt... Read more
Protect Your Bottom Line: Implement These Revalidation Letter Requirements
Here's the lowdown on how these CMS changes apply to your practice.If you're a rural healt... Read more
Version 5010:
The Countdown's On for Electronic Transaction Changes Jan. 1
Compliance, payment, and ICD-10 hang in the balancesAre you ready to say goodbye to versio... Read more
The Countdown's On for Electronic Transaction Changes Jan. 1
Compliance, payment, and ICD-10 hang in the balancesAre you ready to say goodbye to versio... Read more
ICD-10:
Train Physicians Now for Extra Osteoarthritis Documentation in 2013
Unspecified location? Look to the M19 codes.When ICD-9 becomes ICD-10 in October 2013, phy... Read more
Train Physicians Now for Extra Osteoarthritis Documentation in 2013
Unspecified location? Look to the M19 codes.When ICD-9 becomes ICD-10 in October 2013, phy... Read more
Reader Question:
Turn to 99214 to Give Credit for Extra Time
Question: Our family physician spends a lot of time discussing treatment options, imaging ... Read more
Turn to 99214 to Give Credit for Extra Time
Question: Our family physician spends a lot of time discussing treatment options, imaging ... Read more
Reader Question:
For E/M, 3 'Vitals' Equals 1 Exam Bullet
Question: Would you please explain how taking the vital signs contributes to determining t... Read more
For E/M, 3 'Vitals' Equals 1 Exam Bullet
Question: Would you please explain how taking the vital signs contributes to determining t... Read more
Reader Question:
Forget Modifier 55 for Suture Removal
Question: An 11-year-old established patient went to the emergency room in another state o... Read more
Forget Modifier 55 for Suture Removal
Question: An 11-year-old established patient went to the emergency room in another state o... Read more
Reader Question:
Submit 95250, Then 95251 for Glucose Monitoring
Question: What is the best way to bill for continuous glucose monitoring? Do we bill for t... Read more
Submit 95250, Then 95251 for Glucose Monitoring
Question: What is the best way to bill for continuous glucose monitoring? Do we bill for t... Read more
Reader Question:
Choose 10120 for Punch Biopsy FBR
Question: The physician used a punch biopsy to remove a thickly embedded tick from a patie... Read more
Choose 10120 for Punch Biopsy FBR
Question: The physician used a punch biopsy to remove a thickly embedded tick from a patie... Read more
You Be the Coder:
Choose the Correct Code for Kenalog Injections
Question: How should I report an intra-epididymal injection of Kenalog?South Carolina Subs... Read more
Choose the Correct Code for Kenalog Injections
Question: How should I report an intra-epididymal injection of Kenalog?South Carolina Subs... Read more
HCPCS Supplies:
Check Out Modifiers NU, KX to Clear Supply Claims
Prescribing crutches or other supplies? Get sharp on modifiers. When a patient leaves your... Read more
Check Out Modifiers NU, KX to Clear Supply Claims
Prescribing crutches or other supplies? Get sharp on modifiers. When a patient leaves your... Read more
CCI Edits Update:
Latest CCI Edits Target Annual Wellness Codes Again
New bundles for G0438 and G0439 shouldn't hit your bottom line. The latest updates from th... Read more
Latest CCI Edits Target Annual Wellness Codes Again
New bundles for G0438 and G0439 shouldn't hit your bottom line. The latest updates from th... Read more
ICD-10 Watch:
Follow 2 Steps Now to Prepare for ICD-10 Conversion
Analyze your practice's top 30 diagnoses to get a head start toward compliance. It... Read more
Follow 2 Steps Now to Prepare for ICD-10 Conversion
Analyze your practice's top 30 diagnoses to get a head start toward compliance. It... Read more
ICD-10:
Narrow Choice for Essential Hypertension to I10
ICD-10 streamlines to single diagnosis. Many diagnoses will expand to multiple options wit... Read more
Narrow Choice for Essential Hypertension to I10
ICD-10 streamlines to single diagnosis. Many diagnoses will expand to multiple options wit... Read more
Reader Question:
Choose Between 99213, 99214 for Pre-Op Exam
Question: The local orthopedist requires clearance before scheduling patients for total kn... Read more
Choose Between 99213, 99214 for Pre-Op Exam
Question: The local orthopedist requires clearance before scheduling patients for total kn... Read more
Reader Question:
Consider Patients and Provider for 99078 vs. 98960-98962
Question: Our physician wants to implement group patient education meetings, when he'll br... Read more
Consider Patients and Provider for 99078 vs. 98960-98962
Question: Our physician wants to implement group patient education meetings, when he'll br... Read more
Reader Question:
Don't Include Lidocaine Code With Block or Injection
Question: Our physicians often use a local anesthetic or a mixture of triamcinolone and li... Read more
Don't Include Lidocaine Code With Block or Injection
Question: Our physicians often use a local anesthetic or a mixture of triamcinolone and li... Read more
Reader Question:
Close Dermabond Claims With 12001-12007
Question: An established patient visited our office because of severe hyperkeratosis affec... Read more
Close Dermabond Claims With 12001-12007
Question: An established patient visited our office because of severe hyperkeratosis affec... Read more
Reader Question:
Steer Clear of Block Code With Simple Repair
Question: If a physician performs a digital block on a finger and repairs a 2 cm laceratio... Read more
Steer Clear of Block Code With Simple Repair
Question: If a physician performs a digital block on a finger and repairs a 2 cm laceratio... Read more
Reader Question:
Follow-Up Visit? Fill In Two Of Three E/M Components
Question: I am auditing some of my physician's E/M visits, and discovered that he's not di... Read more
Follow-Up Visit? Fill In Two Of Three E/M Components
Question: I am auditing some of my physician's E/M visits, and discovered that he's not di... Read more
Reader Question:
Scratch J0570 From Your Superbills
Question: We're receiving denials when we report codes J7610 and J0570. Can you advise reg... Read more
Scratch J0570 From Your Superbills
Question: We're receiving denials when we report codes J7610 and J0570. Can you advise reg... Read more
Reader Question:
Tinnitus Can Be Perceived In Head, Not Just Ear
Question: The family physician documented "ringing in head" for a new patient. What diagno... Read more
Tinnitus Can Be Perceived In Head, Not Just Ear
Question: The family physician documented "ringing in head" for a new patient. What diagno... Read more
You Be the Coder:
Correctly Reporting Arthrocentesis with Meds
Question: The physician used ultrasound guidance when performing arthrocentesis on the pat... Read more
Correctly Reporting Arthrocentesis with Meds
Question: The physician used ultrasound guidance when performing arthrocentesis on the pat... Read more
Annual Visits:
Ensure Correct Modifier Reporting for EKG With Annual Visit, or Face Denials
Heads up: New Medicare stance steers you away from modifier 25. If your family physician r... Read more
Ensure Correct Modifier Reporting for EKG With Annual Visit, or Face Denials
Heads up: New Medicare stance steers you away from modifier 25. If your family physician r... Read more
ICD-9 2012:
Fifth Digits Add Specificity to 173.x Skin Cancer Codes
Check these new options to help physicians pinpoint the type of diagnosis. When the update... Read more
Fifth Digits Add Specificity to 173.x Skin Cancer Codes
Check these new options to help physicians pinpoint the type of diagnosis. When the update... Read more
Modifier Review:
Ace Extremity Fracture Claims With These Modifier Strategies
Tip: Repeating a procedure or service doesn't always mean extra pay. With football and soc... Read more
Ace Extremity Fracture Claims With These Modifier Strategies
Tip: Repeating a procedure or service doesn't always mean extra pay. With football and soc... Read more
ICD-10:
786.05 Will Have New Code, But Same Descriptor, in 2013
Physicians should check for underlying disorders that cause symptoms.If your physician giv... Read more
786.05 Will Have New Code, But Same Descriptor, in 2013
Physicians should check for underlying disorders that cause symptoms.If your physician giv... Read more
Reader Question:
Don't Automatically Report 99339-99340 for ALF Patients
Question: One of our physicians evaluated a new patient in an assisted living facility for... Read more
Don't Automatically Report 99339-99340 for ALF Patients
Question: One of our physicians evaluated a new patient in an assisted living facility for... Read more
Reader Question:
Add Modifier 59 for Repeated Nosebleed Procedure
Question: My physician saw a patient in the office for a nosebleed. Later that day, the pa... Read more
Add Modifier 59 for Repeated Nosebleed Procedure
Question: My physician saw a patient in the office for a nosebleed. Later that day, the pa... Read more
Reader Question:
Collect From Secondary Payer Before Patient
Question: We have many patients with secondary insurance, some of which have deductibles... Read more
Collect From Secondary Payer Before Patient
Question: We have many patients with secondary insurance, some of which have deductibles... Read more
Reader Question:
Coding Negative Strep Test Forces You to Rely on Symptoms
Question: We performed a strep test on a patient who presented with vomiting, rash, and he... Read more
Coding Negative Strep Test Forces You to Rely on Symptoms
Question: We performed a strep test on a patient who presented with vomiting, rash, and he... Read more
Reader Question:
Set Well and E/M Visits on Separate Days
Question: We often bill well woman and sick visits on the same day if the sick visit warra... Read more
Set Well and E/M Visits on Separate Days
Question: We often bill well woman and sick visits on the same day if the sick visit warra... Read more
Reader Question:
Select Pap Test Codes By Age and Medicare Status
Question: What CPT® code should we submit for a Pap smear?Rhode Island Subscriber An... Read more
Select Pap Test Codes By Age and Medicare Status
Question: What CPT® code should we submit for a Pap smear?Rhode Island Subscriber An... Read more
You Be the Coder:
Patient Wheezing? 519.11 Might Outweigh 786.07
Question: Sometimes our physician suggests diagnosis 519.11 for wheezing, but sometimes he... Read more
Patient Wheezing? 519.11 Might Outweigh 786.07
Question: Sometimes our physician suggests diagnosis 519.11 for wheezing, but sometimes he... Read more
Diagnostic Tests:
Check Frequency Rules and Risk Categories Before Coding Colonoscopy Screenings
Watch out: Medicare has specific requirements other payers might not follow.The days have ... Read more
Check Frequency Rules and Risk Categories Before Coding Colonoscopy Screenings
Watch out: Medicare has specific requirements other payers might not follow.The days have ... Read more
Office Visits:
3 Steps Shape Up Your E/M Coding for Chronic Conditions
Follow 1997 guidelines when counting elements, and ethically bump pay approximately $33.Th... Read more
3 Steps Shape Up Your E/M Coding for Chronic Conditions
Follow 1997 guidelines when counting elements, and ethically bump pay approximately $33.Th... Read more
ABNs:
Yes, You Can Still Use an ABN-Style Waiver for Non-Covered, Non-Medicare Services
Steer clear of angry patients and lost reimbursement by covering your bases up front.When ... Read more
Yes, You Can Still Use an ABN-Style Waiver for Non-Covered, Non-Medicare Services
Steer clear of angry patients and lost reimbursement by covering your bases up front.When ... Read more
ICD-10:
You'll Have Separate Fibromyalgia, Myalgia Diagnoses in 2013
ICD-10 also establishes new myositis code.If your family physician diagnoses a patient wit... Read more
You'll Have Separate Fibromyalgia, Myalgia Diagnoses in 2013
ICD-10 also establishes new myositis code.If your family physician diagnoses a patient wit... Read more
Reader Question:
Count Toes to Choose Between 11720 and 11721
Question: What CPT Codes is best for cutting and filing ten toenails?Indiana SubscriberAn... Read more
Count Toes to Choose Between 11720 and 11721
Question: What CPT Codes is best for cutting and filing ten toenails?Indiana SubscriberAn... Read more
Reader Question:
Code Malignant Facial Lesion With 173.3
Question: The physician removed a lesion from the patient's temple area. The pathology rep... Read more
Code Malignant Facial Lesion With 173.3
Question: The physician removed a lesion from the patient's temple area. The pathology rep... Read more
Reader Question:
Be Aware of Coumadin Cautions Before Coding 99363, 99364
Question: I know Medicare doesn't cover Coumadin clinics, but thought some commercial plan... Read more
Be Aware of Coumadin Cautions Before Coding 99363, 99364
Question: I know Medicare doesn't cover Coumadin clinics, but thought some commercial plan... Read more
Reader Question:
Be Prepared to Educate Payers on Modifier 33
Question: We get denials from several insurance companies, stating that modifier 33 is inv... Read more
Be Prepared to Educate Payers on Modifier 33
Question: We get denials from several insurance companies, stating that modifier 33 is inv... Read more
Reader Question:
Check Incident-To Rules For Follow-Up Visits
Question: One of our non-physician practitioners saw a patient during a follow-up visit. W... Read more
Check Incident-To Rules For Follow-Up Visits
Question: One of our non-physician practitioners saw a patient during a follow-up visit. W... Read more
Reader Question:
Don't Pass 99211 for PA/NP Counseling
Question: Our office provides birth control start appointments for college-age women. The ... Read more
Don't Pass 99211 for PA/NP Counseling
Question: Our office provides birth control start appointments for college-age women. The ... Read more
You Be the Coder:
Diagnosing 'Resolved' Back Pain
Question: What diagnosis code should we report for resolved back pain? Does ICD-9 include ... Read more
Diagnosing 'Resolved' Back Pain
Question: What diagnosis code should we report for resolved back pain? Does ICD-9 include ... Read more
CCI 17.2 Edits:
Nix Annual Wellness Visit With ECG, E/M, and Behavior Assessment
Tip: Appending modifier 25 can help save AWV with some claims.Until now, you've been able ... Read more
Nix Annual Wellness Visit With ECG, E/M, and Behavior Assessment
Tip: Appending modifier 25 can help save AWV with some claims.Until now, you've been able ... Read more
Diagnosis Coding:
Check Out New V Codes That Will Affect Your 'History' Diagnosis Coding
New ICD-9 codes also stress anaphylactic 'reactions,' not 'shock'.New and revised ICD-9 di... Read more
Check Out New V Codes That Will Affect Your 'History' Diagnosis Coding
New ICD-9 codes also stress anaphylactic 'reactions,' not 'shock'.New and revised ICD-9 di... Read more
E/M Services:
Double Check Documentation Before Dropping from 99204 to 99203
You're not only losing revenue -- you're also coding improperly.If your coders are so... Read more
Double Check Documentation Before Dropping from 99204 to 99203
You're not only losing revenue -- you're also coding improperly.If your coders are so... Read more
ICD-10:
Atrial Fibrillation Maps to Single Code in ICD-10
Locate results before coding extra ECGs or other tests.Reporting an atrial fibrillation di... Read more
Atrial Fibrillation Maps to Single Code in ICD-10
Locate results before coding extra ECGs or other tests.Reporting an atrial fibrillation di... Read more
Reader question:
Age, Medicare Status Help Decide Pap Test Codes
Question: What CPT® code should we submit for a Pap smear?Rhode Island SubscriberAns... Read more
Age, Medicare Status Help Decide Pap Test Codes
Question: What CPT® code should we submit for a Pap smear?Rhode Island SubscriberAns... Read more
Reader question:
Family Member Counseling Not Always Billable
Question: A Medicare patient's daughter scheduled an appointment with the family physician... Read more
Family Member Counseling Not Always Billable
Question: A Medicare patient's daughter scheduled an appointment with the family physician... Read more
Reader question:
Select 079.99 or 079.89 for "Viral Syndrome"
Question: Our family physician often uses the phrase "viral syndrome" to describe a patien... Read more
Select 079.99 or 079.89 for "Viral Syndrome"
Question: Our family physician often uses the phrase "viral syndrome" to describe a patien... Read more
Reader question:
Skip E/M With 94760, 94761 for Medicare Patients
Question: Our payers deny a significant number of pulse oximetry codes because they state ... Read more
Skip E/M With 94760, 94761 for Medicare Patients
Question: Our payers deny a significant number of pulse oximetry codes because they state ... Read more
Reader question:
Steer Clear of 'Seen and Agreed' Note or Face Denials
Question: Our physician works with residents each year. It's very time consuming, but he d... Read more
Steer Clear of 'Seen and Agreed' Note or Face Denials
Question: Our physician works with residents each year. It's very time consuming, but he d... Read more
Reader question:
Don't Avoid 25 Because of the Same Diagnosis
Question: I recently heard that you do not need different diagnosis codes to use modifier ... Read more
Don't Avoid 25 Because of the Same Diagnosis
Question: I recently heard that you do not need different diagnosis codes to use modifier ... Read more
You Be the Coder:
Understanding Multiple Uses of G8553
Question: We're still working to become compliant with eprescribing. We don't have a large... Read more
Understanding Multiple Uses of G8553
Question: We're still working to become compliant with eprescribing. We don't have a large... Read more
Case Study:
Learn When to Code Anaphylaxis Versus Allergic Reaction
Tip: Count the number of body systems involved to make the right choice.Summertime is here... Read more
Learn When to Code Anaphylaxis Versus Allergic Reaction
Tip: Count the number of body systems involved to make the right choice.Summertime is here... Read more
Knee Injections:
Count Muscles, Not Injections, When Coding Trigger Points
Here's your guide to success with TPI versus other knee injections.All knee injections&nbs... Read more
Count Muscles, Not Injections, When Coding Trigger Points
Here's your guide to success with TPI versus other knee injections.All knee injections&nbs... Read more
E/M:
Avoid Getting Caught in These 3 Common E/M Traps
Incident to, critical care must meet certain criteria.As a family medicine coder, you're a... Read more
Avoid Getting Caught in These 3 Common E/M Traps
Incident to, critical care must meet certain criteria.As a family medicine coder, you're a... Read more
ICD-10:
Prepare for Additional Code Reporting for Foreign Body Removal
Once ICD-10 goes into effect, check the type of retained body.Choosing your primary diagno... Read more
Prepare for Additional Code Reporting for Foreign Body Removal
Once ICD-10 goes into effect, check the type of retained body.Choosing your primary diagno... Read more
Reader Question:
Choose Between 782.9 and 705.89 for Body Odor
Question: A mother brought her 6-year-old daughter to our office because she was concerned... Read more
Choose Between 782.9 and 705.89 for Body Odor
Question: A mother brought her 6-year-old daughter to our office because she was concerned... Read more
Reader Question:
Look Beyond Obesity for Primary Diagnosis
Question: Some of our insurers refuse to pay for obesity as a primary or secondary diagnos... Read more
Look Beyond Obesity for Primary Diagnosis
Question: Some of our insurers refuse to pay for obesity as a primary or secondary diagnos... Read more
Reader Question:
Keep Your ABN Handy for Urinalysis Screening Tests
Question: Is a urinalysis (screening) included in or bundled with a patient's initial prev... Read more
Keep Your ABN Handy for Urinalysis Screening Tests
Question: Is a urinalysis (screening) included in or bundled with a patient's initial prev... Read more
Reader Question:
Coding for Closure with Dermabond
Question: An established patient visited our office because of severe hyperkeratosis affec... Read more
Coding for Closure with Dermabond
Question: An established patient visited our office because of severe hyperkeratosis affec... Read more
Reader Question:
Skip Preventive Exam Codes for Skin Cancer Screening
Question: My physician saw a patient for a skin cancer screening. Should I use the prevent... Read more
Skip Preventive Exam Codes for Skin Cancer Screening
Question: My physician saw a patient for a skin cancer screening. Should I use the prevent... Read more
Reader Question:
Payer Policy Trumps Coding Guidelines
Question: Our Medicaid carrier refuses to accept the new vaccination codes, but we know it... Read more
Payer Policy Trumps Coding Guidelines
Question: Our Medicaid carrier refuses to accept the new vaccination codes, but we know it... Read more
Reader Question:
Get Specific Diagnosis Before Coding Tissue Infection
Question:Our physician treated a soft-tissue infection on a patient's finger. Which diagno... Read more
Get Specific Diagnosis Before Coding Tissue Infection
Question:Our physician treated a soft-tissue infection on a patient's finger. Which diagno... Read more
You Be the Coder:
Selecting Correct ICD-9 Code for Multiple Burns
Question: An established patient reports to our physician with firstand second-degree burn... Read more
Selecting Correct ICD-9 Code for Multiple Burns
Question: An established patient reports to our physician with firstand second-degree burn... Read more
Injection Coding:
Ask Yourself 3 Questions Before Coding CTS Shots
Verify evidence of previous treatments for successful claims.If you're coding for a patien... Read more
Ask Yourself 3 Questions Before Coding CTS Shots
Verify evidence of previous treatments for successful claims.If you're coding for a patien... Read more
Pediatrics:
Follow 3 Steps When Coding and Billing Camp and Sport Exams
From ICD-9 coding to your forms policy, we've got you covered.Summer camp season is coming... Read more
Follow 3 Steps When Coding and Billing Camp and Sport Exams
From ICD-9 coding to your forms policy, we've got you covered.Summer camp season is coming... Read more
Documentation:
Examine MD's Notes to Determine if E/M Is 'Separate' or 'Inherent'
The answer to your question gives 'yes' or 'no' to modifier 25.If your family physician pe... Read more
Examine MD's Notes to Determine if E/M Is 'Separate' or 'Inherent'
The answer to your question gives 'yes' or 'no' to modifier 25.If your family physician pe... Read more
ICD-10:
"Unspecified" Conjunctivitis Coding Will Remain Simple in 2013
Tip: Check whether more detailed diagnoses are more appropriate.Although ICD-9 currently i... Read more
"Unspecified" Conjunctivitis Coding Will Remain Simple in 2013
Tip: Check whether more detailed diagnoses are more appropriate.Although ICD-9 currently i... Read more
Reader Questions:
Multiple X-Ray Charges OK for Different Purposes
Question: A new patient presented to the office because of an injured left ankle she hurt ... Read more
Multiple X-Ray Charges OK for Different Purposes
Question: A new patient presented to the office because of an injured left ankle she hurt ... Read more
Reader Questions:
Origins of Blood Signal Either 569.3 or 578.1
Question: I'm not sure when I should use 569.3 and 578.1 for bloody stool. Are they one an... Read more
Origins of Blood Signal Either 569.3 or 578.1
Question: I'm not sure when I should use 569.3 and 578.1 for bloody stool. Are they one an... Read more
Reader Questions:
Review Incident-To Guidelines For Follow-Ups
Question: One of our non-physician practitioners saw a patient during a follow-up visit. W... Read more
Review Incident-To Guidelines For Follow-Ups
Question: One of our non-physician practitioners saw a patient during a follow-up visit. W... Read more
Reader Questions:
V70.0 Counts for Well Woman UA
Question: One of our physicians wants to order urinalysis as a routine part of a well woma... Read more
V70.0 Counts for Well Woman UA
Question: One of our physicians wants to order urinalysis as a routine part of a well woma... Read more
Reader Questions:
Patient Age Helps Point to "Intoeing" Diagnosis Code
Question: What diagnosis should we report for "intoeing"?New Hampshire SubscriberAnswer: T... Read more
Patient Age Helps Point to "Intoeing" Diagnosis Code
Question: What diagnosis should we report for "intoeing"?New Hampshire SubscriberAnswer: T... Read more
Reader Questions:
Check All Notes for Chronic Condition Details
Question: The 1997 audit guidelines state that I can reach an extended history by updating... Read more
Check All Notes for Chronic Condition Details
Question: The 1997 audit guidelines state that I can reach an extended history by updating... Read more
Reader Questions:
Imaging Confirmation Separates 20610 From 27096
Question: Which CPT® code applies to a sacroiliac joint injection? Would we bill it ... Read more
Imaging Confirmation Separates 20610 From 27096
Question: Which CPT® code applies to a sacroiliac joint injection? Would we bill it ... Read more
You Be the Coder:
Use -79 for Repeat Wart Freezing Within Global
Question: Eight days after an initial wart freezing, the patient returns, and the physicia... Read more
Use -79 for Repeat Wart Freezing Within Global
Question: Eight days after an initial wart freezing, the patient returns, and the physicia... Read more
Nosebleeds:
Stop Nosebleed Coding Problems by Understanding Extent of Repair
Checkpoint: You'll sometimes just need E/M codes, not 30901.A patient comes to your office... Read more
Stop Nosebleed Coding Problems by Understanding Extent of Repair
Checkpoint: You'll sometimes just need E/M codes, not 30901.A patient comes to your office... Read more
CCI 17.1:
Watch Involved Joints Before Coding Arthrotomy
Tip: Exploration and drainage codes override some biopsy or synovectomy choices.The latest... Read more
Watch Involved Joints Before Coding Arthrotomy
Tip: Exploration and drainage codes override some biopsy or synovectomy choices.The latest... Read more
ICD-10:
Big Changes Will Come for ADD/ADHD Coding Under ICD-10
Prepare for 5 ��" not 2 ��" code choices in 2013.You may know ... Read more
Big Changes Will Come for ADD/ADHD Coding Under ICD-10
Prepare for 5 ��" not 2 ��" code choices in 2013.You may know ... Read more
Collections:
Afraid You're Not Getting Paid On Time? Check Out Your State's Prompt Pay Laws
Medicare contractors must pay clean claims within 30 days, but private payers vary.It's a ... Read more
Afraid You're Not Getting Paid On Time? Check Out Your State's Prompt Pay Laws
Medicare contractors must pay clean claims within 30 days, but private payers vary.It's a ... Read more
Reader Questions:
Choose From 99393-99395 Based on Patient Age
Question:Our FP saw a patient for a sports physical clearance. During the visit, the patie... Read more
Choose From 99393-99395 Based on Patient Age
Question:Our FP saw a patient for a sports physical clearance. During the visit, the patie... Read more
Reader Questions:
Check Out G0372 for Power Wheelchair Evaluation
Question:What code applies to a face-to-face evaluation for a power wheelchair? Maryland S... Read more
Check Out G0372 for Power Wheelchair Evaluation
Question:What code applies to a face-to-face evaluation for a power wheelchair? Maryland S... Read more
Reader Questions:
No MPFS RVW Means No Medicare Coverage
Question:Can you explain to me why some codes (such as 99172) do not have an associated re... Read more
No MPFS RVW Means No Medicare Coverage
Question:Can you explain to me why some codes (such as 99172) do not have an associated re... Read more
Reader Questions:
Let Patient Deal With Auto Insurer for Migraine After MVA
Question:One of our patients has a 30-year history of migraines, but the migraines worsene... Read more
Let Patient Deal With Auto Insurer for Migraine After MVA
Question:One of our patients has a 30-year history of migraines, but the migraines worsene... Read more
Reader Questions:
Billing for a TB Test and Its Follow-Up
Question:What is the correct way to code for Mantoux administration and follow-up? North D... Read more
Billing for a TB Test and Its Follow-Up
Question:What is the correct way to code for Mantoux administration and follow-up? North D... Read more
Reader Questions:
Describe Abnormal Feces Fluidity With 787.91
Question:A patient says she has had chronic bowel problems for the last 10 years, with dia... Read more
Describe Abnormal Feces Fluidity With 787.91
Question:A patient says she has had chronic bowel problems for the last 10 years, with dia... Read more
Reader Questions:
Nurse Could Count for 98960 Professional
Question: Is it appropriate to use code 98960 for a nurse who completes extensive asthma e... Read more
Nurse Could Count for 98960 Professional
Question: Is it appropriate to use code 98960 for a nurse who completes extensive asthma e... Read more
Reader Questions:
Choose Q0112 for Medicare KOH Slide
Question:The FP scraped skin and prepared a KOH prep to look for infectious agents. How sh... Read more
Choose Q0112 for Medicare KOH Slide
Question:The FP scraped skin and prepared a KOH prep to look for infectious agents. How sh... Read more
Reader Questions:
Subcu Foot Splinter Removal Could Be 28190
Question:The physician removed a 1.5 cm splinter from beneath the dermis of the patient's ... Read more
Subcu Foot Splinter Removal Could Be 28190
Question:The physician removed a 1.5 cm splinter from beneath the dermis of the patient's ... Read more
You Be the Coder:
Best Injection Choice for Allergy Shot
Question:Our office orders allergy serum for patients, which the patients pay up for up fr... Read more
Best Injection Choice for Allergy Shot
Question:Our office orders allergy serum for patients, which the patients pay up for up fr... Read more
Bone Scans:
3 Tips You Can't Afford to Overlook for Osteoporosis Screenings
Medical necessity and acceptable timeframes are must-haves before coding.You could soon be... Read more
3 Tips You Can't Afford to Overlook for Osteoporosis Screenings
Medical necessity and acceptable timeframes are must-haves before coding.You could soon be... Read more
Evaluation and Management:
Don't Let ROS Confusion Muddle Your E/M Code Choice
Know the differences in levels to move toward correct selection.When it comes time to calc... Read more
Don't Let ROS Confusion Muddle Your E/M Code Choice
Know the differences in levels to move toward correct selection.When it comes time to calc... Read more
Dermatology:
Count Every Patch and Office Visit for Complete Patch Test Coding
Pay day: Every patch could earn your physician $6.When your family physician conducts a pa... Read more
Count Every Patch and Office Visit for Complete Patch Test Coding
Pay day: Every patch could earn your physician $6.When your family physician conducts a pa... Read more
ICD-10:
Start Thinking About More Specific Codes for Strep Throat Diagnosis
ICD-10 will replace 034.0 with 3 detailed options.Charts for strep throat -- in adult... Read more
Start Thinking About More Specific Codes for Strep Throat Diagnosis
ICD-10 will replace 034.0 with 3 detailed options.Charts for strep throat -- in adult... Read more
Reader Questions:
Choose Carefully Between Modifiers 51 and 59
Question: The doctor controlled a patient's nasal hemorrhage (30901) and removed a benign ... Read more
Choose Carefully Between Modifiers 51 and 59
Question: The doctor controlled a patient's nasal hemorrhage (30901) and removed a benign ... Read more
Reader Questions:
Don't Expect Insurance Payment for Driver's Physicals
Question: What is the best way to code and bill for driver's physicals? I'm thinking the p... Read more
Don't Expect Insurance Payment for Driver's Physicals
Question: What is the best way to code and bill for driver's physicals? I'm thinking the p... Read more
Reader Questions:
692.4 or 995.2x Could Fit Multiple Chemical Sensitivities
Question: What diagnosis code applies to multiple chemical sensitivities?Wyoming Subscribe... Read more
692.4 or 995.2x Could Fit Multiple Chemical Sensitivities
Question: What diagnosis code applies to multiple chemical sensitivities?Wyoming Subscribe... Read more
Reader Questions:
Removal Tactic Helps Guide Lesion Coding
Question: We have an ongoing discussion in our office regarding how to code for excisions ... Read more
Removal Tactic Helps Guide Lesion Coding
Question: We have an ongoing discussion in our office regarding how to code for excisions ... Read more
Reader Questions:
Choose Either 17110 or 17111 for Removal, Not Both
Question: The physician removed plantar warts from each of a patient's feet. Do I submit t... Read more
Choose Either 17110 or 17111 for Removal, Not Both
Question: The physician removed plantar warts from each of a patient's feet. Do I submit t... Read more
Reader Questions:
Verify Payer Details Before Billing 99307
Question: How do I bill if our physician went to the nursing home to see Medicare patients... Read more
Verify Payer Details Before Billing 99307
Question: How do I bill if our physician went to the nursing home to see Medicare patients... Read more
Reader Questions:
Follow-Up BC Visit? Choose From 99401-94404, 99211-99215
Question: Our physicians have our patients come back to our office after three months of p... Read more
Follow-Up BC Visit? Choose From 99401-94404, 99211-99215
Question: Our physicians have our patients come back to our office after three months of p... Read more
You Be the Coder:
Include Secondary Dx With 702.11 or 702.19
Question: Our physician excised a 0.4 cm lesion and documented, "She has a bleeding black ... Read more
Include Secondary Dx With 702.11 or 702.19
Question: Our physician excised a 0.4 cm lesion and documented, "She has a bleeding black ... Read more
Inhalers:
94664: Remember These 4 Keys to Inhaler Service Success
Inhaler demo could pay you $16 -- if you know how to navigate the rules.When the nurs... Read more
94664: Remember These 4 Keys to Inhaler Service Success
Inhaler demo could pay you $16 -- if you know how to navigate the rules.When the nurs... Read more
CPT 2011:
Observation Codes 99224, 99225, 99226 Help Answer the 'Middle Day' Code Question
Expanded choices eliminate payer-to-payer coding variation.2011 brings a new coding option... Read more
Observation Codes 99224, 99225, 99226 Help Answer the 'Middle Day' Code Question
Expanded choices eliminate payer-to-payer coding variation.2011 brings a new coding option... Read more
Rural Care:
Check New Preventive Service Fee Waivers for Medicare Patients
PPACA waived fees starting Jan. 1, but CMS won't until April 4.If you code for a rural hea... Read more
Check New Preventive Service Fee Waivers for Medicare Patients
PPACA waived fees starting Jan. 1, but CMS won't until April 4.If you code for a rural hea... Read more
ICD-10:
M54.5 Will Offer New Lumbago Descriptor in 2013
Shifting from 724.2 to M54.5 shouldn't cause too much pain.If your family physician often ... Read more
M54.5 Will Offer New Lumbago Descriptor in 2013
Shifting from 724.2 to M54.5 shouldn't cause too much pain.If your family physician often ... Read more
Reader Questions:
Bilateral X-Ray Doesn't Always Mean -50
Question: Our physician x-rayed a patient's symptomatic knee and ordered an x-ray of the o... Read more
Bilateral X-Ray Doesn't Always Mean -50
Question: Our physician x-rayed a patient's symptomatic knee and ordered an x-ray of the o... Read more
Reader Questions:
Play It Safe for Screenings and Get Signed ABN
Question: A Medicare patient came to our office for screening laboratory tests in addition... Read more
Play It Safe for Screenings and Get Signed ABN
Question: A Medicare patient came to our office for screening laboratory tests in addition... Read more
Reader Questions:
Medical Necessity Could Mean Extra Hemoccult Pay
Question: Preventive care guidelines state that hemoccult slides are covered once each yea... Read more
Medical Necessity Could Mean Extra Hemoccult Pay
Question: Preventive care guidelines state that hemoccult slides are covered once each yea... Read more
Reader Questions:
Dates and Physician Presence Dictate 99221 Alone or With
Question: Our physician saw a patient in the office, then admitted her to the hospital lat... Read more
Dates and Physician Presence Dictate 99221 Alone or With
Question: Our physician saw a patient in the office, then admitted her to the hospital lat... Read more
Reader Questions:
Check Each Component Before Submitting 80053
Question: The physician ordered a basic metabolic panel and hepatic function panel for a p... Read more
Check Each Component Before Submitting 80053
Question: The physician ordered a basic metabolic panel and hepatic function panel for a p... Read more
Reader Questions:
481 or 485? Know the Pneumonia Diagnosis Difference
Question: What is the difference between "lobar pneumonia" and "lobular pneumonia?" When t... Read more
481 or 485? Know the Pneumonia Diagnosis Difference
Question: What is the difference between "lobar pneumonia" and "lobular pneumonia?" When t... Read more
Reader Questions:
Get Specific With TMJ Diagnosis for Success
Question: Our provider included two diagnoses in the documentation for a temporomandibular... Read more
Get Specific With TMJ Diagnosis for Success
Question: Our provider included two diagnoses in the documentation for a temporomandibular... Read more
Reader Questions:
Opt for 716.16/905.4 Combo Over V Code
Question: A patient has early post traumatic arthritis and early degenerative joint diseas... Read more
Opt for 716.16/905.4 Combo Over V Code
Question: A patient has early post traumatic arthritis and early degenerative joint diseas... Read more
You Be the Coder:
Mind Your Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The family physician used a scalpel and... Read more
Mind Your Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The family physician used a scalpel and... Read more
CCI:
Newest CCI Edits Clarify More Procedures That Include Guidance
Don't submit 77001 or 77002 with fracture care, TPI, arthrocentesis. The newest edition o... Read more
Newest CCI Edits Clarify More Procedures That Include Guidance
Don't submit 77001 or 77002 with fracture care, TPI, arthrocentesis. The newest edition o... Read more
CPT 2011:
5 Tips Lead You to G0438, G0439 Coding Success
Boost your bottom line by reporting new annual wellness visits correctly. If you want you... Read more
5 Tips Lead You to G0438, G0439 Coding Success
Boost your bottom line by reporting new annual wellness visits correctly. If you want you... Read more
ICD-10:
Prepare for New Essential Hypertension Codes
401.x will become I10. ICD-10 implementation in 2013 is coming fast, so take steps now to... Read more
Prepare for New Essential Hypertension Codes
401.x will become I10. ICD-10 implementation in 2013 is coming fast, so take steps now to... Read more
Collections Corner:
Get Proactive and Capture Every Allowable Non-Par Dollar
Follow these steps to collect money your doctors earned. As insurance companies threaten ... Read more
Get Proactive and Capture Every Allowable Non-Par Dollar
Follow these steps to collect money your doctors earned. As insurance companies threaten ... Read more
Reader Questions:
Start and Stop Times Crucial to Infusion Coding
Question: We're starting to bill for hydration and therapeutic infusions at our clinic. D... Read more
Start and Stop Times Crucial to Infusion Coding
Question: We're starting to bill for hydration and therapeutic infusions at our clinic. D... Read more
Reader Questions:
36416 With 85018: Yes, But Be Aware of Bundles
Question: Are we allowed to bill 36416 with 85018? Answer: Yes, you can submit 36416 (Col... Read more
36416 With 85018: Yes, But Be Aware of Bundles
Question: Are we allowed to bill 36416 with 85018? Answer: Yes, you can submit 36416 (Col... Read more
Reader Questions:
Pinpoint Diagnosis for CPAP Machine
Question: We received charts for using a CPAP machine with diagnosis V46.8. Is that the b... Read more
Pinpoint Diagnosis for CPAP Machine
Question: We received charts for using a CPAP machine with diagnosis V46.8. Is that the b... Read more
Reader Questions:
Don't Mix Family History With Personal History
Question: My understanding has been that I cannot bill for "family history of" a conditio... Read more
Don't Mix Family History With Personal History
Question: My understanding has been that I cannot bill for "family history of" a conditio... Read more
Reader Questions:
No CCI Bundle? Here's Where to Find Modifier Details
Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which ... Read more
No CCI Bundle? Here's Where to Find Modifier Details
Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which ... Read more
Reader Questions:
Look to Cause for Coding Bruises
Question: What is the ICD-9 code for "easy bruising"? Answer: Easy bruising is a symptom ... Read more
Look to Cause for Coding Bruises
Question: What is the ICD-9 code for "easy bruising"? Answer: Easy bruising is a symptom ... Read more
You Be the Coder:
Coding 96372 With 90471
Question: During an office visit, our nurse administered a B12 injection and a flu shot t... Read more
Coding 96372 With 90471
Question: During an office visit, our nurse administered a B12 injection and a flu shot t... Read more