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Primary Care Coding Alert
Primary Care Coding Alert
Family Practice Coding Alert - 2013; Volume 15, Number 12
CPT® Coding Strategies:
Sanitize Your Flu Vaccine Coding With These 4 Tips
Hint: Don’t forget to report administration with separate codes. As your code ch...
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Back to Basics:
Follow The 3-Year Rule To Determine Patient Status
Hint: The place of service(POS) won’t influence your choice. The first step to c...
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ICD-10 Update:
Concentrate on Severity While Reporting Asthma With J45
Hint: Identify symptoms and medication use for accurate reporting. When your FP diagno...
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Reader Question:
Facing Denials For Same Session 99407 and E/M? Check This
Question: I am billing 99407 with 99213 and getting denials. I have used the modifier 25...
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Reader Question:
Report Appropriate DSMT Codes Based on Time and Provider
Question: A patient seen for diabetes (250.02) in the doctor’s office and the phys...
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You Be the Coder:
Count Number of Muscle Groups For Accurate TPI Reporting
Question: Our FP recently performed trigger point injections to relieve muscle spasms. H...
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Family Practice Coding Alert - 2013; Volume 15, Number 11
CPT® 2014 Update:
Incorporate New E/M and Ultrasound Wound Care Therapy Codes in 2014
Good news: Common TCM guidelines will rid confusion while reporting transitional care. ...
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2014 Physician Fee Schedule:
Brace Yourself for Fee Deductions If Proposed MPFS Gets Accepted
Sunny side: Chronic care non-face-to-face services might bring in bonuses in 2015. Whi...
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ICD-10 Update:
Don't Get Sidelined By These 3 ICD -- 10 Myths
Don’t assume that ICD-10 will allow you to use the same code twice. With the hea...
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Reader Question:
Include Supply Codes With Depo Provera Administration
Question: Our FP saw a patient for her third Depo Provera shot. What is the appropr...
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Reader Question:
Append EF Modifier For EPSDT Examination Codes
Question: We are receiving denials from Medicaid stating 92551 (hearing exams) whic...
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Reader Question:
Append Modifier for Destruction, Excision Procedures
Question: One of our physicians destroyed a premalignant lesion on a patient’...
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You Be the Coder:
Factor in Counseling to Select Vaccine Codes
Question: Rotavirus vaccine is only given to children less than the age of eight at 2,4,...
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Family Practice Coding Alert - 2013; Volume 15, Number 10
CPT® 2014 Update:
Get A Grip On Coding Changes Affecting Family Practice In 2014
Good news: You will now have a new code set for inter-professional discussions. If you...
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Mythbuster:
Bust The Bubble On 3 EHR Myths That Could Cost Your Practice Precious Dollars
Warning: Blindly relying on your electronic system could mean payer audits. If you are...
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ICD-10 Update:
Enjoy Better Specificity For Pressure Ulcer Coding in ICD-10
Separate codes for bilateral locations reduce confusion while reporting multiple ulcers....
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Reader Question:
Focus on Muscles - Not Left/Right - for TPIs
Question: Our physician administered bilateral trigger point injections in three locatio...
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Reader Question:
Check Bundling Between Epidurals and E/M Depending on DOS
Question: I have done continuous epidural for my patient and injected different concentr...
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Reader Question:
Report Appropriate E/M for Suture Removal by Another Physician
Question: We recently had a patient coming into our practice to meet our family physicia...
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You Be the Coder:
Joint Codes Are Best Bet for Sinus Tarsi Injection
Question: Question: I recently received a denial for a cortisone injection to the sinus ...
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Family Practice Coding Alert - 2013; Volume 15, Number 9
CCI 19.2 Update:
Bundles Revise Your E/M With Office Procedures Reporting
In addition: Watch for these bundles affecting negative wound pressure therapy. Apply ...
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Money Matters:
Enhance Your PQRS Reporting Bonus Ethically By Selecting Right Options
Hint: Base your decisions by analyzing the number of providers in your group. If you&r...
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ICD-10 Update:
Get Set For Broader Reporting Options For Anorectal Abscess
Hint: Use separate code when you clinician diagnoses anal and rectal abscesses. ...
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Check These Anorectal Abscess Types
Based on location of the abscess in the anal and rectal regions, anorectal abscesses can...
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Reader Question:
Include 94010 for Spirometry During Office Visit
Question: What is the proper way to bill an E/M visit when performing spirometry during ...
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Reader Question:
File Appropriate E/M Code for Pre-Op Clearance
Question: What CPT® code do we file for preoperative clearance by one of our family ...
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Reader Question:
Consider Block Scheduling to Balance Late Patient Back-Ups
Question: We’ve had a lot of patients showing up late for their appointments recen...
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Reader Question:
Get Good Documentation for Unexpected Shot for Nerves
Question: One of our patients was on his way to have an MRI at the hospital. His daughte...
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You Be the Coder:
Billing 2 MD Visits on Same Day Is OK if Specialties Differ
Question: Can a patient be seen by two different providers in a billing group on the sam...
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Family Practice Coding Alert - 2013; Volume 15, Number 8
CPT® Coding Strategies:
Cue Into Accurate Newborn Exam Reporting With This Guidance
Hint: Use new patient or established codes depending on previous review of the infant. ...
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Key Elements:
Forgetting to Document PFSH Details Might Cost You More Than $70 Per Encounter
Hint: Omitting history captured in previous visits will mean loss of revenue. When you...
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ICD-10 Update:
Segregate Your Diabetes Mellitus Codes Based on Type
Hint: Use fourth and fifth digit expansion to specify complications. When your FP diag...
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Reader Question:
Let Medical Necessity Drive Your E/M Code Choice
Question: Our physician documents office visits very thoroughly. Because he documents in...
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Reader Question:
E/M With G0438, G0439 Is Possible, But Tricky
Question: Can we bill an E/M code with a 25 modifier along with annual check-up codes G0...
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Reader Question:
Here's When to Report 300.4 Instead of 311 or 300.00
Question: What is the appropriate way to code a claim when the physician calls out anxie...
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You Be the Coder:
Correctly Report Pre-Op Clearance for Surgery
Question: What CPT® code should we submit for pre-op clearance by one of our family ...
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Family Practice Coding Alert - 2013; Volume 15, Number 7
TCM Codes:
Remember 4 Things When Reporting Transitional Care to Medicare
New rules apply when you follow CMS guidelines instead of CPT® Now that you’...
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Well Visits:
Understand Payer Differences Before Coding Pap Smears With Yearly Physicals
Heads up: Medicare follows its own guidelines, not CPT® rules. If your physicians ...
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E/M Coding:
Take Steps to MDM Determination Success - Every Time
This system will help you correctly calculate each piece of the MDM puzzle. Are you in...
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ICD-10:
Neck Pain Makes Easy Shift from 723.1 to M54.2
Good news: You won’t need to learn a new descriptor for ICD-10. Family physicia...
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Reader Question:
Special In-House Code Might Be Best for CDL Physicals
Question: One of our physicians wants to bill an E/M code for a commercial driver&...
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Reader Question:
Verify Anatomic Locations Before Submitting Multiple Lines of 20600
Question: Our physician treated a patient who has osteoarthritis in her hands by injecti...
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Reader Question:
Switching Diagnoses on Claim Can Be OK
Question: Our physician documented gingivitis as a contributing factor in a patien...
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Reader Question:
Verify MD/NP Collaboration Agreement Before Locum Tenens Time Starts
Question: One of the physicians in our practice will be traveling for two months a...
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Reader Question:
Include Retained FB Code With Toe Blister, When Applicable
Question: I’m coding a case of treatment for an ischemic blister of the right grea...
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You Be the Coder:
Understanding Whether to Report 11042 With 10120
Question: Is it acceptable to code 11042 and 10120 together? If so, do I need to include...
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Family Practice Coding Alert - 2013; Volume 15, Number 6
CCI 19.1:
Newest Coding Edits Reverse Bundling for Some Injection Administrations
Start reporting vaccine administration with office consultation. The latest update fro...
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Office Visits:
Don't Miss These 3 Chances to Bill Services With Preventive Care
Tip: Check whether the payer also requires modifier 25. Preventive wellness visits are...
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Billing:
Follow These 3 Steps to Cleaner Incident-To Claims
Don’t forget to check your state’s laws for NPP scope of services. Having...
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ICD-10:
Get Extra Details to Avoid 'Unspecified' Viral Infection Diagnosis
Code 079.99 makes an easy switch, but payers might not reimburse. When your physician ...
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Reader Question:
Bill 92504 Alone, Not With 69210
Question: The physician cleared cerumen impaction from the patient’s left ear and ...
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Reader Question:
Replace Deleted Code G0366 With G0402 or G0403
Question: A 65-year-old patient who just enrolled in Medicare came to our office for his...
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Reader Question:
Q2038, G0008 Is Acceptable Fluzone Pairing for Medicare Patients
Question: Medicare denies our claims for flu vaccines with claim status codes of 25...
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Reader Question:
Submit 692.6 for Poison Ivy Diagnosis
Question: I’m having trouble finding a diagnosis code for 96372 when the physician...
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Reader Question:
Code 90714 Applies to All TD Vaccines in U.S.
Question: I know that, as of the first of the year, code 90718 has been deleted. I have ...
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You Be the Coder:
Diagnosing Initial Vs. Follow-Up Fracture Visit
Question: Our physician treated a patient for a fracture of the second metatarsal. A fol...
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Family Practice Coding Alert - 2013; Volume 15, Number 5
Preventive Services:
Yes, You Can Bill a Separate Problem During a Well Check Visit
Watch for significant service that could boost pay. When a patient comes to your offic...
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ICD-10:
4 J Code Options Help You Nail Strep Throat Diagnoses
Wait for lab results before assigning the final code. ICD-9 coding: When using the ICD...
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Billing:
Follow This 3-Step Advice Before Waiving Copays
Tip: Get your own verification of financial hardship. Every physician wants to collect...
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Reader Question:
Penalties Could Be Coming for Illegible Documentation
Question: My physician’s handwriting really is difficult to read sometimes, a...
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Reader Question:
Watch Details When Deciding Between Levels 4 and 5 E/M
Question: We have enough details for an encounter to reach these levels: &mi...
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Reader Question:
No Incision Means No 10120 for Removal
Question: My physician documented that a tick was embedded in the patient’s abdome...
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Reader Question:
Look at 917.2 for Toe Blister
Question: What is the correct diagnosis for an ischemic blister of the right great toe? ...
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Reader Question:
Start With V13.3 for Atypical Nevus Diagnosis
Question: I can’t seem to find a clear diagnosis code for personal history of atyp...
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You Be the Coder:
Billing Same-Day Physician/NP Services
Question: Our nurse practitioner (NP) is working with our family physician in the same c...
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Family Practice Coding Alert - 2013; Volume 15, Number 4
Follow These 3 Tips to Strengthen Your Bone Density Coding
Check your LCDs to see if coverage is once every 2 years. The restrictions Medicare se...
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Documentation:
Need to Amend a Patient Encounter? Better Check These Directions First
Heads up: Single-line corrections are fine. If you discover your family practitioner f...
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ICD-10:
Watch for Where BMI Codes Get More Specific Under ICD-10
Good news: Most ICD-9 codes have straight crosswalk for ICD-10. Obesity in adults and ...
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Reader Question:
Use V65.40 or V65.49 for Visit to Discuss Lab Tests
Question: A patient would like to schedule an appointment with her physician to review l...
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Reader Question:
17110 Includes Simple Repair Work
Question: Our physician performed an excision of two warts (one from the elbow and...
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Reader Question:
Begin With 95004-95071 for Allergy Testing
Question: Our physician’s documentation regarding an allergy test is as foll...
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Reader Question:
Preventive Codes Could Apply to 'Health Coach' Services
Question: I am looking for CPT® or HCPCS codes for health coach services that would ...
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Reader Question:
Submit 29405 and Q4038 for Second Cast Placement
Question: A patient was put in a cast after surgery, then came to our clinic the very ne...
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Reader Question:
Yes, You Can Report COPD and Chronic Bronchitis, but Not With Separate Codes
Question: Is it appropriate to code 491.0 with 496 when the patient has chronic bronchit...
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Reader Question:
No CC or Prescribed Service Could Mean Preventive Counseling
Question: A patient met with our physician to discuss his need for a scooter. He denied ...
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You Be the Coder:
No Patient History? Here's How to Decide E/M Level
Question: Our physician saw patient in the office, but couldn’t get all necessary ...
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Family Practice Coding Alert - 2013; Volume 15, Number 3
CCI 19.0:
Implement These Edits For Multiple Vaccines
Tip: Pay special attention to 300+ E/M pairs with influenza vaccines. Family practice ...
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CPT® 2013:
Brush Up on Counting Criteria Before Reporting New TCM Codes
Tip: Watch individual days, not just calendar months. CPT® 2013 introduced t...
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ICD-10:
Watch Your Fifth Digits for Otalgia Coding in 2014
ICD-10 will introduce 4 new options. Otalgia is one of the most common complaints in a...
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Reader Question:
Signature Variations Are Acceptable, if They're on Your Signature Log
Question: We’re having trouble making sure our providers meet signature requi...
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Reader Question:
Report 255.0 for Hypercortisolemia
Question: One of our providers ordered labs with hypercortisolemia as the supportin...
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Reader Question:
E/M Without Vitals Is Billable - With Good Documentation
Question: A daughter brought her mom to our office. The mother was seen by the doct...
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Reader Question:
+99354 Can Apply to Office Visit After Hospital Stay
Question: What is the best way to code for an extended office visit following an ac...
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You Be the Coder:
Choosing Between Routine Screening and Diagnostic Test Result
Question: A patient came in for a bone density scan, which was positive for osteope...
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Family Practice Coding Alert - 2013; Volume 15, Number 2
CPT® 2013:
Watch the Clock to Get Full Advantage from New Care Coordination Codes
Heads up: Here’s your chance to report services across multiple specialties ...
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Compliance:
Does Your Electronic Prescription System Pass Muster?
Get started now to avoid further pay hits in 2014. deputy director of the ...
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News Flash:
Add Modifiers 24 and 27 to Your Choices for Bypassing CCI Edits
Plus: You can also override bundles with modifiers LM and RI Coders learned years ago ...
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ICD-10:
K Codes Require You to Extract More Acute Appendicitis Details
Hint: Start your search based on the presence or absence of peritoneal involvement. A...
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Reader Question:
Consider Each Additional Service When Billing With G0402
Question: I’m trying to understand what we can bill to Medicare during a patient&r...
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Reader Question:
Check Payer Guidelines for Submitting Modifiers With L4360
Question: One of my third-party payers is denying L4360 because they are asking for &quo...
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Reader Question:
Multiple Diagnoses Are Fine – if They Aren't Symptoms
Question: Can I code tonsillitis, pharyngitis, and upper respiratory infection together?...
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You Be the Coder:
Choosing a Modifier for Non-Surgical Service in Global Period
Question: A patient came to our office for a minor skin surgery procedure. He was back f...
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Family Practice Coding Alert - 2013; Volume 15, Number 1
2013 AMA Symposium Update:
Get the Scoop on Transition Codes, PCIP Pay Requirements for FPs
Caution: Missing primary care designation could wreck your Medicare pay. . Family pract...
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E/M Coding:
Implement These 5 Simple Tips to Boost Your E/M Bottom Line.
Heads up: Dig past 'follow-up' for acceptable chief complaint. E/M coding might be part...
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ICD-10:
Ratchet Up Your Mono Coding to Include Infection, Complication Details
Heads up: Coding under ICD-10 will depend on the level of detail providers note. When ...
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Reader Question:
Note That Modifier 50 Doesn't Apply to 69205
Question: The physician administered anesthesia before removing a bead from each of a ch...
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Reader Question:
Check These Code Families for 'Case Management' Possibilities
Question: Services such as phone calls to patients, filling out forms, and coordinating ...
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Reader Question:
Always Pair Vaccine Product With Administration Code
Question: I'm new to family medicine coding and have a lot to learn. Can I bill 90658 al...
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Reader Question:
Steer Clear of Submitting 99211 With 96372
Question: One of our patients purchases her medicine through her prescription program an...
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Reader Question:
Codes Specify Partial ECG Service, Not Modifiers
Question: Our office owns an EKG/ECG device. How should we bill for tests performed in o...
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Reader Question:
Headache Doesn't Always Point to 346.x
Question: A co-worker says we can submit "headache" and "migraine" on the same claim, bu...
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You Be the Coder:
Follow-Up Coding for 10060
Question: A patient saw our physician because of an abscess, and returned for a follow-u...
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