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Primary Care Coding Alert
Primary Care Coding Alert
Primary Care Coding Alert - 2022; Volume 24, Number 12
ICD-10 Coding:
View This FAQ, Review What Was New in 2022
Test your memory of some recent major ICD-10 updates. Whether you're a new or seasoned c...
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Condition Spotlight:
Advance Your Asthma Coding Abilities Using These Tips
Look for advice on how to handle proper sequencing. Now that winter is officially here, ...
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Compliance:
Practice Proper PHI Handling, Remain HIPAA-Compliant
See how many E/M visits you'd need to provide to pay even a minor fine. With the promise ...
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Reader Questions:
Beware the 5th Character in This Sixth Disease Scenario
Question: Our provider saw one of our pediatric patients who had a fever and a bad ra...
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Reader Questions:
Get Technical in This New vs. Established Patient Scenario
Question: Our clinic had a patient come in for a wellness visit. They had only been t...
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You Be the Coder:
Ramp Up Your Record Reading Prowess to Report Rhinitis
Question: The provider diagnosed a patient with persistent allergic rhinitis. She has...
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Primary Care Coding Alert - 2022; Volume 24, Number 11
News You Can Use:
Fly Through Flu Vaccine Coding with this Clip-and-Save Chart
Find out which code is making a comeback this season. Whether your clinic administers jus...
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Behavioral Health:
Review What’s Required for Coding Behavioral Health Integration
Find whether 2023 consult codes will affect BHI coding. Many communities within the Uni...
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E/M Coding:
Curb Your Confusion on How to Count Data Toward MDM
Also learn expert advice on when not to count data. If you consider data counting to be o...
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Reader Questions:
Look for Keywords to Properly Report Candidiasis
Question: I've been using B37.3 to report yeast infections, but the last claim I submitted...
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Reader Questions:
Gear Up for Solid GERD Coding
Question: Our provider established that one of our patients suffers from gastro-esophageal...
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Reader Questions:
Find Out When to Report a Flu Diagnosis
Question: I thought I had to wait for the test result before coding a flu diagnosis, but j...
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You Be the Coder:
Do You Know the New COVID-19 Booster Codes?
Question: The newest COVID-19 boosters have come out recently. What the codes are, and whi...
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Primary Care Coding Alert - 2022; Volume 24, Number 10
News You Can Use:
Report Monkeypox Testing and Vaccines Using 3 New Codes
Look for updated reporting instructions from CMS. The CPT® Editorial Panel has approved ...
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E/M Coding:
Correctly Code for Time to Avoid Auditor Red Flags
Fixing red flag 2 can boost your bottom line. The 2021 updates to the CPT® Office and O...
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Medicare Part B:
Check Your Processes to Avoid Medicare Part B Billing Errors
Check out the advice on how to effectively resolve problems. Keeping up with guideline u...
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Reader Questions:
Look for This Code to Report Long COVID
Question: We've seen several patients whose records say they have “long COVID” bu...
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Reader Questions:
Be Careful Not to Assume Level Based on Condition
Question: Does a patient's status as morbidly obese automatically put a patient encou...
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Reader Questions:
Know When to Code to Signs and Symptoms for a UTI
Question: I've been using N39.0 for urinary tract infections (UTIs), but it was recen...
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You Be the Coder:
Know How Linked Conditions Affect Mental Health Coding
Question: The physician diagnosed a teen patient with mixed anxiety and depressive di...
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Primary Care Coding Alert - 2022; Volume 24, Number 9
News You Can Use:
Get an Inside Look at the 2023 Inpatient/Observation Care Codes’ Revisions
Prepare for a change in MDM elements and new time parameters. CPT® updates are here agai...
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ICD-10 Revisions:
Consider How Z79.- Code Expansion Could Affect E/M Visits
Hint: Think MDM leveling. With medical records constantly on the move between offices as...
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Condition Spotlight:
Keep an Eye on Documentation for Correct Conjunctivitis Coding
Learn when to use B30.- versus H10.- codes. Some common medical conditions seem to alwa...
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Reader Questions:
Secure Your Sequela Savvy Status
Question: How do I determine whether a condition is considered sequela? How do I app...
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Reader Questions:
Know When to Code Just the Cold
Question: If a patient has a sore throat and a cold, do I code both conditions? Mass...
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Reader Questions:
Using 99211 Is a New-Patient No-No
Question: Should I be reporting all services performed by a nurse, including those pr...
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You Be the Coder:
Breathe New Life Into Your Understanding of Asthma Coding
Question: My provider assessed a patient with asthma who was experiencing acute exace...
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Primary Care Coding Alert - 2022; Volume 24, Number 8
News You Can Use:
Report Stress, Grief, and Past Substance Use With These New ICD-10 2023 Codes
And learn these 9 new codes to report drug and alcohol remission. Recently, the Centers ...
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Coding Quiz:
Can You Ace This Back-to-School Coding Quiz?
Learn the ABCs of coding school and sports physicals. This time of year, it seems like e...
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Condition Spotlight:
See What’s on the Horizon for Dementia Coding in ICD-10 2023
Hint: Check for upward of 70 new codes. ICD-10 2023 will make significant changes to ICD-...
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Coding Quiz Answers:
Check Your Answers to Our Physicals Quiz
See how well you can identify the correct CPT® codes. Once you've answered the quiz ques...
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Reader Questions:
Get the Skinny on These Hyperlipidemia Codes
Question: What is the difference between E78.5 (Hyperlipidemia, unspecified) and E78...
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Reader Questions:
Puncture Misconceptions About Venipuncture Coding
Question: I recently used 99195 (Phlebotomy, therapeutic (separate procedure)) for a ...
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Reader Questions:
Monitor This Commonly Misunderstood RPM Rule
Question: Our provider thinks one of our patients is eligible for the remote physiol...
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You Be the Coder:
Get to the Heart of When to Use Modifier 25 With EKG
Question: Do the CMS 2022 guidelines require modifier 25 for an evaluation and manage...
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Primary Care Coding Alert - 2022; Volume 24, Number 7
Condition Spotlight:
Don’t Let Heat-Related Encounters Leave You Hot Under the Collar
Look for comorbidities to accurately assess MDM. Feeling warm in the summer months is one...
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Modifiers:
Learn When and How to Use Modifier 25 (Part 2)
Hint: Established patient with a new problem doesn't guarantee a billable E/M service. La...
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Procedure Coding:
Increase Your Comfort Level Coding Common Skin Lesion Procedures
Procedure details are not just nice to have, they're essential for coding accurately. Pr...
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Reader Questions:
Remember the Reason for the Visit With This Rx Refill Encounter
Question: How do you bill for an established adult patient coming in for a medicatio...
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Reader Questions:
Know the Score in This Split/Shared Situation
Question: The primary care practitioner (PCP) and the nurse practitioner (NP) both sa...
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Reader Questions:
Identify When Unspecified Is as Specific as You Can Get
Question: A colleague said to try not to use unspecified ICD-10 codes. However, numer...
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You Be the Coder:
Can You Reckon the Referral’s Role in Determining MDM?
Question: Our providers say that referrals are always considered low risk under the R...
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Primary Care Coding Alert - 2022; Volume 24, Number 6
ICD-10 Coding:
Do You Understand the Newest Low Back Pain Codes?
Find out when it's appropriate to use codes from the G89.- category. Low back pain codes ...
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Modifiers:
Learn When and How to Use Modifier 25 (Part 1)
And identify the correct documentation necessary to support it. One of the most commonly ...
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Case Study Corner:
Can You Code These Constipation Encounters?
Practice identifying the nuances of coding this common yet complex condition Frequent c...
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Reader Questions:
Understand When and How to Add After-Hours and Weekend Codes
Question: I work at a family practice and the doctor has come across CPT® codes 990...
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Reader Questions:
Know When Not to Count Data Review Toward MDM
Question: A patient with sleep apnea was fitted for a continuous positive airway pres...
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Reader Questions:
Avoid Double Billing for Image Interpretation
Question: In the Amount and/or Complexity of Data to be Reviewed and Analyzed element...
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You Be the Coder:
Don’t Let the Index Distract You While Looking for ADHD Codes
Question: The doctor's notes say this patient has attention deficit hyperactivity dis...
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Primary Care Coding Alert - 2022; Volume 24, Number 5
Condition Spotlight:
Avoid Rash Decisions When Coding Lyme This Season
Know when unspecified code A69.20 is your best option. As temperatures start to rise, so ...
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ICD-10 Coding:
Study These Scenarios to Become a Sequencing Scholar
Check out scenario three to understand underlying conditions. Proper sequencing of ICD-...
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Mythbusters:
Bust These Myths to Banish Bad Coding Habits for Good
Improving your first-pass acceptance ratio might be easier than you think. The phrase, ...
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Reader Questions:
Don’t Assume Low Risk in This OTC Scenario
Question: We have a patient who frequently takes Flonase who comes to see us for epis...
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Reader Questions:
Take Note When Chapters Include Excludes Notes
Question: Can I bill R53.83 and F33.1 together if they are unrelated? AAPC Forum Pa...
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Reader Questions:
Let the Symptoms Speak for This Dermatitis Dx
Question: The provider determined an acute rash was an allergic reaction to nickel ex...
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You Be the Coder:
Can You Clarify This Z Code Colonoscopy Conundrum?
Question: A patient came in for follow-up on a chronic condition, and the provider noticed...
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Primary Care Coding Alert - 2022; Volume 24, Number 4
ICD-10 Coding:
Clear Away Confusion Around COVID Coding
And stay ahead of the curve with these new treatment codes. The pandemic rolls on, new tr...
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Guidelines:
Understand How to Code Developmental/Behavioral Screens and Tests
Do you know which instruments match the codes? The four codes that comprise the Developm...
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Condition Spotlight:
Locate the Answers to Your Frequently Asked Stomach Pain Questions
Here's all the clinical knowledge you need before applying an R10.- code. With 27 differ...
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Reader Questions:
Confirm Before Coding Causality
Question: Am I able to code M06.9 with D89.89 if the patient suffers immunosuppressio...
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Reader Questions:
Avoid Getting Burned When Coding Sequela
Question: Is the condition of an injury in its healed state ever considered a sequela...
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Reader Questions:
Can You Distinguish Between Anorexia Codes?
Question: I'm confused about how to code for anorexia. ICD-10 has two coding options:...
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You Be the Coder:
Stay on the Level With This New Chronic Condition E/M
Question: A patient had labs drawn and came back in to review the results. Upon revie...
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Primary Care Coding Alert - 2022; Volume 24, Number 3
Care Management:
Worried About PCM Denials? Here’s What to Do
Billing with other care management E/M services is probably to blame. Maybe you implement...
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Condition Spotlight:
Step Up Your UTI Coding With This Handy Guide
Know how and when to bypass N39.0. Coding for urinary tract infections (UTIs) seems very ...
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Mythbusters:
Bust These Myths, Distinguish New vs. Established Patients Correctly
There's more to determining patient status than the 3-year rule. With all the changes to...
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Reader Questions:
Hear This Advice for Using New Audio-Only E/M Modifier
Question: I know that, at the beginning of this year, the American Medical Associatio...
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Reader Questions:
Boost Your Understanding of These Pfizer COVID Vaccine Administration Codes
Question: Which administration code should I be using for the third/booster dose of t...
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Reader Questions:
Revisit This Unique Lab Reorder
Question: Two weeks ago, a patient saw one of our providers who orders labs. The pati...
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You Be the Coder:
Lower Your Expectations for This COVID E/M Encounter
Question: A patient with COVID symptoms visited our primary care provider (PCP). The...
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Primary Care Coding Alert - 2022; Volume 24, Number 2
Condition Spotlight:
Understand These 3 Scenarios, Get Your Epistaxis Coding Under Control
And remember these 3 proven tips for billing success. If a patient presents to your provi...
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Coding Quiz:
Take This Quiz to Fine Tune Your Eating Disorder Dx Understanding
Learn how to choose between codes for different manifestations and unusual conditions. C...
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Behavioral Health:
Get the Answers to Your Frequently Asked BHI Code Questions
Here's what you need to know about providing, keeping track of, and billing for the servic...
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Coding Quiz Answers:
Check Your Answers to Our Eating Disorders Quiz
See how well you can match these clinical conditions to their ICD-10 codes. Once you've ...
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Reader Questions:
Capture All Conditions Affecting Patient Care and Treatment
Question: When preparing a claim, should you enter the diagnosis code only for the conditi...
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Reader Questions:
Don’t Sweat This Hyperhidrosis Chemodenervation Code Choice
Question: Our internist performed intradermal injections of botulinum toxin on a patient s...
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Reader Questions:
Use These Encounter Codes in Suspected STD Situations
Question: If a provider tests a patient for a sexually transmitted disease (STD), but the ...
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You Be the Coder:
Mend This Medicare AWV Muddle
Question: I am new to Medicare billing, so I need some help. At a patient's annual wellnes...
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Primary Care Coding Alert - 2022; Volume 24, Number 1
News You Can Use:
Be Positive With CMS’ Final Rule Despite CF Decrease
Vaccination, CCM pricing increase should offset, experts feel. First, here is the bad new...
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Documentation:
Find Out if Your Practice Is Triggering OIG Work Plan Audits
Make sure you avoid these 5 primary care pitfalls. No one wants to attract unwanted att...
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Case Study Corner:
Can You Code This Pilonidal Cyst Case Study Correctly? Find Out.
Hint: Pay attention to condition synonyms and procedure complexity. If you revert to au...
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Reader Questions:
Follow This Guidance to Code Adverse COVID Vaccine Reaction
Question: We administered a COVID-19 vaccine to a patient and, as we usually do, we ...
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Reader Questions:
Don’t Code for Irrigation and Instrumentation
Question: If a provider performs an ear lavage and uses instrumentation on both ears,...
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Reader Questions:
Know Which of These Codes to Use for MVA Neck Pain
Question: Our provider treated a patient for a sore neck after the patient was involv...
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You Be the Coder:
Proceed With Caution on This SK Claim
Question: One of our providers removed a 1.5 cm inflamed seborrheic keratosis from a patie...
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