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Primary Care Coding Alert

Case Study Corner:
Correctly Code These RSV Bronchiolitis Cases
Also: review the RSV testing codes. One of the most common diagnoses that primary care pr... Read more
News You Can Use:
Get to Know the 2025 ICD-10 Code Set
Specify obesity classes with new codes. With more than 250 new diagnosis codes, the 2025 ... Read more
Practice Management:
Find 7 Myths and 1 Truth About Fee-for-Time Billing
Prep now for holiday fee-for-time fill-ins. Everyone needs a vacation, and primary care ... Read more
You Be the Coder:
Use These Codes for High-Risk Meds During Pregnancy
Question: I need help locating the ICD-10 codes for use of high-risk medication durin... Read more
Reader Questions:
Beware of Damaging Disclaimers
Question: One of the physicians at our practice uses dictation software, and the vend... Read more
Reader Questions:
EKG and ECG Are Same Procedure
Question: I've seen the abbreviations EKG and ECG in my provider's documentation. Wha... Read more
Reader Questions:
Hear This Advice on Timely Filing Denials
Question: After getting a denial on a claim for a patient insured by an employment be... Read more
Reader Questions:
Look out for Combination Diagnosis Codes
Question: A patient presented with a severe sore throat, pain when swallowing, a hig... Read more
Testing:
Avoid Allergy Testing, Immunotherapy Coding Traps
Check your answers to these common allergy questions to keep claims on track. Every codin... Read more
News You Can Use:
Review This False Claims Act Case, Learn How to Avoid Big Fines
Strengthen your understanding of MDM guidelines. As you may know, the Department of Jus... Read more
Practice Management:
Ask These Questions When Searching for an AI Coding System (Part 2)
Will the price point deter future adopters? Last month, Primary Care Coding Alert exami... Read more
Reader Questions:
Wade Through Dermatitis Codes to Report This Rash
Question: We recently saw a young patient who presented with small, raised bumps on ... Read more
Reader Questions:
Differentiate Between Types of Hypertension
Question: What is the difference between hypertension and pulmonary hypertension (HTN... Read more
Reader Questions:
Look Beyond Reimbursement When Reporting Z Codes
Question: Do the ICD-10-CM Z codes affect reimbursement, or are they strictly for sta... Read more
You Be the Coder:
Study These Behavior Change Service Codes
Question: We have an inpatient addicted to meth and other drugs. The practitioner doc... Read more
Preventive Services:
Prepare for Proper Preventive Service Coding (Part 2)
Review the requirements of MWVs and AWVs. In Primary Care Coding Alert Volume 26 Number 7... Read more
E/M Coding:
Bolster Your Distinct Time Billing Knowledge
Remember to bill with only one provider's number. Billing for split or shared services be... Read more
Practice Management:
Ask These Questions When Searching for an AI Coding System (Part 1)
Can NLP decipher language differences between doctors? Choosing the right artificial in... Read more
Reader Questions:
Find Guidance in This Consultation Question
Question: A child's family consulted with a provider, but the child was not present. ... Read more
Reader Questions:
Flex Your Coding Muscles with This Charley-Horse Case
Question: The practitioner documents that a patient had a charley-horse. Which code i... Read more
Reader Questions:
Distinguish NCD From LCD
Question: What's the difference between a national coverage determi­nation (NCD) and... Read more
You Be the Coder:
Think Critically About This Critical Care Scenario
Question: Our hospital physician provided a neonate with critical care throughout the... Read more
Preventive Services:
Prepare for Proper Preventive Service Coding (Part 1)
Get the scoop on in-house blood testing codes. In the world of family medicine, preventi... Read more
Condition Coding:
Learn to Stomach Common Gastrointestinal Codes
Also: find several GI symptom codes for quick reference. Gastrointestinal problems can pr... Read more
Practice Management:
Overcome 2023 E/M Update Challenges with Expert Advice
Get tips on how and when to query. When the inpatient evaluation and management (E/M) gu... Read more
Reader Questions:
Protect Your Practice’s Electronic Signatures
Question: In our recent risk evaluation, we discovered that the electronic signatures... Read more
Reader Questions:
What Is the Timeframe for Defining Chronic Conditions?
Question: I can't find any information in the ICD-10 Official Guidelines, and I'm wo... Read more
You Be the Coder:
Expand Your Understanding of Fatigue Coding
Question: For diagnostic purposes, are all fatigue syndromes the same? For example, i... Read more
Condition Spotlight:
Update Your Understanding of Asthma Coding
And don't forget cause/effect sequencing. This past January, the Centers for Disease Cont... Read more
Practice Management:
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective onboarding. Coding education is an ongoing effor... Read more
Mythbuster:
Shatter These 4 Myths, Strengthen Signs and Symptoms Smarts
Get the 411 on what to code – and what to leave off – your claims. Choosing the ICD... Read more
Reader Questions:
Heed This Laterality Guidance in This X-ray Scenario
Question: I need to report X-rays for a patient who injured both feet. Do I report t... Read more
Reader Questions:
See How to Report Pregnancy and Exam for This Scenario
Question: Recently, we had a newly pregnant patient come in for her preventative well... Read more
You Be the Coder:
Do You Know When Primary Can Be Secondary?
Question: Is it possible to code a secondary neoplasm as primary, or is a primary dia... Read more
Condition Spotlight:
Learn to Differentiate Among Headache Codes
Also: review the latest additions to the migraine code set. Headaches come and go, and ma... Read more
ICD-10 Coding:
Navigate These Scenarios, Keep Your Pharyngitis Coding on Track
Hint: Exposure to smoking may be relevant. Coding pharyngitis may seem cut-and-dried, b... Read more
Practice Management:
Upgrade Your Understanding of Transgender Patient Care
Pronoun mismatches can lead to denials. Patients are always looking for healthcare prov... Read more
Reader Questions:
See Which QPP Policies Didn’t Make the 2024 Final Rule
Question: Were there any Quality Payment Program (QPP) policies that the Centers for ... Read more
Reader Questions:
Remember the Basics of Reporting SDoH
Question: I'm reading all about the importance of reporting social determinants of he... Read more
You Be the Coder:
Review the Coding of Pressure Ulcer Stages
Question: If a patient has a pressure ulcer on their back, what is the difference amo... Read more
ICD-10 Coding:
Put More Pep In Your Post-Menopausal Condition Coding
Remember the differences between urge and stress incontinence. Primary care practitioners... Read more
Condition Spotlight:
Up Your COPD Coding Know-How With This How-To
Find out what diagnoses fall under J44.-. With guidelines and Includes, Excludes1, Exclu... Read more
Mythbusters:
Bust These Myths to Clarify your QHP Questions
See who qualifies as a QHP. What constitutes a qualified healthcare professional (QHP), ... Read more
Reader Questions:
Remember Combo Codes in This Atherosclerosis Case
Question: If a patient has atherosclerotic heart disease with angina pectoris, do I r... Read more
Reader Questions:
Understand UTI Coding Post Pregnancy
Question: I've coded urinary tract infections (UTIs) several times, but my colleagues... Read more
You Be the Coder:
Be Ready for Spring Sports with These Codes
Question: Our physicians are starting to see a lot of school-aged patients who need S... Read more
Case Study Corner:
Clear the Way for Accurate Cerumen Removal Coding
Hint: removal method is key. Removal of ear wax, or cerumen, is one of the most common in... Read more
ICD-10 Coding:
Don’t Lose Sleep Over These Sleep Disturbance Codes
Also: refresh your memory of the sleep apnea codes. A primary care practitioner (PCP) is... Read more
Practice Management:
Clean Up Your Payer-Provider Relationship
Hint: it starts by understanding each side's struggles. Traditionally, the relationship b... Read more
Reader Questions:
Report the Right Vasomotor Rhinitis Code
Question: A patient presented with a runny nose, nasal congestion, and postnasal dri... Read more
Reader Questions:
Add These Codes to Your Lesion-Removal Repertoire
Question: When I billed +17003 along with 99213-25, the 99213 only paid at half its a... Read more
Reader Questions:
Select SDoH Codes For Financial Strain Affecting Rxs
Question: During a recent follow-up appointment with an established patient, the pati... Read more
You Be the Coder:
See When — and When Not — to Code Congenital Conditions
Question: Should I code for corrected gastroschisis when the patient comes in complai... Read more
Final Rule:
Implement +G2211 into Your 2024 Coding Strategy
Also: find CMS guidance regarding +G2211 and modifier 25 In addition to the final rule up... Read more
E/M Coding:
Test Your Understanding of MDM With These 3 Scenarios
Also: see what one MAC says about prescription drug management. Calculating levels of m... Read more
ICD-10 Coding:
Breathe New Life Into “Simple” Bronchitis Coding
Also: see which Z codes could apply to your claim. Bronchitis is a common condition, and ... Read more
Reader Questions:
Read Descriptors Carefully for MZL Dx
Question: Our physician diagnosed a patient with a urinary tract infection (UTI), but... Read more
Reader Questions:
Serve Correct Coding in This Tennis Elbow Case
Question: Encounter notes indicate that the provider met with a new patient complaini... Read more
You Be the Coder:
Can You Code This Abnormal Atrial Rhythm Scenario?
Question: Our primary care practitioner (PCP) recently saw a patient for a follow-up... Read more
Final Rule:
Find Four Takeaways From the 2024 MPFS Final Rule
Also: Gain insight into the split/shared policy update. On Nov. 16, the Centers for Medi... Read more
Quiz:
Has Mental Health Coding Got You Down? Take This Quiz to Find Out
Answer these questions to help you increase your coding confidence. When the blues are a ... Read more
Lesions:
Ensure Your Skincare Coding Skills are More Than Surface-Level
Also: understand Medicare frequency rules for routine care. Patients often think of the... Read more
Quiz Answers:
Check Your Answers to Our Mental Healthcare Quiz
Find out if your coding comprehension is correct. Once you've answered the quiz questions... Read more
Reader Question:
Avoid Double-Billing by Dissecting This Same-Office Scenario
Question: My office has primary care physicians (PCPs) and ob-gyn doctors. We have a ... Read more
Reader Question:
Remember ICD-10 Update When Reporting Resistant Hypertension
Question: My physician documented resistant hypertension. How should I report this? ... Read more
You Be the Coder:
See if You Can Correctly Code This HIV Encounter
Question: One of our physicians diagnosed a patient who is four weeks pregnant with H... Read more
Primary Care Coding:
Consider Patient Exigencies in Light of No-Shows
Question: Are there any specific guidelines for billing no-show appointments for Medi... Read more
Primary Care Coding:
Take This Advice, Keep Your 2024-25 Winter Vaccine Coding Healthy
Keep your respiratory virus vaccine administration reporting on point. Each year, respira... Read more
Primary Care Coding:
Try These Tips for Smoking Cessation Without Tobacco-Related Disease Symptoms
Question: Smoking and tobacco use cessation counseling services require an appropriat... Read more
Primary Care Coding:
Check Out This Primer for Risk Adjustment in Primary Care
Get the foundation you need in risk adjustment to optimize your documentation workflow. W... Read more
Primary Care Coding:
Complete All Blank Fields for Valid ABN
Question: I'm looking at an advanced beneficiary notice (ABN) form and see seven separate ... Read more
Primary Care Coding:
Rely on This Modifier for Gender Mismatch
Question: A provider prescribed a patient a retinoid, which requires a urine pregnancy tes... Read more
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