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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Rely on This Modifier for Gender Mismatch
Question: A provider prescribed a patient a retinoid, which requires a urine pregnancy tes... Read more
Primary Care Coding:
Get to Know the New Obesity-Designated-by-Class Codes
Go beyond documentation to help end the stigmatization of your obese patients. On Oct. 1,... Read more
Get to Know the New Obesity-Designated-by-Class Codes
Go beyond documentation to help end the stigmatization of your obese patients. On Oct. 1,... Read more
Primary Care Coding:
Find Medication Source to Bill Injections Correctly
Question: When a patient comes to one of our providers for an injection, does the coding d... Read more
Find Medication Source to Bill Injections Correctly
Question: When a patient comes to one of our providers for an injection, does the coding d... Read more
Primary Care Coding:
Pay Attention to Code Descriptor for This Z Code
Question: In what situation should I include ICD-10-CM code Z79.899? A lot of the patients... Read more
Pay Attention to Code Descriptor for This Z Code
Question: In what situation should I include ICD-10-CM code Z79.899? A lot of the patients... Read more