- Pediatric Coding: Find Differences Between Apnea Types - (Jan 31, 2025)
Question: When I see documentation that says a newborn patient has apnea, is it always sleep apnea, like in adults? Vermont Subscriber Answer: Apnea is defined as an at least 20-second stoppage of respiratory airflow. There are several types of [...]
- Medicare Regulations: Use an Additional Code for ACP Conversation - (Jan 21, 2025)
Question: My provider is conducting conversations about advance care planning (ACP) during annual wellness visits (AWV) for Medicare beneficiaries when they’re open to the discussion. What’s the best code to use to reflect the time spent on these conversations? Virginia [...]
- Neurology & Pain Management Coding: Ask Doc for Sleep Apnea Details - (Jan 09, 2025)
Question: When a patient suffers from sleep apnea, how do I choose the correct ICD-10-CM code? I have an encounter form in front of me that says the patient suffers from “sleep apnea.” Is this all the information I’ll need [...]
- Path/Lab Coding: Distinguish Bone Codes for Accurate Payment - (Dec 04, 2024)
Question: Our pathologist examines many specimens of bones, joints, and various bony fragments from an orthopedic practice. Especially when we receive fragments of bone, possibly in different containers, we're often uncertain how to apply the bone and joint pathology exam [...]
- Neurology Coding: Keep up With all Sleep Apnea Codes - (Nov 27, 2024)
Question: Encounter notes indicate that the patient suffered from “altitude-related sleep apnea.” Should I just report an unspecified sleep apnea code for this condition? Colorado Subscriber Answer: There actually is a code for altitude-related sleep apnea: Report G47.32 (High altitude [...]
- Ob-Gyn Coding: Here’s What to Ask Your Payers About IUD Coding - (Oct 29, 2024)
Understand why some payers won’t pay for removals. Many coders confess they’re tearing their hair out when it comes to coding intrauterine device (IUD) claims, because payer policies can widely vary. In other words, some payers will reimburse IUD insertions [...]
- Medicare Regulations: Remember SDOH Assessment Responsibilities - (Oct 29, 2024)
Question: When exactly do we need to perform and report social determinants of health (SDOH) assessments for Medicare beneficiaries? Kansas Subscriber Answer: The SDOH risk assessment is an optional element of the Medicare annual wellness visit (AWV) that providers can, [...]
- Reader Questions: Don’t Let This Misstep Lower Your Ovary Pay - (Sep 13, 2024)
Question: The surgeon submitted a right oophorectomy specimen in one container with two separate containers for a pelvic lymph node biopsy and a para-aortic lymph node biopsy. The surgeon indicated the patient was at high risk for ovarian cancer based on [...]
- CPT® 2025: Be Ready for Revised Genomic Sequence Codes, Updated HPV Options, and More - (Sep 13, 2024)
Know where to find resequenced codes in CPT® 2025. The official 2025 CPT® code set is out! Take your understanding of path/lab changes to the next level by focusing on code revisions, resequenced codes, and guideline updates. Tip: See “Sneak a [...]
- Reader Questions: Decipher High-Risk HPV Test Codes - (Aug 16, 2024)
Question: Our lab performs high-risk HPV testing for cervical specimens, but I’m not sure which procedure code best describes the test. Please explain the difference between the HPV test code choices to help me select the most appropriate way to report [...]