CHOLECYSTECTOMY WITH C.D.E. WITH MCC DRG Code 411

Question: In 2019, a patient had a bilateral mastectomy and bilateral breast reconstruction. The patient then came back requesting further surgery to improve breast symmetry. The patient is not currently undergoing treatment. Should we bill this with Z85.3 or C50.411 [...]

This modifier tells Medicare that the service isn’t covered. If you need to estimate what to charge a Medicare patient when your ob-gyn performs a preventive service as well as an evaluation and management (E/M) service at the same visit, [...]

Question: Could you please clarify what “MUE” means and explain how it impacts my coding? Indiana Subscriber Answer: MUE is an acronym for medically unlikely edits, which the Centers for Medicare & Medicaid Services (CMS) established as a unit-of-service edit for HCPCS [...]

Question: When we perform tumor immunohistochemistry for ER/PR status for breast tissue, how should we report the procedure and the hormone status findings? Nevada Subscriber Answer: To select the appropriate procedure code for breast tissue immunochemistry for estrogen receptor (ER) and/or progesterone [...]

And know why the changes are going to matter for Medicare billing. On Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) will add and/ or expand over 250 new ICD-10-CM diagnosis codes, affecting almost every chapter. Of [...]

And know why the changes are going to matter for Medicare billing. On October 1, 2024, the Centers for Medicare & Medicaid Services (CMS) will add and/or expand over 250 new ICD-10 diagnosis codes affecting almost every category. In medical [...]

Take this three-scenario challenge to test your skills. To ethically maximize your ob-gyn practice’s bottom line, you need to know the difference between reporting an annual exam code versus beginning global maternal care. Take this coding challenge to see how [...]

Get the 411 on what to code – and what to leave off – your claims. Choosing the ICD-10 codes that most accurately reflect a healthcare encounter can be really complicated if you don’t understand the myriad of guidelines involved [...]

Question: Encounter notes indicate that a patient has a solitary bone cyst on their shoulder. What is the best diagnosis code for this patient? Illinois Subscriber Answer: With the information you presented, you can get to M85.41- (Solitary bone cyst, shoulder). You [...]

Get the 411 on what to code – and what to leave off – your claims. Choosing the ICD-10-CM codes that most accurately reflect a healthcare encounter can be really complicated if you don’t understand the myriad of guidelines involved [...]