DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC DRG Code 446

Location cuts both ways. A recent clarification on critical care services from the Centers for Medicare and Medicaid Services (CMS) should come as a major relief to your physicians as well a boost to reimbursement. Scenario: Your physician performs CPR [...]

The answer to this commonly-held belief may surprise you. Your physician performs CPR for a non-responsive patient in the observation care unit of the hospital, where he attends to the patient for 30 minutes, and the patient is later moved [...]

Question: Our anesthesiologist provided MAC anesthesia for a patient’s surgery to complete a biopsy of the temporal artery. The surgeon’s diagnosis was 446.5 (Giant cell arteritis). What is the correct anesthesia code?  Indiana Subscriber Answer: The surgeon probably reported 37609 (Ligation or [...]

HITECH Act shows its teeth within 4 months of being implemented. In the first lawsuit of its kind since the HITECH Act became official last year and gave state attorneys general authority to prosecute HIPAA privacy and security violations, Connecticut [...]

You no longer have to lump these two diseases under 359.89. Stumped by what code to use for inclusion body myositis (IBM)? ICD-9 2010 ends your search with a specific code. There are three main types of inflammatory myopathies: polymyositis, [...]

Question: Is thrombotic thrombocytopenic purpura a covered diagnosis for Rituximab infusions? Idaho Subscriber Answer: The answer depends on individual payers. CIGNA, the current Part B carrier for Idaho, does cover Rituximab infusions for thrombotic thrombocytopenic purpura (TTP) patients under certain [...]

Question: We are providing daily wound care to a patient who fell and hit her shin on a concrete step several months ago. Her leg was lacerated and it hasn't healed. Since then the wound has become infected. The wound [...]

Microscopic examination of pathology tissue specimens often involves the use of special stains. To appropriately capture reimbursement for these services, pathology coders need to be familiar with these stains as well as the specialized rules for reporting them. Some stains [...]