MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC DRG Code 507

Q&As clear up some confusion. Despite what you might have read from Medicare or your MAC as recently as this week, hospices have another month to prepare for the potentially burdensome edit requiring hospice certifying physicians to be enrolled or [...]

Question: Which diagnosis codes support 31575?  Ohio Subscriber  Answer: Medical policies differ regarding diagnoses that support performing 31575 (Laryngoscopy, flexible fiberoptic; diagnostic). But some indications for 31575 may be: Airway obstruction (chronic, 496; NEC, 519.8) Aspiration, chronic (507.0, Pneumonitis due to inhalation of [...]

Take advantage of these helpful definitions to guide your Section G coding. Activities of daily living, behavior, non-medication pain intervention, pressure ulcers and much else received the attention of the Centers for Medicare & Medicaid Services (CMS) in the revisions [...]

Enjoy a third K0710 example to guide your MDS coding. Section A wasn’t the only part of the MDS that received significant changes in the RAI manual update released on Sept. 15. The Centers for Medicare & Medicaid Services (CMS) [...]

Heed expert advice on how to calculate for column 3. Since the October 2013 RAI manual update, there have been many questions circulating about how to properly code K0710 — Percent Intake by Artificial Route. And specifically, the newly added [...]

Question: A patient fell while intoxicated and was admitted because of a fractured humerus (surgical neck). The patient was having DT’s and was also diagnosed with acute respiratory failure and aspiration pneumonia. Additional diagnoses were malnutrition from alcohol and chronic [...]

Look to the 438.xx codes for complications. The Centers for Medicare & Medicaid Services has made clear it’s not happy with the state of diagnosis coding for hospice patients. Thankfully, you have an opportunity to improve your accuracy before your [...]

Hint: Don’t forget to code the inhaled substance separately with an appropriate T code. When your pulmonologist diagnoses pneumonitis due to the inhalation of any solids or liquids, you’ll select an ICD-10 code based on the type of solids or [...]

Question: A 65-year-old patient who just enrolled in Medicare came to our office for his IPPE. I billed G0402 with G0366. Medicare denied the claim with a status code of 507 (HCPCS). Is there some reason why we should not [...]

Question: A 65-year-old patient who just enrolled in Medicare came to our office for his IPPE. I billed G0402 with G0366. Medicare denied the claim with a status code of 507 (HCPCS). Is there some reason why we should not [...]