View the ICD-9 code's corresponding Diagnosis Related Groups (DRGs). In a click, verify the DRG, its IPPS allowable, length of stay, and more. Protect your facility's payments by subscribing to DRG Coder.
Medical necessity edits are based on payer reimbursement policies (usually Medicare LCDs) so you would need to take a look at your particular payer’s published policies to see whether or not the edi... [ Read More ]
Lab order diagnoses codes are Z01.818 and M16.11 - only labs were charged and our guidelines are to change the Z01.818 to Z01.812 in this situation; however, when I do that, the Hgb fails medical nece... [ Read More ]
Good Evening,
Working on a patient's visit where an preoperative evaluation along with a transitional care management was done at the same time.
The TCM-99496 dx48.0 Neoplasm of uncertain behavior l... [ Read More ]
I'd agree with you on assigning the diagnosis that is the reason for the surgery, but I would not assign Z01.818 because the placement of a stent is not an 'examination'. If the procedure is required... [ Read More ]
I'm probably overthinking this, but my docs frequently get asked to place stents for ureteral identification when patients are having other surgery - GI and GYN are most common. When I bill them, ther... [ Read More ]
Z01.818 cannot be coded on it's own, insurance payors will likely deny the claim. I've seen this happen many times in my edits and denials. Z12.11 would not be applicable in this case, unless the pers... [ Read More ]
[QUOTE="magdalena.iordan@yahoo.com, post: 452729, member: 165825"]
[B]96130[/B]
Hello fellow coders,
I was reading through the posts on this topic and I am in the same boat as you guys when it come... [ Read More ]
I am curious to know how people are coding for Zoladex when given for ovarian suppression for premenopausal women starting chemo or an AI? In the past we have used the Z codes Z31.84 for fertility pre... [ Read More ]
Primary care office in Orchard Park looking for FT Medical Biller with Medent experience.
M-F
Benefits, Insurance, Vacation, 401k
Send resumes to [EMAIL]Mfalkowski@opfppc.net[/EMAIL]
Thank You
... [ Read More ]
If the patient is scheduled to have a procedure following the colonoscopy and that's the reason for the colonoscopy, Z12.11 is not applicable. I see patients have EGDs prior to bariatric surgery. In ... [ Read More ]
Hint: Look at your ICD-10-CM long-term drug use appendix. Whether you’re coding the long-term use of a drug targeting a specific cancer, a drug targeting a condition caused by the cancer, a drug targeting the side effects of a cancer [...]
Question: I have a coding question on bilateral upper extremity vein mapping. My facility is struggling with the diagnosis to support medical necessity for upper vein mapping for initial arterial inflow and venous outflow (AV) hemodialysis access. We are billing 93985 [...]
Don’t forget to check for comorbid conditions. Knowing how to navigate and select all of the codes necessary to report a preoperative encounter takes a lot of effort. But in the process, you’ll boost your evaluation and management (E/M) service [...]
Question: When can we bill a visit after a surgery for cancer? My colleague says that we can bill the “where we go from here” initial chemotherapy plan during the post-op period. But I’m not sure. Can we bill subsequent office [...]
Question: When can we bill a visit after a surgery for cancer? My colleague says that we can bill the “where we go from here” initial chemotherapy plan during the post-op period. But I’m not sure. Can we bill subsequent office [...]
Don’t forget to check for comorbid conditions. Knowing how to navigate and select all of the codes necessary to report a preoperative encounter takes a lot of knowledge. Boost your evaluation and management (E/M) service coding confidence and remember that [...]
Question: When can we bill a visit after a surgery for cancer? My colleague says that we can bill the “where we go from here” initial chemotherapy plan during the post-op period. But I’m not sure. Can we bill subsequent office [...]
Don’t forget to check for comorbid conditions. Knowing how to navigate and select all of the codes necessary to report a pre-operative encounter takes a lot of knowledge. Boost your E/M service coding confidence, and remember that some ICD-10-CM knowledge [...]
Hint: Don’t forget how comorbid conditions can impact pre-op E/M coding. Whether you’re an ace at preoperative evaluations or just getting started, they can be confusing, especially when it’s time to choose the right codes for your claims. From knowing [...]
See if you caught the right codes for this common pneumonia. Coders had ample warning that the J code category of ICD-10-CM code set would see a lot of changes, but now you have an opportunity to see how you [...]
Increase Diagnoses Coding Compliance with Medicare Transmittal and Manuals directives right at code level.