Coding Challenge

What Diagnosis Code Do I Use for a Fern Test?

Ob-Gyn Coding Tip: Scan for leukorrhea signs when fluid is present. Question: My physician performs a fern test on a patient, trying to rule out rupture of membranes. What diagnosis code applies? Answer: If the test result proves positive, then you should report 658.13 (Premature rupture of membranes with antepartum condition or complications). Otherwise, use V89.01 [...] Related articles:

  1. What’s the Correct Diagnosis Code for a Urine Drug Test?Question: What is the proper ICD-9 code when the lab...
  2. How Do I Code Suspected Lyme?Question: Our lab processes a blood specimen using a direct probe...
  3. Can’t Locate an H. Pylori Lab Test Code? 2 Clues Point the Way Solve CLO test culture code dilemma and other mysteries....

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November 30, 2009
Coding Challenge

Coding News Coding News – News about Coding 2009-11-30 23:00:02

Split Postoperative Cataract Care Question: An ophthalmic surgeon performs cataract surgery, and then turns the patient over to the optometrist for postoperative management only. How should I code between the two providers? Do I need a modifier? Washington Subscriber Answer: If the ophthalmic surgeon turns the patient over to the optometrist for all 90 days of postoperative care, the optometrist will report 66984 [...] Related articles:

  1. Optometry Coding: Eye Exams, Cataract Surgery and Co-ManagementE/M or Eye Code? Choose Wisely With These Documentation Tips...
  2. Bone Up On ASC Orthopedic Coding With These Global Period, Modifier Tips 3 ways your physician claim better look different than...
  3. Medical Coder’s Modifier 25 Checklist Append 25 with the greatest of ease … Appending...

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November 30, 2009
CPT 2010 / Hot Coding Topics / radiology

Celebrate CT Colonography’s 2010 Move to Category I

But don’t assume the new codes will yield improved fees. Virtual colonoscopy coverage may be a mixed bag, but the AMA showed some confidence in the service by moving its codes from temporary Category III status to full-fledged Category I in 2010. The switch from Category III to Category I does offer some hope of better reimbursement [...] Related articles:

  1. New CPT Codes for Cardiac CT, Imaging Appear for 2010Plus: Say goodbye to two perfusion codes. If you’ve ever...
  2. Virtual Colonoscopy Reimbursement: Still ‘Virtual’ For Now Many cancer clinicians are all for virtual colonoscopy because...
  3. Don’t Wait for CPT: Maximize Virtual Colonoscopy Payment Now Learn whether to file an ABN with 0066T, 0067T....

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November 30, 2009
Provider News

SGR Update: What’s Up With That 21 Percent Physician Pay Cut?

Here’s what you should be watching on Capitol Hill. It’s that time of year again — the time when we all bite our nails wondering if Medicare will slash physician payments in the New Year. This year, the drama is more intense as Congress decides whether to permanently repeal the Sustainable Growth Rate (SGR) formula that creates [...] Related articles:

  1. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...
  2. PFS 2010 Highlights: Consultations Axed, More Reimbursement for PCPsRight before many of us left for the beach or...
  3. CMS Will Offer New Modifier to Denote Admitting Physician on ClaimsPop the champagne cork & get ready for brand new...

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November 29, 2009
Hot Coding Topics

CPT 2010 Update: Laboratory & Pathology Coding

Stop using general codes for analyte-specific tests. Here’s why. You have 15 new codes scattered throughout the pathology/laboratory CPT chapter, so we’ll help you jump start your 2010 claims with this how-to inventory. “From chemistry to surgical pathology, you’ll find new codes in CPT 2010 that you need to know,” says Peggy Slagle, CPC, billingcompliance coordinator [...] Related articles:

  1. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...
  2. Match Pathology Report Keywords to Uterus Codes Common descriptions and diagnoses lead the way. Never again...
  3. Payer Update: NGS Directives Vs. Proper Skin Lesion CodingIgnore the LCD and stick with what you know about...

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November 29, 2009
Toolkit

Test Yourself: ICD-9 2010 for Ob-Gyn Coders

Is your ob-gyn practice using the new codes correctly? 3 quick questions say for sure. This year, ICD-9 2010 brought new hyperplasia, mammogram, and fertility preservation codes. In some cases, these codes simply expanded on existing options, and it’sup to you to spot when you should report the new versus old alternatives. Dig in to [...] Related articles:

  1. What Diagnosis Code Do I Use for a Fern Test?Ob-Gyn Coding Tip: Scan for leukorrhea signs when fluid is...
  2. Are You Up For ICD-9 2010? Quick Quiz Says For Sure Surgery Coders: These 5 questions reveal if you need an...
  3. Prostate Specific Antigen (PSA) Test Coding Tips Make sure you know when to support your coding...

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November 29, 2009
Coding Challenge / modifier 52 / multiple wake test

Can a Sleep Study Code Describe an Awake Test?

Question: A sleep study was ordered for a patient diagnosed with hypersomnolence. The neurologistincluded a multiple wake test in the sleep study. What CPT code should I use for the multiple wake test? Answer: You should use 95805 (Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during [...] Related articles:

  1. Protect Sleep Study Pay With These Documentation Essentials How to keep your polysomnography claims off Medicare’s hit...
  2. Sleep Study Reimbursement: How to Claim Your Piece of the Pie Medicare promises to cover facility and home-based testing —...
  3. CMS: Apnea is Key for Sleep Testing Coverage Medicare benes who suffer from obstructive sleep apnea (OSA)...

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November 29, 2009
Provider News

CMS Will Offer New Modifier to Denote Admitting Physician on Claims

Pop the champagne cork & get ready for brand new inpatient coding rules. With the changes to consult coding in 2010, it will be more important than ever to report hospital visits properly. In the past, only the admitting physician reported initial hospital care codes (99221- 99223), and specialists who saw the patient separately often billed inpatient [...] Related articles:

  1. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...
  2. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  3. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...

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November 21, 2009
CPT 2010 / Hot Coding Topics

Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics Coding

Urodynamics income will go down by half, experts calculate. You will have three new urodynamics codes to learn starting Jan. 1. CPT 2010 adds the following codes: • 51727 — Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique • 51728 — … with voiding pressure studies (ie, bladder voiding pressure), any technique • 51729 — … [...] Related articles:

  1. Urology Coding: TURP, Urodynamics and Stone RemovalTURP 101: Use This Comprehensive Guide to Master TURP Coding...
  2. Urology Coder’s ICD-9 2010 UpdateGet Ready Now for Urinary Diversion, Renal Disease Dx Changes...
  3. Is this Biopsy Mistake Costing Your Urology Practice $400 Per Claim? Tip: Look beyond the term ‘fulguration’ when you choose...

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November 21, 2009
Coding Challenge / surgery

Surgical Coding Mysteries: The Case of the Separate Mesh

Beware Separate Mesh Removal Question: The surgeon performed the following: Made 10 cm supraumbilical transverse incision with 15-blade scalpel carried down through subcutaneous tissue using Bovie. Used combination electrocautery and blunted dissection to isolate area of scar tissue on patient’s right side. Noted sutures from previous umbilical hernia repair and mesh from right-lower abdominal hernia repair. Excised [...] Related articles:

  1. Don’t Mesh Up Your +57267 CodingAn ob-gyn doc with coding know-how tells us how to...
  2. What a Mesh! (+57267)Take this advice to avoid messing up your mesh coding:...
  3. Surgical Coding: Modifiers 58, 78, and 79SURGICAL MODIFIER CHOICES Surgery Modifier Choices are Key to Surgery...

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November 21, 2009
Coding Challenge / CPT / pathology

Lab Fee G Codes Crosswalk to CPT

Question: Did you get any info at the CPT 2010 conference about the “Table of Drugs and the Appropriate Qualitative Screening, Confirmatory, and Quantitative Codes” on page 386 CPT? This is brand new, and I need to learn about it. Answer: CMS created lab fee G codes to substitute for CPT codes due to concern [...] Related articles:

  1. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...

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November 18, 2009
Coding Challenge / CPT 2010 / Medicare

AMA Symposium Report: Low-Level Consult Reporting in 2010

Hey, Coding News readers! It’s your turn to weigh in on the consult controversy. Question: What should you do for Medicare 2010 coding if an inpatient consult on a patient’s initial hospital day does not support 99221? Answer: Kenneth Simon, MD, MBA, FACS, CMS, senior medical officer at the CPT symposium was very adamant that you [...] Related articles:

  1. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. OK to Code Debridement With Consult?Question: Can you charge for an inpatient consult and a bedside...

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November 18, 2009
BCBS / CPT / Hot Coding Topics / Medicaid

Medicare’s Consult Rule Trickle Down Effect

And what it means for pediatric practices. A report from AMA in Chicago. Although CPT clarifies the transfer of care definition, the fix came too late for Medicare, meaning your private payers may follow suit. Continued Errors Result in E/M Boon The Office of Inspector General found a high error rate on consultation codes. Different opinions on when [...] Related articles:

  1. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. AMA Symposium Report: Low-Level Consult Reporting in 2010 Hey, Coding News readers! It’s your turn to weigh...

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November 18, 2009
Coding Challenge / E/M

ED Coding Question: Observation or Other E/M Code?

Question: A 42-year-old patient reports to the ED early on Tuesday morning for evaluation of uncontrollable shaking in her extremities and severe pain in her neck. The EP admits the patient to observation at 7 a.m. and orders blood tests and a CT scan — however, the shaking continues to worsen. The EP consults with a [...] Related articles:

  1. Capture ‘Patient Limbo’ Period With These Observation Coding Steps Internist deciding on admission? That’s your signal to look...
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  3. Observation Coding Do’s and Don’ts What’s the POS for an ED hallway? Answers to...

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November 16, 2009
CPT / Provider News

Neonatal Critical Care Coding: CPT 2010 Clarifies Resuscitation Guidance

Payers denying 99465-25? Here’s help straight from the AMA Symposium in Chicago. Question: There’s a notation in the CPT 2009 manual that the neonatal critical care codes include delivery room resuscitation. Is this true? Answer: No, a parenthetical note following 99465 (Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute [...] Related articles:

  1. Bust 4 Myths About Pediatric Critical Care Services MYTHBUSTER: Codes 99291, +99292 apply to infants, young pediatric...
  2. Coding Critical Care? What You Can’t Bill SeparatelyAlthough there are some physician services you can report separately...
  3. Critical Care Coding Checklist Certain patient conditions could indicate 99291 service. Given the...

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November 15, 2009
Coding Challenge / Pain Management

Pain Management Coding: Endoscopic Lumbar Nerve Decompression

Hint: Think ‘unlisted procedure.’ Question: One of our physicians is looking into “endoscopic lumbar spinal nerve decompression.” One of the medical device representatives indicated he could bill it like the lateral extraforaminal approach for lumbar decompression, but I haven’t found much information. What’s your advice? Answer: Despite what you physician might have heard, your most appropriate choice [...] Related articles:

  1. Spinal Surgery Coding Challenge: Is Hemilaminectomy Bundled With Fusion?Question: Our orthopedic surgeon turned in a note that says,...
  2. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  3. Anesthesia & Pain Management Denials: Sweep Them Away Now ‘Good Housekeeping’ tips that reduce denials. Tip 1: Beware...

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November 14, 2009