Grasping 93010’s effect on new vs. established patient status could bring a $58 reward.
Whether you call them ECGs or EKGs, chances are you see a lot of electrocardiograms in your practice. That means that even the tiniest coding errors...
Help is here: One troublesome, confusing edit is no longer an issue.
You may still be getting to know your CPT 2010 manual, but the new edition of CCI, effective April1, is already looking to make some code pairings impossible....
Here’s why you should append modifier 25.
Question: A 47-year-old male reports to the ED complaining of a painful, swollen, and reddening right thumb. The physician performs an expanded problem focused history and examination, which uncovers two splinters. The ED...
The answer hinges on the urologist’s interpretation.
Question: A patient had a robotic prostatectomy for prostate cancer on Jan. 1. Then the patient started experiencing voiding problems in February. At that time my doctor did a cystoscopy to check for...
Keep tabs on details to help justify more extensive treatments later.
Plantar fasciitis — a condition in which the plantar fascia becomes inflamed and painful — is the most common form of heel pain and can be treated many different...
Forget about incident-to in the facility, but consider this similar billing technique.
ED coders that have never heard of “incident-to” billing have nothing to worry about, as you cannot code for “incident-to” services in the hospital. Coders that don’t understand...
Upcoming policy change will slash your payments by half.
Big changes are on the horizon if you participate with insurance provider Horizon Blue Cross Blue Shield (BCBS) of New Jersey.
In a recent memo, BCBS states that effective May 17,...
Wrap your brain around using letters in your diagnosis codes.
If you aren’t curious about how the ICD-9 codes crosswalk to ICD-10, maybe you should be.
“The transition date for ICD-10 codes is Oct 1, 2013,” stressed CMS’s Stewart Streimer...
Relying on the physician’s encounter form could be a big mistake.
Question: I used 491.9 to report a patient’s bronchitis, but the payer denied my claim and requested additional information. What was wrong?
Vermont Subscriber
Answer: Your claim may have...
Test your ob record skills with this four part challenge.
If your ob-gyn simply confirms a patient’s pregnancy during an office visit, you’ll be able to report V72.42 (Pregnancy, confirmed). But when should you start the ob record? Take this...
Find out where to report date of services on your claim form.
Question: Which date(s) of service should I report for 30-day cardiac event monitoring?
Washington Subscriber
Answer: For Noridian Medicare, your Part B administrator for Washington, you’ll need to...
Medicare clears up confusion surrounding ‘8-hour rule.’
Reporting your FP’s observation services can be tricky business, as there is confusion about how, when, and why to choose from one observation code set or another.
Add to that a common misconception...
Don’t separately report a cursory H&P from the sleep code.
Question: If a nurse practitioner (NP) performed an H&P (history and physical exam) or a subsequent visit with a patient prior to a sleep study, can you bill the H&P...
Don’t let ‘wrong surgery’ modifier mistakes stall your reimbursement.
You use modifier TC for the technical component of a test. So logically, you should use modifier PC for the professional component, right? Wrong. But many coders are making that mistake...
Find out what steps Congress must take to delay the much feared 21.2 percent pay cut.If a new bill — already approved by the Senate — moves forward, you could have another six months before the 21.2 percent...
In MSP cases, non-consult code for both payers may be best.
If you have payers who didn’t play follow-the-leader with Medicare in cutting out consult codes, you have a dilemma on your hands. You have to decide what to do...