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
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
CMS / CPT / Medicare / Provider News

CMS at AMA Chicago: We’re Reducing Consult Request Requirement

CMS auditors will look for 1 less thing in consult documentation. With Medicare’s invalidation of consultation codes 99241-99255 in 2010, your ICD-9 codes better prove why two MDs are necessary on the same patient’s hospital care or the physician better specify why in his note. Separate ICD-9 codes will help substantiate the medical necessity for providing consultative [...] Related articles:

  1. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  2. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  3. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...

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November 13, 2009
CPT 2010 / Hot Coding Topics

PQRI: No Coumadin Due to Fall Risk

Plus, experts at the AMA meeting in Chicago tell you what to do if you can’t get H1N1 vaccine for PQRI Measure 110 or other vaccine measures. Question: My internist decided not to put a patient on Coumadin because the patient has a higher risk of falling than from having a stroke. Our group participates in [...] Related articles:

  1. Smokin’ PQRI Pointers We’ve got the G codes you need to score...
  2. Make Sure These Errors Don’t Sink Your PQRI BonusCMS shows which issues sidelined these practices. Most practices would...
  3. Track Payer’s Preferred H1N1 Admin Code — or Risk RejectionsCode 488.1 does not = confirmed lab. Swine flu has...

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November 13, 2009
CMS / CPT / Medicare / Provider News

Medicare Changes to 2010 CPT Inpatient Consultation Codes

Prevent 99251-99245 denials in 2010 with this checklist. Multiple physicians using the same hospital codes sounds like a recipe for denials, but that’s what Medicare is instructing physician inpatient consultants and care coordinators to do. Whether carriers will kick out these submissions as coordination of care or inpatient admit limiting admit edits is contractor specific, Charles [...] Related articles:

  1. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...
  2. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  3. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open...

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November 13, 2009
CPT / Hot Coding Topics

2010 Tumor Excision Coding: Lesion Vs. Chunk Size

Straight from the AMA in Chicago — answers to your lesion excision coding questions for 2010. Question: A thigh lesion measures 2 cm but requires a resection down to the subcutaneous layer of 4 cm. Which lesion excision code should I use? Answer: “You should use the larger of the subcutaneous codes,” says Albert E. Bothe, Jr, [...] Related articles:

  1. Lesion Excision Coding Challenge: 2 Lesions, 1 CutQuestion: Our nonphysician practitioner (NPP) discovers a pair of benign...
  2. Shave Duplicate Lesion Excision Denials Question: Our dermatologist shaved three epidermal lesions that the...
  3. Payer Update: NGS Directives Vs. Proper Skin Lesion CodingIgnore the LCD and stick with what you know about...

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November 13, 2009
CPT / Hot Coding Topics / Medicare

Medicare 2010 CPT Consultation Code Changes

New rules for consult coding straight from the AMA Meeting in Chicago — plus where your practice will gain and lose reimbursement. If you can’t figure out how to match a low level consult to an initial hospital care code, you’re not alone. Code 99251 doesn’t crosswalk to 99221, agreed William J. Mangold, Jr., MD, JD, Noridian [...] 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. Consultation 5 R’s Miss 1 element, and invite auditors to check out...

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November 12, 2009
CPT 2010 / Hot Coding Topics

From the AMA in Chicago: CPT 2010 Out of Order Codes

Here’s where you can find a full list of resequenced codes. Notice that new sign in your CPT book? No, that hash mark’s not to delete a message or to sign into a conference; it’s to alert you to an out of order code. The “#” works like a flashing yellow light: Slow down, there might be [...] Related articles:

  1. 2010 Tumor Excision Coding: Lesion Vs. Chunk SizeStraight from the AMA in Chicago — answers to your lesion...
  2. Lesion Excision Coding Challenge: 2 Lesions, 1 CutQuestion: Our nonphysician practitioner (NPP) discovers a pair of benign...
  3. Radiology Billing Checklist: Rules for Additional Tests without Treating Physician’s OrderKeep these additional test rules at your fingertips if your...

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November 11, 2009
CPT 2010 / Provider News

CPT 2010 Update: Non-Face-to-Face Prolonged Services

New Year’s hats & horns for looser guidelines that let you count work spread over days. Groaning thinking of all the time you’ll never capture for complex cases requiring extensive pre-visit time? CPT 2010 brings you hope. Extensive guideline revisions “liberalize prolonged non-face-to-face services codes,” reports Richard Tuck, MD, FAAP, pediatrician at PrimeCare of Southeastern Ohio in [...] Related articles:

  1. Asthma Attack Coding: When To Use Prolonged or High-Level E/M     Checklist deters payback requests for insufficient +99354...
  2. Bust 4 Myths About Pediatric Critical Care Services MYTHBUSTER: Codes 99291, +99292 apply to infants, young pediatric...
  3. Watch Out for 3 Telephone Service Coding PitfallsCaution: You may need to incorporate the call into an...

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November 5, 2009
CPT / Hot Coding Topics

New CPT Codes for Cardiac CT, Imaging Appear for 2010

Plus: Say goodbye to two perfusion codes. If you’ve ever wondered whether Medicare actually pays attention to CPT’s Category III codes, the AMA offers an answer with the release of the new codes included in CPT 2010. First and foremost, CPT will delete the Category III cardiac computed tomography (CT) imaging codes 0144T-0151T and replace them with [...] Related articles:

  1. Cardiac Anesthesia Workshop: Coding for TEE Discover if your transesophageal echocardiography (TEE) anesthesia is payable...
  2. 2010 CPT Category II & III Codes You Might Miss Yes, our CPT books are fountains of knowledge, but...
  3. Break Down Outpatient ESRD Into These G-Code Mirroring Cat I Codes We tell you the inpatient dialysis codes that trigger...

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October 27, 2009
CPT / modifier 22 / Provider News

Surgical Coding Update: 21930, 21931 & More Debut for CPT 2010

Tumor excision codes get specific. Will surgical oncology practices take a reimbursement hit? We’re starting to learn what new CPT codes we’ll be using come January 1, 2010. Coding News will keep you posted over the coming weeks, along with analysis from coding experts around the country so that you know what to expect for your practice’s [...] Related articles:

  1. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  2. 141 New ICD-9 Codes Debut for 2010 Like a passel of fresh-faced debutantes, the new ICD-9...
  3. Surgical Coding: Modifiers 58, 78, and 79SURGICAL MODIFIER CHOICES Surgery Modifier Choices are Key to Surgery...

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October 27, 2009