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93000-93010: Hone Your ECG Coding Skills With 3 Essential Pointers

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…

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Horizon BCBS Modifier Cut May Threaten Your Income

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,…

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Consider Observation Codes for Patients In Apparent Limbo

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…

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CMS Speaks: Weigh Your 2-Payer Consult Coding Options

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…

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Learn the Ins and Outs of Add-on Codes to Ensure Payable Claims

Knowing how to use add-on codes can net you up to $258 in additional reimbursement.

CPT is full of “add-on” codes, additions to minor and major surgical procedures as well as to E/M services. Fortunately for urology there are not…

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Use This Sample Appeal Letter As Ammo in Your Fight Against Modifier 25 Denials

Attach your procedure notes and the OIG’s report to pack extra punch.

Even if you follow all of CMS’s rules in reporting modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the

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Ensure Multi-Vaccine Payment With This Coding Advice

You may need to append modifier 25, depending on payer policies.

Question: Our physician billed 90634, 90710, and 90606 for vaccines given to a 5-year-old patient. The insurance company denied payment and said they required a modifier. What should we

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Achieve Modifier 25 Success in Just 3 Easy Steps

Are you a 'gold star' ASC coder?

Understand ‘significant’ and ‘separate’ to earn a gold star.

Knowing when to report modifiers and choosing the best one for each situation can be an easy trip-up for coders. If you find yourself especially befuddled…

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EM Coding: Should I Select 99211 for Most Med Checks?

Insurers might want to see a clear explanation as to why the E/M was necessary.

Question: An established patient with a plan of care in place for her gastroesophageal reflux disease (GERD) reports to the gastroenterologist; two weeks ago, the

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E/M Coding: Use Current Diagnosis to Support E/M Visit

Don’t forget to include the code for the arthrocentesis.

Question: A new patient sees the orthopedist because of shoulder problems. The physician schedules an MRI and the patient returns the following week to discuss the findings. The physician had already

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  1. ICD-9 Coding for Rotator Cuff Pain: 727.61 or 840.4?Question: In treating pain stemming from an injury to the…
  2. Orthopedic Coding Quick Start Guide: ASC Shoulder ProceduresShoulder ICD-9 and CPT codes you’ll most likely see in…
  3. Rotator Cuff Repair Coding: Catch the Arthroscopy Every Time Acute or chronic? A $60 difference is at stake….
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Ob-gyn Coding Challenge: EM End-Result Tells You What ICD Code To Go For

Check out these ICD-10 ob-gyn diagnosis coding equivalents.

Question: A patient presented for an initial OB visit. Another clinic confirmed her pregnancy, but she has never received prenatal care. The patient got her usual initial OB service (i.e. lab orders),

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Get Paid for EM Visits: How Much ROS Documentation Is Enough?

Caution: Keep enough paperwork on hand to back up EHR.
Transitioning to the world of Electronic Health Records (EHR) can make your coding easier on many levels, but don’t take it for granted. Physicians often fall short in their review of systems (ROS) documentation whether you use paper charts or rely on EHR, but you can […]

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  1. Bullet-Proof Level-4, Level-5 E/Ms with These ROS Documentation TipsROS documentation musts that most practices get wrong. Gastroenterology Coders:…
  2. E/M Coding Focus: Geriatric Patients & DementiaDetermine HPI or ROS during assessment for geriatric patients. Your…
  3. Bulletproof Your Doc’s PSA Documentation with This Form You’re just one click away from a code-focused order….
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E/M Coding: Don’t Sell Yourself Short on Problem Sports Exams

Tip: Time-based E/M might be in line when managing diabetes, asthma, ADHD.
Overlooking time as the key factor on a camp or sports exam in which the patient has a problem could cut $30 per claim.
Opportunity: An office visit (99201-99215, Office or Other Outpatient Services) using time as the key factor might be appropriate, but keep […]

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  1. Counseling Must Dominate Exception Claims For Seamless PaymentChoose the service level using the documented history, exam, and…
  2. Mid-Level E/M Coding BreakdownOur chart shows you how to choose among 99212, 99213 &…
  3. E/M Challenge: Can I Report 99214 and +99354?Counseling representing more than 50 percent of E/M visit? Choose…
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Migraine ICD-9 Codes: How Do I Get My 5th Digits Right?

Discover what the 5th digit represents and why you need it on your claim.
Question: A presents to the ED with complaints of a headache that’s worsening daily. He is experiencing visual blurring and nausea but no vomiting. This is the third headache of this nature in three weeks, and it has lasted “four or five […]

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  1. Ahhhhh: Relief for Your Migraine ICD-9 Coding Headaches Don’t let migraines’ five subcategories and 30 codes suck…
  2. Should You Code Presenting Symptoms Along With Dx? Question: An established patient complains of trouble breathing and…
  3. Winter Laceration Repair: How Do I Code For Dermabond?Warning: Your coding will vary depending on who’s getting the…
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CMS Will Soon Issue Consult Code Replacement Advice, According to Open Door Forum

Plus: You can now download a list of all practitioners who can order/refer.
If you’ve been confused about how to report low-level hospital visits now that consult codes are gone, you aren’t alone. CMS intends to tackle this problem by issuing more specific guidance on the topic in the near future.
That’s according to a Feb. 2 […]

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  1. CMS Open Door Forum: RACs Are BackPlus: Medicare officials clarify who can bill incident-to services and under…
  2. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open…
  3. Ask 3 Questions to Head Off 2010 Consult Problems Before They Start Ever used an unlisted E/M code? Get ready. By…
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Gastroenterology Coding Challenge: Repositioning a G Tube

Reading 44373’s code descriptor is key to getting your G Tube claim right.
Question: The gastroenterologist goes to the hospital to treat a patient that had recently been admitted because his gastrojejunostomy tube had migrated to his stomach. After performing a problem focused interval history and exam, the gastroenterologist decides to perform an EGD to reposition the […]

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  1. Gastroenterology Coding Education: Bravo Cap Placements Question: A new patient reports to the gastroenterologist with complaints…
  2. How Should I Code a Fibrinolytic Agent Instillation Via Chest Tube?Different calendar dates matter, but multiple instillations the same day…
  3. Winter Laceration Repair: How Do I Code For Dermabond?Warning: Your coding will vary depending on who’s getting the…
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