Coder’s Navigation Tool: 2010 Medicare Physician Fee Schedule

It’s that time of year coders — yes, time to comb through pages and pages and pages of the final 2010 Medicare Physician Fee Schedule. We’ve got a handy place to start.
If you want a quick overview of fee schedule’s financial impact on your physician practice’s specialty, go here and scroll to page 1171. There, […]

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Cardiology Coding Question: Separate Reporting for 37204

Question: Should I separately report right and left bronchial artery embolization?

Answer: You should report 37204 (Transcatheter occlusion or embolization [e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation], percutaneous, any method, non-central nervous system, non-head or neck) twice for right and left lung embolization at the same encounter.
In addition, if the cardiologist […]

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2 New 2010 CPT Codes for High-Tech Cardiology Services

Steer clear of Cat. I codes for intravascular spectroscopy — here’s where to look instead.
The CPT update season is fast approaching. Warm up for the changes coming your way with a look at new-for-2010 Category III codes aimed at diagnosing coronary artery disease.
Match 0206T to MCG
One of the new Category III codes with a Jan. 1 […]

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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 […]

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Capture Separate CV Access Radiological Guidance

Don’t miss out on $20 per procedure when your surgeon performs central venous (CV) access device placements.
If your physician uses fluoroscopic or ultrasonic guidance during the placement, you should separately report that service. We’ll show you how and tell you what modifier moves you need to make to prevent denials.
Choose Between +76937 and +77001

If your […]

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Eye Surgery Coding Challenge: Denials for 15823 & 67904

Question: I started receiving denials for 15823 and 67904. To report this combo, should I use a modifier?
Answer: If the ophthalmologist performs the blepharoplasty (bleph) with excessive weight (15823, Blepharoplasty, upper eyelid; with excessive skin weighting down lid) on one eye and the blepharoptosis (ptosis) repair (67904, Repair of blepharoptosis; [tarso] levator resection or advancement, […]

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Track Payer’s Preferred H1N1 Admin Code — or Risk Rejections

Code 488.1 does not = confirmed lab.
Swine flu has made an early arrival in several states and in your 2009 preventive and sick coding. To avoid denials for H1N1 vaccination administration, you’re going to have to check which of three administration code options your major payers want. “Some payers want you to use the new […]

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Big Insurers Underspend On Medical Care, Senate Probe Finds

Which big health insurance company did lawmakers single out? Is it the one that gives you the most denials trouble?
A US Senate probe confirms what many coders and billers have been suspecting all along — that six major medical insurers aren’t spending as much as they should providing actual health care.
Insurance industry officials say that […]

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Radiology Coding Education: Is 76705 OK for Back?

Question: For a lower back ultrasound of a soft tissue mass, which CPT code is appropriate?
Answer: Code 76705 (Ultrasound, abdominal, real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) is appropriate for this lower back ultrasound.
Although the code descriptor states “abdominal” and not “back,” CPT Assistant (May 2009) clarifies that 76705 is appropriate […]

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Nonphysician Providers & Incident To Checklist

Check state laws PLUS this crucial document.
In last week’s Coder’s Cranium, we started a checklist of 3 things you should know to correctly bill for a nonphysician practitioner’s services — and stay compliant. This week, we complete the checklist with advice for items 4, 5 & 6.
4. Have You Distinguished Auxiliary Personnel From NPP Services?
NPPs can […]

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Trigeminal Nerve, in yellow.

Neurosugery Coding: 3 Easy Steps Distinguish Between 61790 & 61791

Anatomy know-how points you in the right direction every time.
How do you tell the difference between 61790 (Creation of lesion by stereotactic method, percutaneous, by neurolytic agent [e.g., alcohol, thermal, electrical, radiofrequency]; gasserian ganglion) and 61791 (… trigeminal medullary tract)?
That’s the question a Neurosurgery Coding Alert reader posed when she wrote, “What is the difference […]

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Ophthalmology Coding: GDX, VF, & Temp Plugs — How Many Modifiers?

Question: A patient came in for a GDX and visual field (VF) tests. During the same visit, the ophthalmologist put in temporary plugs. Can we get paid for all services on the same day? I know the office visit needs a modifier. Do I need to put one on the GDX & VF, too?
Answer: Provided the […]

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Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010

Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready for a facet joint codes shift that preps for ICD-10.
The 2010 version of CPT attempts to organize the facet joint injection codes by deleting 64470-64476 and debuting 64490- 64495 in their place, as follows:
• 64490 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves […]

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Does My E/M Coding Have to Match Hospital’s E/M Coding?

Question: My physician removed a catheter in an outpatient hospital exam room. Should I include this removal as part of the E/M? If E/M is appropriate, will the hospital also report an E/M? And, if so, do the physician and hospital E/M codes need to match?
Answer: You should include simple Foley catheter removal as part […]

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Your New Patient Packet Toolkit

How to use technology to speed up new patient check-in.
Not enough hours in the day? Are you always looking for ways to save time? Many medical offices report that sending out new patient packets in advance of the patient’s visit greatly reduces the number of incidents at patient check-in and saves time.
“Normally, it would take […]

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Closed Treatment of Metatarsal Fracture 28470 – 28475

http://www.medicalcodingpro.com. Medical Coding Pro is the coders destination for information. Closed Treatment of Metatarsal Fracture 28470 – 28475

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