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Coders: Watch Out for Claim-Denying Computer Glitches

Don’t wait for your MAC to alert you to an error — be on the lookout for them.
If you’ve been losing reimbursement to computer hiccups at your carrier, you’re not alone. Earlier this year, thousands of Medicare recipients in one state were wrongly told their benefits were being cut by $300 — but the state decided not to notify those affected with a letter. Instead, the state only told […]

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OB or Not OB: That’s the Ultrasound Coding Question

Question: For an ultrasound, the radiologist documented measurements of the uterus, endometrial complex, and ovaries. She noted no evidence of intrauterine pregnancy, no free fluid in the cul-de-sac, physiologic follicle formation, and positive Doppler flow in the ovaries. The patient had syncope but no confirmed pregnancy. Should I report an obstetric or nonobstetric ultrasound?
Answer: Because the patient […]

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Head of right tibia, seen from above

ASC Coding Education: Knee Diagnoses & Procedures

Choose this ICD-9 code if you see ‘jumper’s knee’ in the orthopedic surgeon’s note.
Here’s a handy introduction to common ICD-9 codes related to the knee, along with examples of CPT codes for procedures physicians perform to treat knee diagnoses.
Chondromalacia Patella
Chondromalacia patella (717.7) is also known as “patellofemoral syndrome” or “runner’s knee.” This condition results when […]

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Toolkit: Chart Cardiology’s CCI 15.3 Changes At-a-Glance

Hang on to this handy table to avoid cath placement coding temptations.
Correct Coding Initiative (CCI) 15.3 offered long lists of new edits, but we’ve boiled them down to the ones that affect cardiology coders and billers most.

Cardiology Coders: A CCC™ Exam Prep Training Camp is coming to a city near you.

Related articles:Take Heart, Cardiology Coders: CCI […]

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5 Lessons Radiology Coders Should Learn From CCI 15.3

Wonder if there’s a method to the 76001 madness? Here’s where to look for answers.
The silver lining to the 18,000 Correct Coding Initiative (CCI) that just came rumbling in with CCI 15.3. Analyzing them can help you master radiology coding essentials — including follow-up CTs, fluoro, and more. Apply these five lessons to keep your claims looking […]

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A Physician Coder’s Guide to the 2010 OIG Work Plan

If your practice does lab panels, sleep studies, hospice visits and more, take heed.
The HHS Office of Inspector General has published its 2010 Work Plan, which should give us all a heads up on what the watchdog agency will be auditing and evaluating this year.
Why you should care: The 115-page document is like a map […]

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How Do You Code Sigmoidoscopy with Anoscopy, Biopsy?

Question: Notes indicate that the gastroenterologist performs a rigid sigmoidoscopy; during the encounter, he also performs an anoscopy without anesthesia and three biopsies of the mucous membrane. How should I report this episode? Can I report the exam separately with 46600?
Answer: You can report a single code for these three services. On the claim, report 45305 (Proctosigmodoscopy, rigid; with biopsy, single or […]

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E/M Coding Education: Does ‘No SOB’ Fall Under HPI or ROS?

Question: For a chart with a chief complaint of resolving pneumonia, a note indicates, “No coughing, SOB.” Should I give the pediatrician credit for this ‘no coughing & no shortness of breath’ statement under history of present illness (HPI) or as a review of systems (ROS)?
Answer: This is a gray area of E/M coding that […]

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Fracture Care Coding: Mark Manipulation, Make $100+ More Per Encounter

No maybes here: Answer this question wrong and you will code incorrectly.
When your ED physician performs fracture care for a patient, be ready to pounce on evidence of manipulation, as CPT often breaks fracture care codes along the manipulation line.
The $kinny: Let’s say the physician performs closed treatment on a fractured collarbone; if she uses […]

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Watch Out for 3 Telephone Service Coding Pitfalls

Caution: You may need to incorporate the call into an in-office E/M service.
If you’re reporting services your physician provides over the phone, but you’re not getting paid, the reason might be one of two things — you’re not following the coding rules surrounding the codes or your payer just isn’t paying for those services. Check out these […]

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Revision of a Tricuspid Valve – Why is it necessary?

The tricuspid valve is the atrioventricular valve in the right hand section of the human heart, which regulates the flow of blood from the right atrium (top chamber) to the right ventricle (the bottom chamber).

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More Health Care Services = Higher Costs

Private nursing homes now cost $10 more than it did last year.

You may have to allot more on long term care from your budget as the yearly survey by a financial firm has found its costs are continuously on…

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