CCI / Coding Challenge

Radiology Coding Challenge: Why is Medicare Denying a 38792, 78195 Claim

Tip: Discover true meaning of 38792 note Question: The physician performed a sentinel node injection with lymphoscintigraphy. A note with 38792 states to report 78195 for imaging. So why did Medicare deny a claim that included both codes? Answer: You should report 78195 (Lymphatic and lymph nodes imaging) for this service and leave 38792 (Injection procedure; for [...] Related articles:

  1. CCI 15.0 Update for Radiology Coders 76942 and 78808 on a single claim needs a...
  2. Radiology Coding Challenge: Total Spine MRI Without Contrast Question: Which CPT code should I use for a...
  3. Radiology Coding Challenge: Rate Your Reformatting SkillsQuestion: My radiology report documents axial CT slices from the...

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January 10, 2010
E/M / Hot Coding Topics / modifier 59

CCI 16.0: Now Allows a Modifier to Separate Hundreds of Edits

But other new bundles that 16.0 has in store might put a dent in your reimbursement. You may still be poring through your 2010 CPT manual, but the new edition of CCI, effective Jan. 1, is already looking to make some code pairings impossible. The Correct Coding Initiative (CCI) released version 16.0 earlier this week, revealing 24,060 [...] Related articles:

  1. CCI 15.1: Adhere to These Osteotomy, Laminectomy Edits You’ll need a modifier on this code pair to...
  2. CCI 15.2 Retracts Neurostimulator Edits from 15.1Look for new edits that affect eye exam codes, anesthesia,...
  3. CCI 15.3 Update: You Can Resubmit Dozens of Previously-Bundled 22526 ClaimsNewsflash: CCI 15.3 retroactively deletes hundreds of edit pairs, but...

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December 15, 2009
CCI / Coding Challenge / modifier 59

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, [...] Related articles:

  1. Spinal Surgery Coding Challenge: Is Hemilaminectomy Bundled With Fusion?Question: Our orthopedic surgeon turned in a note that says,...
  2. Avoid This Blepharoplasty Coding Blunder  Don’t settle for denials for a functional surgery that...
  3. Spinal Surgery Coding Challenge: Tethered Cord Release & Dural Tag RemovalQuestion: My neurosurgeon released a tethered cord under the microscope,...

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November 4, 2009
Toolkit

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 [...] Related articles:

  1. Take Heart, Cardiology Coders: CCI Deletions Overturn 93296 Denials Go back to the future. 3 months of denials...
  2. Glide Through Neoplasm Coding With This At-a-Glance GlossaryUnderstand primary and secondary malignancies before coding biopsies. Next time...
  3. Where Anesthesia Coders Go Wrong With CS Cath Placement   Your doc needs to do this to get...

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October 15, 2009
Hot Coding Topics / radiology

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 [...] Related articles:

  1. CCI 15.0 Update for Radiology Coders 76942 and 78808 on a single claim needs a...
  2. What Interventional Radiology Coders Should Know About CCI 15.1 EXTRA–Radiology Reimbursement WEBINAR: Do you know the difference between...
  3. CCI 15.0 Update for Orthopedic Coders Consider Nerve Blocks, Injections Inherent to Most New Ortho...

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October 15, 2009