Tag Archives | Crosswalk

Choosing for Tympanostomy Anesthesia

Question: I’m looking for the anesthesia code for a tympanostomy of the left ear, performed on a 10-month-old child. What’s the correct choice?
Answer: The correct code is 00126 (Anesthesia for procedures on external, middle, and inner ear includin…

Continue Reading

Ensure Compliance With ICD-10 With These 3 Tips

When ICD-9 becomes ICD-10 in 2013, you will not always have a simple crosswalk relationship between old codes and the new ones. Often, you’ll have more options that may require tweaking the way you document services and a coder reports it. Check out the following examples of how ICD-10 will change your coding options when the calendar turns to Oct. 1, 2013.

Celebrate Sinusitis Codes’ One-to-One Relationship for ICD-10

When your physician treats a patient for sinusitis, you should report the appropriate sinusitis code for sinus membrane lining inflammation. Use 461.x for acute sinusitis. For chronic sinusitis — frequent or persistent infections lasting more than three months — assign 473.x.

For both acute and chronic conditions, you’ll choose the fourth digit code based on where the sinusitis occurs. For example, for ethmoidal chronic sinusitis, you should report (473.2, Chronic sinusitis; ethmoidal). Your otolaryngologist will most likely prescribe a decongestant, pain reliever or antibiotics to treat sinusitis.

ICD-10 difference: Good news. These sinusitis options have a one-to-one match with upcoming ICD-10 codes. For acute sinusitis diagnoses, you’ll look at the J01.-0 codes. For instance, 461.0 (Acute maxillary sinusitis) translates to J01.00 (Acute maxillary sinusitis, unspecified). Code 461.1 (Acute frontal sinusitis) maps directly to J01.10 (Acute frontal sinusitis). Notice how the definitions are mostly identical. Like ICD-9, the fourth digit changes to specify location.

For chronic sinusitis diagnoses, you’ll look to the J32.- codes. For instance, in the example above, 473.2 maps direction to J32.2 (Chronic ethmoidal sinusitis). Again, this is a direct one-to-one ratio with identical definitions. Like ICD-9, the fourth digit changes to specify location.

Physician documentation: Currently, the physician should pinpoint the location of the sinusitis. This won’t change in 2013.

However, you’ll scrap the 461.x and 473.x options and turn to J01.-0 and J32.- in your ICD-10…

Continue Reading

ICD-10: Here’s How To Report Hiatal Hernia In 2013

When ICD-9 becomes ICD-10 in 2013, you’ll need to get familiar with different sections in the new diagnosis code system, even if the condition you’re reporting has a simple one-to-one crosswalk.
When your surgeon performs a hiatal hernia repair, yo…

Continue Reading

CPT 2011: Vaccine Product to 90460, 90461 Crosswalk

How to count components for Boostrix, Pediarix – and other immunizations.

Excited by the new vaccine administration codes’ payment per component but not sure how many components specific vaccines have? This chart does the work for you.

Find the product name for a quick cross reference to how many components the vaccine includes and the administration with counseling code combination to report using the new pediatric/adolescent codes.

Note: The ICD-9 vaccine product code listed in the chart uses the generalized vaccine product code (V06.8, Need for prophylactic vaccination and inoculation against other combinations of diseases). For vaccine administration provided outside of a preventive medicine service, the American Academy of Pediatrics recommends using V06.8 for combination vaccines that do not have their own individual single ICD-9 code.

Vaccine Product Manufacturer Components CPT Product Code Number  of Components CPT 2011 Administration with Counseling Code ICD-9-CM 2011 Code
ActHIB Sanofi Pasteur Hib 90648 1 90460 V03.81
Adacel Sanofi Pasteur Tdap (tetanus- diphtheria-acellular pertussis) 90715 3 90460, +90461 x 2 V06.1
Boostrix GlaxoSmithKline Tdap 90715 3 90460, +90461 x 2 V06.1
Cervarix GlaxoSmithKline HPV 90650 1 90460 V04.89
Comvax Merck HepB-Hib 90748 2 90460, +90461 V06.8
Daptacel

Continue Reading

Get a Glimpse at ICD-10 Codes for Cough, Back Pain, and More

Wrap your brain around using letters in your diagnosis codes.

If you aren’t curious about how the ICD-9 codes crosswalk to ICD-10, maybe you should be.

“The transition date for ICD-10 codes is Oct 1, 2013,” stressed CMS’s Stewart Streimer…

Continue Reading

CMS Publishes Q&As Regarding Services Previously Billed As Consults

Medicare’s elimination of payment for consultation services has caused mass confusion throughout the coding community, not just due to the changes it has caused in your billing procedures, but also due to lack of information from CMS.

In an apparent…

Continue Reading

AMA Chimes In On How to Report Consults for Non-Medicare Patients

Beware: Don’t use the CMS consult crosswalk for billing purposes.
You may be seeing light at the end of the tunnel. The AMA just published an article to clarify the use of the consultation codes for non-Medicare patients, and talks about their efforts to get CMS to delay their new policy. You can find the article [...]

Related articles:

  1. CMS Will Offer New Modifier to Denote Admitting Physician on ClaimsPop the champagne cork & get ready for brand new…
  2. CMS’s Refusal to Pay Consults Makes MSP Claims a HeadacheIf you bill consults to private payers, good luck collecting…
  3. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open…
Continue Reading

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…
Related Posts Plugin for WordPress, Blogger...
Continue Reading