Emergency Reporting: Know When To Use +99140 With These Tips

Reporting any qualifying circumstances (QC) codes for anesthesia can be tricky, but knowing when to classify a situation as a true emergency can be a real challenge unless you’re well-versed in the emergency conditions guidelines. Check coding definitions and your provider’s documentation to know whether you can legitimately add two extra units for +99140 (Anesthesia complicated by emergency conditions [specify] [List separately in addition to code for primary anesthesia procedure]) to your claim.

CPT includes a note with +99140 stating that “an emergency is defined as existing when delay in treatment of the patient would lead to a significant increase in the threat to life or body parts.” Your key to knowing a case meets emergency conditions lies in your anesthesiologist’s notes.

“Quite a number of cases come in where the anesthesiologist marks ‘emergency’ but many times the ‘emergency’ isn’t all that clear,” says Leslie Johnson, CCS-P, CPC, director of coding and education for Medi-Corp., Inc., of New Jersey. Documentation supporting an emergency will depend on each case, so read the chart thoroughly when your provider indicates an emergency.

Solution: Talk with your anesthesia providers to clarify what constitutes an emergency and when you can include +99140. If there’s a real reason to report an emergency (such as a ruptured appendix, 540.0), your physician should clearly document the reason. Another diagnosis code to indicate a problem (such as unstable angina, 411.1) could help show the payer you’re reporting an unusual situation. The second diagnosis can also help in an appeal if a payer that ordinarily recognizes +99140 denies the claim.

“An OB patient who comes in for a cesarean section isn’t automatically an emergency,” explains Scott Groudine, M.D., professor of anesthesiology at Albany Medical Center in New York. “However, a diagnosis of fetal distress and prolapsed cord virtually always...

Comments Off on Emergency Reporting: Know When To Use +99140 With These Tips

Coding News Travels to Florida for 2010 Updates

Do you have a question about how you should code in 2010? Write us and we’ll ask the experts. Princesses have their castles, but the big news in Orlando this weekend is that the Coding Queens are coming to town! This week in Orlando, nationally known coding & billing experts like Marvel Hammer, Melanie Witt, Leslie Johnson [...] Related articles:

  1. CCI 15.2 News: 3,500 New Code Pairs, Plus Modifier Status Changes CPT continues to add new codes, and the Correct Coding...
  2. News Flash: Over 300,000 New Code Pair Edits from CCIExtra! CCI also creates a few welcome deletions. If you...
  3. AboutCoding News is the essential digest of updates and advice...

Comments Off on Coding News Travels to Florida for 2010 Updates

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 [...] Related articles:

  1. MAC Auditors Will Stick It To Facet Joint Injection Claims We hook you up with CMS instructions for when...
  2. Audit Hot Spot: Facet Joint Injection ClaimsHere’s why the OIG wants to stick it to facet...
  3. Save Time Coding Facet Injections With This Coding Tool Hint: Location, number and substance are key. Several factors...

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

Surgical Coding Update: 21930, 21931 & More Debut for CPT 2010

Tumor excision codes get specific. Will surgical oncology practices take a reimbursement hit? We’re starting to learn what new CPT codes we’ll be using come January 1, 2010. Coding News will keep you posted over the coming weeks, along with analysis from coding experts around the country so that you know what to expect for your practice’s [...] Related articles:

  1. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  2. 141 New ICD-9 Codes Debut for 2010 Like a passel of fresh-faced debutantes, the new ICD-9...
  3. Surgical Coding: Modifiers 58, 78, and 79SURGICAL MODIFIER CHOICES Surgery Modifier Choices are Key to Surgery...

Comments Off on Surgical Coding Update: 21930, 21931 & More Debut for CPT 2010

Service Doesn’t Meet Incident-To Rules? Report Under NPP’s NPI

Heads up: These vaccine admin codes are excluded from incident-to requirements. Incident-to rules don’t always apply to diagnostic services, but many medical practices aren’t aware of that. And based on a new wave of scrutiny directed toward incident-to claims, you should know physician supervision rules inside and out. A recent audit from the HHS Office of the Inspector [...] Related articles:

  1. Nonphysician Providers and Incident-To: Your Coding Questions AnsweredHere’s why you should keep your physicians’ work schedules on...
  2. Use This Incident-To Checklist to Breathe Easy During an Audit You don’t need to second-guess the way you bill...
  3. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...

Comments Off on Service Doesn’t Meet Incident-To Rules? Report Under NPP’s NPI