11400s Max Out With Margin Measurements

Question: If our surgeon removes a sebaceous cyst from the back that measures 2.5 x 1.75 x 0.5 cm, should we add up all the dimensions or should we just use the biggest dimension of 2.5? Is the answer the same if this were a tumor instead of a cyst? An...

Comments Off on 11400s Max Out With Margin Measurements

338.3 Example Boosts Your Non-Chemo Encounter Coding Savvy

Be sure your coding complies with ICD-9 official guidelines for pain management.

If you don’t know when to check ICD-9 official guidelines, you may have just a 50-50 chance of choosing the proper order for your diagnosis codes.

Case in point: Patients may present to the office for treatment related to pain caused by a neoplasm. In such cases, you will need to determine, which diagnosis codes to report, and you will need to decide what order to list the codes in on your claim. With that in mind, consider how you should code the scenario below.

Start by Examining the Neoplasm-Related Pain Case

Read the following scenario and determine proper ICD-9 coding based on the information given. You’ll find a helpful hint on which section of the official guidelines to review if you get stuck.

Scenario: The physician documents that a patient with lung cancer (middle lobe, primary malignant neoplasm) presented to the office for the purpose of pain management. The pain is documented as acute and caused by the neoplasm.

Hint: See section I.C.6.a.5 of the Official Guidelines for instructions on properly coding these sorts of encounters. The CDC posts ICD-9 guidelines online at: www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm

Next, Determine Which Neoplasm and Pain Codes Apply

For this scenario, before you can decide what order to put the codes in, you will need to decide which codes to report.

Neoplasm: For a primary malignant neoplasm of the lung’s middle lobe, you should report 162.4 (Malignant neoplasm of middle lobe bronchus or lung), says Denae M. Merrill, CPC, HCC coding specialist in Michigan.

Pain: To choose the proper pain diagnosis code, you want to be sure you keep in mind that the neoplasm is the cause. The ICD-9 index entry for pain has several subentries to consider:

  • Cancer associated
  • Neoplasm

...

Comments Off on 338.3 Example Boosts Your Non-Chemo Encounter Coding Savvy

11400s Max Out With Margin Measurements

Question: If our surgeon removes a sebaceous cyst from the back  that measures 2.5 x 1.75 x 0.5 cm, should we add up all the dimensions or should we just use the biggest dimension of 2.5? Is the answer the same if this were a tumor instead of a cyst?

Comments Off on 11400s Max Out With Margin Measurements

Ace CPT and ICD-9 Coding for Intra-Arterial Cases

Whether liver neoplasm is primary or secondary will change your coding.

Good news: You can apply many of the same rules you already know for intravenous chemotherapy coding to intra-arterial coding, too. So take your chemo coding expertise to the next level by adding intra-arterial skills to your arsenal.

Start here: For intra-arterial (IA) chemotherapy, you should choose from the following codes, says Gwen Davis, CPC, associate with Washington-based Derry, Nolan, and Associates.

  • 96420 — Chemotherapy administration, intra-arterial; push technique
  • 96422 — … infusion technique, up to 1 hour
  • +96423 — … infusion technique, each additional hour, (List separately

...

Comments Off on Ace CPT and ICD-9 Coding for Intra-Arterial Cases

From the AMA in Chicago: CPT 2010 Out of Order Codes

Here’s where you can find a full list of resequenced codes. Notice that new sign in your CPT book? No, that hash mark’s not to delete a message or to sign into a conference; it’s to alert you to an out of order code. The “#” works like a flashing yellow light: Slow down, there might be [...] Related articles:

  1. 2010 Tumor Excision Coding: Lesion Vs. Chunk SizeStraight from the AMA in Chicago — answers to your lesion...
  2. Lesion Excision Coding Challenge: 2 Lesions, 1 CutQuestion: Our nonphysician practitioner (NPP) discovers a pair of benign...
  3. Radiology Billing Checklist: Rules for Additional Tests without Treating Physician’s OrderKeep these additional test rules at your fingertips if your...

Comments Off on From the AMA in Chicago: CPT 2010 Out of Order Codes