CPT 2011 / Hot Coding Topics / ICD-10

CodingConferences Coding Changes Top Tips from Editor Leigh Delozier

600 coders, physicians, and office managers gathered in Orlando, Fla. for one and a half jam-packed days of education, networking, and shopping at the December 2011 Coding Update and Reimbursement Conference. Coders’ biggest struggle was absorbing all the information – and not overdoing the holiday buying. Experts offered the inside scoop on medical coding changes for 2011 and beyond. Here are my top picks:

  1. E-prescribing is here to stay – and is about to be more strictly enforced. Physicians need to e-prescribe at least 10 medications for patients during the first 6 months of 2011, or they’ll be added to the list for a 1% penalty hit in 2012. “The prescriptions can be for one patient ten different times, or can be spread out among different patients,” said Marvel Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, in “Take Steps Now to Prepare for 2011 Pain Management Changes”.  “For pain management practices, the prescriptions can be for any type of pain meds.”
  2. Three PQRI measures apply to anesthesia providers: timing of prophylactic antibiotic (measure 30); maximal sterile barrier technique (measure 76); and active warming/temperature (measure 193). You have three reporting options: measure 76 alone; measures 76 and 193; or measures 30 and 76 said Judith Blaszczyk, RN, CPC, ACS-PM. “You must report on 80% of qualifying cases,” she reminded during her workshop, “Take Steps Now to Prepare for 2011 Anesthesia Changes.”
  3. No matter how many years you’ve been coding, you’ve heard, “ICD-10 is on the way.” Now that it’s looming as a reality, take a deep breath and know that you’ll be OK. “We learned to use ICD-9, and we’ll learn to use ICD-10,” Kelly Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I, said in “Diagnosis Coding for Anesthesia”. “We can do this! We are not afraid.”

This...

Comments Off on CodingConferences Coding Changes Top Tips from Editor Leigh Delozier
December 16, 2010
Toolkit

37220 to+37223: Narrow Down On Correct Code With This Handy Tool

Make the transition to new iliac revascularization codes a little simpler by using this chart. Be sure to read “37220 to +37223 Revamp Your Iliac Intervention Coding Options” on the cover to get more information on these new codes. Use the appropri...

Comments Off on 37220 to+37223: Narrow Down On Correct Code With This Handy Tool
December 16, 2010
Coder's Cranium

Pay Attention To These Revised Codes for Colon Motility and Manometric Studies

If you’ve been looking for a code on colon motility study and being frustrated for the lack of it, your search is over. CPT 2011 debuts a new code for a manometric study, along with two revised codes for esophageal pH monitoring.

For gastroenterology, you have a lot of changes to sort through — many involving deletions on low use codes or clean-up work.

Here’s How to Use New Manometric Study Codes

You should pay attention on two new codes for a manometric study: 91117 (Colon motility [manometric] study, minimum 6 hours continuous recording [including provocation tests, e.g., meal, intracolonic balloon distension, pharmacologic agents, if performed], with interpretation and report), and 91013 (Esophageal motility [manometric study of the esophagus and/or gastroesophageal junction] study with interpretation and report; with stimulation or perfusion during 2-dimensional data study [e.g., stimulant, acid or alkali perfusion] [List separately in addition to code for primary procedure]).

CPT 91117 is just for the study itself, not for the same session with catheter placement. The radiologist may place the catheter in a prior procedure and the gastroenterologist may come in and out to supervise the testing and any provocations that are performed. Thus, you should include the provocations in the study and report 97117 only once no matter how many times the testing is done.

You can use 91013 in cases like assessment of the effect on the measured esophageal motility when the patient’s esophagus is exposed to different stimulant liquids, says Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA’s CPT Advisory Panel. The code also applies when intravenous medications are administered to try to produce symptoms. CPT 91010 is included in 91013 and would not be billed separately, he adds.

Use 91034, 91035 in a New Way

Aside from debuting...

Comments Off on Pay Attention To These Revised Codes for Colon Motility and Manometric Studies
December 16, 2010