Coding Challenge / modifier 59

Cardiology Coding Question: Separate Reporting for 37204

Question: Should I separately report right and left bronchial artery embolization? Answer: You should report 37204 (Transcatheter occlusion or embolization [e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation], percutaneous, any method, non-central nervous system, non-head or neck) twice for right and left lung embolization at the same encounter. In addition, if the cardiologist [...] Related articles:

  1. Cardiology Coding Education: Pacemaker Lead Check Question: The cardiologist documented testing pacemaker leads using fluoroscopy...
  2. 2 New 2010 CPT Codes for High-Tech Cardiology ServicesSteer clear of Cat. I codes for intravascular spectroscopy — here’s...
  3. OB or Not OB: That’s the Ultrasound Coding QuestionQuestion: For an ultrasound, the radiologist documented measurements of the uterus,...

Comments Off on Cardiology Coding Question: Separate Reporting for 37204
November 7, 2009
Cardiology / Hot Coding Topics

2 New 2010 CPT Codes for High-Tech Cardiology Services

Steer clear of Cat. I codes for intravascular spectroscopy — here’s where to look instead. The CPT update season is fast approaching. Warm up for the changes coming your way with a look at new-for-2010 Category III codes aimed at diagnosing coronary artery disease. Match 0206T to MCG One of the new Category III codes with a Jan. 1 [...] Related articles:

  1. Cardiology ICD-9 for 2010: All-New Embolism Codes & More A 453.x facelift will require you to hunt for...
  2. Cardiology CPT 2009 Crash Course: Device Monitoring Our programming eval guide can put your 93279-93285 fears...
  3. New CPT Codes for Cardiac CT, Imaging Appear for 2010Plus: Say goodbye to two perfusion codes. If you’ve ever...

Comments Off on 2 New 2010 CPT Codes for High-Tech Cardiology Services
November 7, 2009
CPT 2010 / Provider News

CPT 2010 Update: Non-Face-to-Face Prolonged Services

New Year’s hats & horns for looser guidelines that let you count work spread over days. Groaning thinking of all the time you’ll never capture for complex cases requiring extensive pre-visit time? CPT 2010 brings you hope. Extensive guideline revisions “liberalize prolonged non-face-to-face services codes,” reports Richard Tuck, MD, FAAP, pediatrician at PrimeCare of Southeastern Ohio in [...] Related articles:

  1. Asthma Attack Coding: When To Use Prolonged or High-Level E/M     Checklist deters payback requests for insufficient +99354...
  2. Bust 4 Myths About Pediatric Critical Care Services MYTHBUSTER: Codes 99291, +99292 apply to infants, young pediatric...
  3. Watch Out for 3 Telephone Service Coding PitfallsCaution: You may need to incorporate the call into an...

Comments Off on CPT 2010 Update: Non-Face-to-Face Prolonged Services
November 5, 2009
Hot Coding Topics / modifier 26

Capture Separate CV Access Radiological Guidance

Don’t miss out on $20 per procedure when your surgeon performs central venous (CV) access device placements. If your physician uses fluoroscopic or ultrasonic guidance during the placement, you should separately report that service. We’ll show you how and tell you what modifier moves you need to make to prevent denials. Choose Between +76937 and +77001 If your [...] Related articles:

  1. Focus on Method to Ensure Proper Stereotactic Breast Biopsy CodingWatch out for the 77031 pitfall if the radiologist participates...
  2. Plantar Digital Nerve Coding Education: 64455 & 64632With these 4 tips, you’ll code clean claims every time....
  3. Cardiology Coding Question: Separate Reporting for 37204Question: Should I separately report right and left bronchial artery...

Comments Off on Capture Separate CV Access Radiological Guidance
November 4, 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,...

Comments Off on Eye Surgery Coding Challenge: Denials for 15823 & 67904
November 4, 2009
Hot Coding Topics

Track Payer’s Preferred H1N1 Admin Code — or Risk Rejections

Code 488.1 does not = confirmed lab. Swine flu has made an early arrival in several states and in your 2009 preventive and sick coding. To avoid denials for H1N1 vaccination administration, you’re going to have to check which of three administration code options your major payers want. “Some payers want you to use the new [...] Related articles:

  1. 2 New HCPCS Codes for H1N1 Vaccine AdministrationPlus: New Bevacizumab code is effective Oct. 1. If you’re...
  2. Correct ICD-9 Coding for H1N1 (Swine Flu) Before you carry your swine flu diagnosis over to...
  3. Capture Vaccine Admin Without Charging Products These VFC FAQs help you report the seemingly impossible....

Comments Off on Track Payer’s Preferred H1N1 Admin Code — or Risk Rejections
November 3, 2009
Provider News

Big Insurers Underspend On Medical Care, Senate Probe Finds

Which big health insurance company did lawmakers single out? Is it the one that gives you the most denials trouble? A US Senate probe confirms what many coders and billers have been suspecting all along — that six major medical insurers aren’t spending as much as they should providing actual health care. Insurance industry officials say that [...] Related articles:

  1. Insurers Offer to Charge Sick People Less …… and healthy people more. In an unexpected move last...
  2. $12,910 More Per Year For Health Insurance?Imagine a world where insured patients pay DOUBLE the health...
  3. Stimulus Package Crash Course for Health Care ProvidersIf your head is swimming trying to figure out what...

Comments Off on Big Insurers Underspend On Medical Care, Senate Probe Finds
November 3, 2009
Coding Challenge / radiology

Radiology Coding Education: Is 76705 OK for Back?

Question: For a lower back ultrasound of a soft tissue mass, which CPT code is appropriate? Answer: Code 76705 (Ultrasound, abdominal, real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) is appropriate for this lower back ultrasound. Although the code descriptor states “abdominal” and not “back,” CPT Assistant (May 2009) clarifies that 76705 is appropriate [...] Related articles:

  1. New From CPT Assistant: Help with Trunk Ultrasound Coding Do you know exactly what’s in the mediastinum? Your US...
  2. Double Ultrasound Codes Spell Double Trouble With AuditorsAuthorities scrutinize medical necessity for 76830 & 76856. The OIG...
  3. 5 Lessons Radiology Coders Should Learn From CCI 15.3Wonder if there’s a method to the 76001 madness? Here’s...

Comments Off on Radiology Coding Education: Is 76705 OK for Back?
November 2, 2009
Coder's Cranium

Nonphysician Providers & Incident To Checklist

Check state laws PLUS this crucial document. In last week’s Coder’s Cranium, we started a checklist of 3 things you should know to correctly bill for a nonphysician practitioner’s services — and stay compliant. This week, we complete the checklist with advice for items 4, 5 & 6. 4. Have You Distinguished Auxiliary Personnel From NPP Services? NPPs can [...] 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. Steer Your Incident-To Coding Using These 4 Questions 100 percent pay possible if NPP follows internist’s care...

Comments Off on Nonphysician Providers & Incident To Checklist
November 1, 2009
Hot Coding Topics

Neurosugery Coding: 3 Easy Steps Distinguish Between 61790 & 61791

Anatomy know-how points you in the right direction every time. How do you tell the difference between 61790 (Creation of lesion by stereotactic method, percutaneous, by neurolytic agent [e.g., alcohol, thermal, electrical, radiofrequency]; gasserian ganglion) and 61791 (… trigeminal medullary tract)? That’s the question a Neurosurgery Coding Alert reader posed when she wrote, “What is the difference [...] Related articles:

  1. Add $36 to This Excision Claim in 3 StepsPatience is a virtue, particularly when it comes to coding...
  2. 5 Lessons Radiology Coders Should Learn From CCI 15.3Wonder if there’s a method to the 76001 madness? Here’s...
  3. Skull Biopsy, No Burr Hole: 61500 or 61563?Question: Our surgeon biopsied a lesion from the skull, but...

Comments Off on Neurosugery Coding: 3 Easy Steps Distinguish Between 61790 & 61791
November 1, 2009
Coding Challenge / E/M / modifier 25

Ophthalmology Coding: GDX, VF, & Temp Plugs — How Many Modifiers?

Question: A patient came in for a GDX and visual field (VF) tests. During the same visit, the ophthalmologist put in temporary plugs. Can we get paid for all services on the same day? I know the office visit needs a modifier. Do I need to put one on the GDX & VF, too? Answer: Provided the [...] Related articles:

  1. Ophthalmology Coding: RT/LT or Modifier 50? Prevent Uni-Bi Reporting Errors With This Expert Insight Don’t...
  2. CIGNA Opens Black Box: Get Paid With Modifiers 25 & 59 You now have clear-cut policies to apply, including 1...
  3. Ophthalmology Coding: See Your Way to Clear Reimbursement for Eye Exams and Cataract SurgeryChoose the Right E/M or Eye Code to Optimize Reimbursement...

Comments Off on Ophthalmology Coding: GDX, VF, & Temp Plugs — How Many Modifiers?
October 31, 2009
Anesthesia / Hot Coding Topics / ICD-10 / Pain Management

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
October 28, 2009
Coding Challenge / E/M

Does My E/M Coding Have to Match Hospital’s E/M Coding?

Question: My physician removed a catheter in an outpatient hospital exam room. Should I include this removal as part of the E/M? If E/M is appropriate, will the hospital also report an E/M? And, if so, do the physician and hospital E/M codes need to match? Answer: You should include simple Foley catheter removal as part [...] Related articles:

  1. Must Hospital Admit Codes and Admission Show Same DOS? Overlook this rule, and risk leaving rightful E/M dollars on...
  2. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...
  3. Capture ‘Patient Limbo’ Period With These Observation Coding Steps Internist deciding on admission? That’s your signal to look...

Comments Off on Does My E/M Coding Have to Match Hospital’s E/M Coding?
October 28, 2009
Toolkit

Your New Patient Packet Toolkit

How to use technology to speed up new patient check-in. Not enough hours in the day? Are you always looking for ways to save time? Many medical offices report that sending out new patient packets in advance of the patient’s visit greatly reduces the number of incidents at patient check-in and saves time. “Normally, it would take [...] Related articles:

  1. Front Desk Data Tracking ChecklistClean data means more than just a healthy bottom line....
  2. Dependent-Child Billing & the Birthday Rule Our easy key tells you when the birthday rule...
  3. Checklist Gets You Clean Claims Boost accuracy and payup. Has your office ever received...

Comments Off on Your New Patient Packet Toolkit
October 28, 2009
Tips

Get a Free Medical Coding Practice Exam

http://www.medicalcodingpro.com Medical Coding Pro is the coders destination for information. Get a Free Medical Coding Certification Practice Exam. Go to our website and click on the scroll bar to enter your information!

Comments Off on Get a Free Medical Coding Practice Exam
October 27, 2009