There’s no way around it. To make the conversion to ICD-10 coding by the Oct. 1 deadline, dual coding needs to be on the list. This is when healthcare organizations…
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...
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...
Question: Eight days after an initial wart freezing, the patient returns, and the physician freezes another wart. Is the second procedure bundled into the first, or can we report it with a modifier? Answer: You may be able to report the second occurren...
Question: I have a path report that says “PIN III.” My problem is that the report also says “carcinoma was not identified,” so I’m confused about what to report. Which ICD-9 code is best? Answer: With a diagnosis of PIN III, you should repo...
Question:
We have a patient who had a severe crush injury of the left hand which led to a comminuted fracture of the left 3rd and 5th metacarpals with an intra-articular fracture of the proximal phalanx of the left index finger. The physician’s documentation indicates the following:
Would I report 11043 and 97605 with ICD-9 682.4 and 681.00?
-North Carolina Subscriber
Answer:
The correct codes in this situation would be 11010 (Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and
subcutaneous tissues), 11011 (Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle), or 11012 (Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (e.g., excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and...
Question: We have a Medicaid patient that came in for a ten year-old physical and was found to be sick, so we would like to append modifier 25 to report the well turned-sick visit. Is that accurate?- Virginia Subscriber Answer: Yes. In this situation, ...
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?
Question: Our cardiology practice employs a non-physicián practitioner (NPP) who performs a lot of E/M services for our patients, and that NPP received a bonus payment as part of the Primary Care Incentive Payment Program, which surprised us. We wan...
Question: Our state’s Medicaid carrier denies our claims when we submit 62311 with modifier 59 for postoperative pain management. They say the 62311 is bundled with the anesthesia procedure code. How should we handle this? -Ohio Subscriber Answer: ...
Question: If a patient receives treatment and the condition was resolved, which ICD-9 code should I report if the patient returns in six months for a follow-up visit? Answer: The most accurate way to code visits to follow up on treatment for a previous...
Question: I’m unsure how to code for cannulation of colovesical fistula. The doctor also did a cystoscopy with bilateral retrogrades and bladder biopsies. How should I report this procedure? Answer: There is no specific CPT code for cannulation of th...
Question: What’s the difference between a spinal allograft and an autograft? Answer: If the surgeon harvests bone from the patient’s own body, you’ll code for an autograft with one of the following codes: +20936 — Autograft for spine surger...
Question: Our physician x-rayed a patient’s symptomatic knee and ordered an x-ray of the other knee for comparative purposes. How should we report the comparison x-ray? Answer: Report the appropriate radiology code on two separate lines of your claim...
Question: My urologist performed a cystoscopy, transurethral incision of an orthotopic ureterocele, ureteroscopy, and a double J stent placement. I have drawn a blank on how to report the ureterocele incision. Here is the doctor’s note: “A 24 resec...
Question: I’m confused by the 2011 guidelines for 93922-93923. When should I report 93922-52? Answer: You should report 93922-52 (Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries … 1-2 levels; Reduced services)...