Coding Challenge / CPT / surgery

Surgical Coders: Don’t Overstate Debridement

Tip: This encounter involves topical applications and patient care instruction in addition to removing devitalized tissue.

Question: When the surgeon performs a wound VAC or cleans a wound by scraping with a sharp curette (not excising tissue), is it appropriate to use a debridement code or should we report an active wound care management code from the range 97597-97606?

Ohio Subscriber

Answer: Physicians typically use the debridement codes (11000-11001, Debridement of extensive eczematous or infected skin; … or 11004-11005, Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; …) for debridement by any method.

Without...

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May 20, 2010
Coding Challenge / CPT / Medicare

Tune in to Video-Conference Cat. III Code

Here’s what you need to explain in your cover letter.
Question: Our doctor has agreed to be a specialty resource for a small rural hospital. She recently provided critical care services for an ER patient with acute seizures

...

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April 30, 2010
Coder's Cranium / CPT / modifier 25

Face Off Against Common Sports Physical Coding Challenges

Hint: Gathering upfront pay and watching E/Ms make a difference.

Children need physicals to participate in their favorite sports year round, but the demand can grow with warm weather approaching. Ideally, the need for sports physicals should provide the opportunity...

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April 14, 2010
CCI / CPT / Hot Coding Topics / modifier 59 / NCCI

CCI 16.1: Seize the Opportunity to Report 0193T — But Don’t Get Tripped Up By These Edits

Overlooking these new Interstim and hemorrhoid destruction bundles could mean denial headaches.

Payers like Noridian Part B will cover the female stress urinary incontinence treatment code 0193T, but before you submit a 0193T claim, you’ll have to check with the...

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April 14, 2010
CPT / ICD-9 / modifier 22 / modifier 52 / modifier 59 / Modifiers / surgery / Toolkit

8 Simple Steps Organize Your Op Note Coding

This aspect of op note coding is the “horse that pulls the cart.” Stuck on how to tackle this op note or those sitting on your desk? Follow this advice, provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M. and co-presenter of the “Ob-Gyn Op Notes” session at the [...] Related articles:

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  3. Op Note Coding Clinic: Breast Reconstruction with AlloDermSurgeons now commonly use AlloDerm in a variety of surgeries,...

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February 11, 2010
CPT / Hot Coding Topics / Medicare

Critical Care Coding FAQ: Become a Master of Time

Beware: CPT, CMS differ on ‘family discussion’ parameters. When the physician treats a patient with a critical illness or injury, you need to know when to start and stop the critical care clock in order to avoid miscoding. Check out this FAQ to find out what’s part of critical care, what’s not, and how to correctly [...] Related articles:

  1. Maximize 99291 Coding with This Critical Care FAQ Physician ‘preventing further deterioration’ keys valid critical care claims....
  2. Critical Care Coding Checklist Certain patient conditions could indicate 99291 service. Given the...
  3. Bust 4 Myths About Pediatric Critical Care Services MYTHBUSTER: Codes 99291, +99292 apply to infants, young pediatric...

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February 8, 2010
CPT 2010 / Hot Coding Topics

2010 CPT General Surgery Coding Update: Changes for Lap, Abdominal Repair & Hemorrhoidectomy

Can you find codes in 2010’s resequencing mess? We show you how. Reporting your general surgeon’s service with an unlisted code means more documentation work and a payment guessing game — that’s why you’ll welcome CPT 2010’s more specific codes. General surgery can get all the details at this on-demand, specialty-specific audio update. But we won’t keep you in [...] Related articles:

  1. What’s the Code for Lap Hiatal Hernia Repair? Question: In accordance with the new laparoscopic hernia codes, does 49652...
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  3. Surgical Coding: Scar Revision on Previous Mastectomy SiteTip: Find mastectomy scar revision in wound repair Question: Our...

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December 30, 2009
Coder's Cranium / CPT 2010

The ASC Coder’s Resource Guide for 2010

Here’s a quick, handy way to get to all of Medicare’s new rules and reimbursement rates Ambulatory surgery center coders have a lot to learn for 2010, stressed Joanne Schade-Boyce at the ASC 2010 Coding & Reimbursement Update in Orlando. It’s absolutely essential that ASC coders study the AMA’s CPT Changes this year, Schade-Boyce recommended. Why? [...] Related articles:

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  3. Op Note Decoder Ring: Red Flags for Multiple ProceduresNever rely on an op note’s “procedure performed” line for...

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December 12, 2009
CPT 2010 / Pain Management / Toolkit

CPT 2010 Code Selection Chart for Paravertebral Facet Joint Injections

CPT 2010 introduces a slew of new codes for paravertebral facet injections, so why not consult our handy flow chart to help you select the correct code? © Neurology Coding Alert. To read the full article on the new facet joint injection codes for 2010, download your 2 FREE sample issues here. Was it painful for you to [...] Related articles:

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  3. Save Time Coding Facet Injections With This Coding Tool Hint: Location, number and substance are key. Several factors...

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December 10, 2009
CPT 2010 / Hot Coding Topics / Pain Management

Facet Joint Injection Coding for 2010

Marvel Hammer’s Quick Start Guide to changes you’ll face in 2010. Tons of pain management coders gathered at the Orlando conference this week, and everyone was abuzz about the coding changes the painful reimbursement cuts their practices are going to get next year. Some big news: Effective January 1, 2010 radiological imaging will be required and bundled [...] Related articles:

  1. MAC Auditors Will Stick It To Facet Joint Injection Claims We hook you up with CMS instructions for when...
  2. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  3. Audit Hot Spot: Facet Joint Injection ClaimsHere’s why the OIG wants to stick it to facet...

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December 8, 2009
CPT 2010 / Hot Coding Topics

CPT 2010 Update: Tally Up Common Audiology Code Groups Into Single Codes

Plus, add this new tympanometry code to your cache next year. One of CPT 2010’s initiatives is to move several codes typically performed together into one code. Check out these new audiology testing codes and understand the rationale before Jan. 1 hits. For instance, if your physician performs a vestibular evaluation in 2010, you will report new [...] Related articles:

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  2. Can a Sleep Study Code Describe an Awake Test? Question: A sleep study was ordered for a patient...
  3. Bundle of His Recording Coding ChallengeQuestion: How should I report right atrial pacing and recording...

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December 5, 2009
CPT 2010 / Hot Coding Topics / radiology

Celebrate CT Colonography’s 2010 Move to Category I

But don’t assume the new codes will yield improved fees. Virtual colonoscopy coverage may be a mixed bag, but the AMA showed some confidence in the service by moving its codes from temporary Category III status to full-fledged Category I in 2010. The switch from Category III to Category I does offer some hope of better reimbursement [...] Related articles:

  1. New CPT Codes for Cardiac CT, Imaging Appear for 2010Plus: Say goodbye to two perfusion codes. If you’ve ever...
  2. Virtual Colonoscopy Reimbursement: Still ‘Virtual’ For Now Many cancer clinicians are all for virtual colonoscopy because...
  3. Don’t Wait for CPT: Maximize Virtual Colonoscopy Payment Now Learn whether to file an ABN with 0066T, 0067T....

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November 30, 2009
CPT 2010 / Hot Coding Topics

Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics Coding

Urodynamics income will go down by half, experts calculate. You will have three new urodynamics codes to learn starting Jan. 1. CPT 2010 adds the following codes: • 51727 — Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique • 51728 — … with voiding pressure studies (ie, bladder voiding pressure), any technique • 51729 — … [...] Related articles:

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  3. Is this Biopsy Mistake Costing Your Urology Practice $400 Per Claim? Tip: Look beyond the term ‘fulguration’ when you choose...

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November 21, 2009