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:

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October 31, 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:

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  3. Capture ‘Patient Limbo’ Period With These Observation Coding Steps Internist deciding on admission? That’s your signal to look...

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October 28, 2009
Coding Challenge / E/M

E/M Coding Education: Does ‘No SOB’ Fall Under HPI or ROS?

Question: For a chart with a chief complaint of resolving pneumonia, a note indicates, “No coughing, SOB.” Should I give the pediatrician credit for this ‘no coughing & no shortness of breath’ statement under history of present illness (HPI) or as a review of systems (ROS)? Answer: This is a gray area of E/M coding that [...] Related articles:

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October 12, 2009
E/M / Hot Coding Topics

Watch Out for 3 Telephone Service Coding Pitfalls

Caution: You may need to incorporate the call into an in-office E/M service. If you’re reporting services your physician provides over the phone, but you’re not getting paid, the reason might be one of two things — you’re not following the coding rules surrounding the codes or your payer just isn’t paying for those services. Check out these [...] Related articles:

  1. Test Your E/M Coding & Billing Savvy Are you an E/M Emeritus? Take this quiz to...
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  3. This 4-Step Coding Process Grabs $125 Extra in Vasectomy-Related PaymentTurn to V25.x for your diagnosis code choice. Vasectomies are...

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October 10, 2009