CCI / Hot Coding Topics / pathology

Pathology Billing: Calculate How MUE/CCI Restricts Your Outside Consult Pay

Don’t bank on accepted 88321-88323 unit of service. Your pathologist consults with an outside lab on slides taken from a 2006 lumpectomy and a 2009 lymph node fine needle aspiration (FNA). That’s 88321 x 2 — right? Maybe. Your payer determines the answer to that question. The problem: “Although the American Medical Association (AMA) says the unit of service for [...] Related articles:

  1. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...
  2. Match Pathology Report Keywords to Uterus Codes Common descriptions and diagnoses lead the way. Never again...
  3. Zero In On Correct Nasal-Specimen Coding With This Quick Quiz Missing multiple 88304 specimens could cost your practice $125....

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January 17, 2010
Hot Coding Topics / radiology

Radiology Coding: CPT 2010 Breathes New Life Into Your Respiratory Coding

Master 32561’s guidelines to prevent a major units gaffe. Flip through the Surgery/Respiratory System section of your CPT 2010 manual, and you’ll see the coding committee has been hard at work adding to and revising your options. Discover the added cath removal code, the all new fibrinolytic agent instillation code, and the reshaped bronchoscopy descriptors, so [...] Related articles:

  1. CCI 15.0 Update for Radiology Coders 76942 and 78808 on a single claim needs a...
  2. Capture Separate CV Access Radiological GuidanceDon’t miss out on $20 per procedure when your surgeon...
  3. Multiple Bronchoscopy Coding Crash Course Head off denials & ratchet up reimbursement with these...

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January 14, 2010
Hot Coding Topics

CMS’s Refusal to Pay Consults Makes MSP Claims a Headache

If you bill consults to private payers, good luck collecting the balance from Medicare secondary payers. Don’t even think about billing a consult to Medicare — even if it’s only a secondary payer claim. Medicare may have scratched consultations off of its list of payable services, but many other insurers did not follow suit. This leaves you in [...] Related articles:

  1. CMS Will Offer New Modifier to Denote Admitting Physician on ClaimsPop the champagne cork & get ready for brand new...
  2. Consultation 5 R’s Miss 1 element, and invite auditors to check out...
  3. VaVaVoom: V-Codes Give Your Claims a Smoother RideSo what’s the deal, exactly, with V codes? Here are...

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January 12, 2010
Hot Coding Topics

PQRI 2010: Tips That Boost Your Practice’s Revenue

Follow our links and advice to put more plusses in your claims column Back again for 2010 is Medicare’s incentive-driven physician quality reporting initiative (PQRI), aimed at tracking quality metric or patient care services that physicians provide. When the practice treats enough patients in the same category, some PQRI dollars might be only a few codes [...] Related articles:

  1. Smokin’ PQRI Pointers We’ve got the G codes you need to score...
  2. PQRI: No Coumadin Due to Fall RiskPlus, experts at the AMA meeting in Chicago tell you...
  3. Accurate Diabetes ICD-9 Coding = PQRI BonusInternal medicine providers interested in a year-end bonus from Medicare...

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January 9, 2010
Audit / Hot Coding Topics / MAC / modifier 58 / modifier 78 / modifier 79

Global Billing: Document ‘Unrelated’ for Modifier 79 Services

MACs are looking for ‘red flags’ to halt additional global period pay Billing for additional services during a global surgery period is always tricky, but now you can expect special scrutiny for modifier 79 claims. After the OIG got wind of fraudulent surgery billing with modifier 79 (Unrelated procedure or service by the same physician during the postoperative period), CMS contractors have been on the hunt [...] Related articles:

  1. These 8 Services Are Not Part Of The Global Surgical PackageIf you’re not reporting these services separately, you’re losing money....
  2. Modifier Cheat Sheet: Banish Your E/M Modifier Phobias ForeverOnce you have this tool, you’ll never again wonder which...
  3. Bone Up On ASC Orthopedic Coding With These Global Period, Modifier Tips 3 ways your physician claim better look different than...

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January 7, 2010
Hot Coding Topics

CPT 2010 Update: Urogynecology Coding

Remember, supervision requirements still apply to new codes. CPT 2010 brings some big changes to urogynecology coding. Your urodynamics coding — and income — changes drastically as of Jan. 1. Get to Know These 3 New Complex Cystometrogram Codes You will have three new urodynamics codes to learn starting Jan. 1. CPT 2010 adds the following codes: • 51727 — Complex cystometrogram (ie, calibrated [...] Related articles:

  1. Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics CodingUrodynamics income will go down by half, experts calculate. You will...
  2. Keep All the Urodynamics Codes Straight With This Handy Cheat SheetKnowing the differences between the tests is your key to...
  3. 3 Mythbusters Overcome Your Urogynecology Bladder Scan Coding Troubles Uncover how you can bill a distinct E/M visit...

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January 5, 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...
  2. Multi-Laceration Repair Coding Case StudiesDo you know when to code repairs that occur in...
  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
E/M / Hot Coding Topics / modifier AI

Ask 3 Questions to Head Off 2010 Consult Problems Before They Start

Ever used an unlisted E/M code? Get ready. By now, you’ve heard that CMS is doing away with all inpatient (99251-99255) and outpatient (99241- 99245) consultation codes in 2010 — but are you prepared for the issues this may cause, starting Jan. 1? Ask these three questions of your practice and payers, and you’ll fend off [...] Related articles:

  1. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...
  2. CMS Will Offer New Modifier to Denote Admitting Physician on ClaimsPop the champagne cork & get ready for brand new...
  3. OK to Code Debridement With Consult?Question: Can you charge for an inpatient consult and a bedside...

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December 17, 2009
E/M / Hot Coding Topics / modifier 59

CCI 16.0: Now Allows a Modifier to Separate Hundreds of Edits

But other new bundles that 16.0 has in store might put a dent in your reimbursement. You may still be poring through your 2010 CPT manual, but the new edition of CCI, effective Jan. 1, is already looking to make some code pairings impossible. The Correct Coding Initiative (CCI) released version 16.0 earlier this week, revealing 24,060 [...] Related articles:

  1. CCI 15.1: Adhere to These Osteotomy, Laminectomy Edits You’ll need a modifier on this code pair to...
  2. CCI 15.2 Retracts Neurostimulator Edits from 15.1Look for new edits that affect eye exam codes, anesthesia,...
  3. CCI 15.3 Update: You Can Resubmit Dozens of Previously-Bundled 22526 ClaimsNewsflash: CCI 15.3 retroactively deletes hundreds of edit pairs, but...

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December 15, 2009
Cardiology / Hot Coding Topics

CPT 2010: Add New AV Shunt Codes to Your Toolbox

Initial vs. additional access matters in 2010. Love them or hate them, the trend toward guidance-inclusive codes doesn’t seem to be slowing. Case in point: CPT 2010 ousts 36145 (Introduction of needle or intracatheter; arteriovenous shunt created for dialysis [cannula, fistula, or graft]) and 75790 (Angiography, arteriovenous shunt [e.g., dialysis patient], radiological supervision and interpretation) and instead [...] Related articles:

  1. Neurosurgery Shunt Coding Chart Tip: You can report +62160 if your MD documents...
  2. What Interventional Radiology Coders Should Know About CCI 15.1 EXTRA–Radiology Reimbursement WEBINAR: Do you know the difference between...
  3. Where Anesthesia Coders Go Wrong With CS Cath Placement   Your doc needs to do this to get...

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December 13, 2009
Hot Coding Topics

Podiatry Coding Clinic: G0245 and G0246

Here’s when you may need to get an ABN Medicare policies covering routine foot care for diabetic patients suffering from peripheral neuropathy with loss of protective sensation (LOPS) have been in force since 2002. Yet many still find the related G codes confusing. Today, let’s nail down the what documentation should be in the podiatrist’s note [...] Related articles:

  1. Podiatry Coding Education: 28293 For Joint Replacement for Hallux LimitusQuestion: Our podiatrist performed a joint replacement for hallux limitus and...
  2. Charcot Foot Coding: When To Boot 250.00 Boot 250.00 for Charcot Foot, Embrace Dual Dxs Stop...
  3. Diabetes Coding Blunders That Cause Denials Do you know the 5 fourth digits for 250.xx...

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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:

  1. Diagnostic Radiology ICD-9 Code Update: New Mammo Code 793.82 New code 793.82 shakes up the whole 793.x range...
  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
E/M / Hot Coding Topics / modifier 26

ED Coding Education: FAST Exams

Watch It: If you fly through FAST exam coding, you could miss vital info When your physician performs a FAST (focused assessment by sonography for trauma) examination, be sure to go through the notes slowly or you could miss one of the three common codes. FAST exam patients are almost always in some physical trauma, which requires [...] Related articles:

  1. Coding for OB Ultrasounds and Annual ExamsCoding for OB Ultrasounds Are you confused about ultrasound coding?...
  2. Radiology Coding Education: Is 76705 OK for Back?Question: For a lower back ultrasound of a soft tissue...
  3. Pediatric PE Coding: Look Out for These Documentation Misses Here’s why oral thrush could be a major issue....

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December 2, 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
Hot Coding Topics

CPT 2010 Update: Laboratory & Pathology Coding

Stop using general codes for analyte-specific tests. Here’s why. You have 15 new codes scattered throughout the pathology/laboratory CPT chapter, so we’ll help you jump start your 2010 claims with this how-to inventory. “From chemistry to surgical pathology, you’ll find new codes in CPT 2010 that you need to know,” says Peggy Slagle, CPC, billingcompliance coordinator [...] Related articles:

  1. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...
  2. Match Pathology Report Keywords to Uterus Codes Common descriptions and diagnoses lead the way. Never again...
  3. Payer Update: NGS Directives Vs. Proper Skin Lesion CodingIgnore the LCD and stick with what you know about...

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November 29, 2009