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:

  1. Urology Coding: TURP, Urodynamics and Stone RemovalTURP 101: Use This Comprehensive Guide to Master TURP Coding...
  2. Urology Coder’s ICD-9 2010 UpdateGet Ready Now for Urinary Diversion, Renal Disease Dx Changes...
  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
BCBS / CPT / Hot Coding Topics / Medicaid

Medicare’s Consult Rule Trickle Down Effect

And what it means for pediatric practices. A report from AMA in Chicago. Although CPT clarifies the transfer of care definition, the fix came too late for Medicare, meaning your private payers may follow suit. Continued Errors Result in E/M Boon The Office of Inspector General found a high error rate on consultation codes. Different opinions on when [...] Related articles:

  1. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. AMA Symposium Report: Low-Level Consult Reporting in 2010 Hey, Coding News readers! It’s your turn to weigh...

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November 18, 2009
CPT 2010 / Hot Coding Topics

PQRI: No Coumadin Due to Fall Risk

Plus, experts at the AMA meeting in Chicago tell you what to do if you can’t get H1N1 vaccine for PQRI Measure 110 or other vaccine measures. Question: My internist decided not to put a patient on Coumadin because the patient has a higher risk of falling than from having a stroke. Our group participates in [...] Related articles:

  1. Smokin’ PQRI Pointers We’ve got the G codes you need to score...
  2. Make Sure These Errors Don’t Sink Your PQRI BonusCMS shows which issues sidelined these practices. Most practices would...
  3. Track Payer’s Preferred H1N1 Admin Code — or Risk RejectionsCode 488.1 does not = confirmed lab. Swine flu has...

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November 13, 2009
CPT / Hot Coding Topics

2010 Tumor Excision Coding: Lesion Vs. Chunk Size

Straight from the AMA in Chicago — answers to your lesion excision coding questions for 2010. Question: A thigh lesion measures 2 cm but requires a resection down to the subcutaneous layer of 4 cm. Which lesion excision code should I use? Answer: “You should use the larger of the subcutaneous codes,” says Albert E. Bothe, Jr, [...] Related articles:

  1. Lesion Excision Coding Challenge: 2 Lesions, 1 CutQuestion: Our nonphysician practitioner (NPP) discovers a pair of benign...
  2. Shave Duplicate Lesion Excision Denials Question: Our dermatologist shaved three epidermal lesions that the...
  3. Payer Update: NGS Directives Vs. Proper Skin Lesion CodingIgnore the LCD and stick with what you know about...

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November 13, 2009
CPT / Hot Coding Topics / Medicare

Medicare 2010 CPT Consultation Code Changes

New rules for consult coding straight from the AMA Meeting in Chicago — plus where your practice will gain and lose reimbursement. If you can’t figure out how to match a low level consult to an initial hospital care code, you’re not alone. Code 99251 doesn’t crosswalk to 99221, agreed William J. Mangold, Jr., MD, JD, Noridian [...] Related articles:

  1. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. Consultation 5 R’s Miss 1 element, and invite auditors to check out...

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November 12, 2009
CPT 2010 / Hot Coding Topics

From the AMA in Chicago: CPT 2010 Out of Order Codes

Here’s where you can find a full list of resequenced codes. Notice that new sign in your CPT book? No, that hash mark’s not to delete a message or to sign into a conference; it’s to alert you to an out of order code. The “#” works like a flashing yellow light: Slow down, there might be [...] Related articles:

  1. 2010 Tumor Excision Coding: Lesion Vs. Chunk SizeStraight from the AMA in Chicago — answers to your lesion...
  2. Lesion Excision Coding Challenge: 2 Lesions, 1 CutQuestion: Our nonphysician practitioner (NPP) discovers a pair of benign...
  3. Radiology Billing Checklist: Rules for Additional Tests without Treating Physician’s OrderKeep these additional test rules at your fingertips if your...

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November 11, 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...

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November 7, 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...

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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....

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November 3, 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...

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November 1, 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...

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October 28, 2009
CPT / Hot Coding Topics

New CPT Codes for Cardiac CT, Imaging Appear for 2010

Plus: Say goodbye to two perfusion codes. If you’ve ever wondered whether Medicare actually pays attention to CPT’s Category III codes, the AMA offers an answer with the release of the new codes included in CPT 2010. First and foremost, CPT will delete the Category III cardiac computed tomography (CT) imaging codes 0144T-0151T and replace them with [...] Related articles:

  1. Cardiac Anesthesia Workshop: Coding for TEE Discover if your transesophageal echocardiography (TEE) anesthesia is payable...
  2. 2010 CPT Category II & III Codes You Might Miss Yes, our CPT books are fountains of knowledge, but...
  3. Break Down Outpatient ESRD Into These G-Code Mirroring Cat I Codes We tell you the inpatient dialysis codes that trigger...

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October 27, 2009
Audit / Hot Coding Topics / Oig / RAC / radiology

Double Ultrasound Codes Spell Double Trouble With Auditors

Authorities scrutinize medical necessity for 76830 & 76856. The OIG is watching your ultrasound orders and code combinations — and it doesn’t like what it sees. Take note of these problem spots to keep your claims in the clear. An OIG audit of ultrasound services billed in 2007 found that nearly one in five ultrasound claims “had characteristics that raise [...] Related articles:

  1. OB or Not OB: That’s the Ultrasound Coding QuestionQuestion: For an ultrasound, the radiologist documented measurements of the uterus,...
  2. New From CPT Assistant: Help with Trunk Ultrasound Coding Do you know exactly what’s in the mediastinum? Your US...
  3. OIG Auditors to Cardiologist: You’re Billing Medicare ProperlyReport reveals what he and his billing staff did right....

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October 24, 2009
CMS / Hot Coding Topics / MAC

Medical Office Billing: 7 Ways to Escape Computer Claim Casualties

Pay attention to EOBs and keep talking to your MAC. You could be losing money to a computer glitch and not know it, experts say. If you don’t nip a computer glitch in the bud, you may be plagued with improper denials and other claim holdups. Here are seven things you can do to seek out and [...] Related articles:

  1. Coders: Watch Out for Claim-Denying Computer Glitches Don’t wait for your MAC to alert you to...
  2. Medical Office Billing: Benefits Verification, Copayment and Consolidated BillingIs Lack of Verification Costing Your Practice? Stop the Bleeding...
  3. Make Even Problem Payers Pay Up With These Tips From 2 ProsFollow this 3-step path and get results from every payer. At...

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October 21, 2009
Audit / Hot Coding Topics / Oig

Service Doesn’t Meet Incident-To Rules? Report Under NPP’s NPI

Heads up: These vaccine admin codes are excluded from incident-to requirements. Incident-to rules don’t always apply to diagnostic services, but many medical practices aren’t aware of that. And based on a new wave of scrutiny directed toward incident-to claims, you should know physician supervision rules inside and out. A recent audit from the HHS Office of the Inspector [...] 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. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...

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October 20, 2009
Hot Coding Topics / MAC

Coders: Watch Out for Claim-Denying Computer Glitches

Don’t wait for your MAC to alert you to an error — be on the lookout for them. If you’ve been losing reimbursement to computer hiccups at your carrier, you’re not alone. Earlier this year, thousands of Medicare recipients in one state were wrongly told their benefits were being cut by $300 — but the state decided not to notify those affected with a letter. Instead, the state only told [...] Related articles:

  1. Medical Office Billing: 7 Ways to Escape Computer Claim CasualtiesPay attention to EOBs and keep talking to your MAC....
  2. Modifier 22 Moves for Ob-Gyn CodersThis U/S tactic will save you time — and add money...
  3. 15% More Pay Awaits Coders Who Can Max Out NPP BenefitCorrectly code NPP’s hospital services, or you’ll sell the practice...

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October 17, 2009