Coding Challenge / E/M / modifier 25

Gastroenterology Coding Challenge: Repositioning a G Tube

Reading 44373’s code descriptor is key to getting your G Tube claim right. Question: The gastroenterologist goes to the hospital to treat a patient that had recently been admitted because his gastrojejunostomy tube had migrated to his stomach. After performing a problem focused interval history and exam, the gastroenterologist decides to perform an EGD to reposition the [...] Related articles:

  1. Gastroenterology Coding Education: Bravo Cap Placements Question: A new patient reports to the gastroenterologist with complaints...
  2. How Should I Code a Fibrinolytic Agent Instillation Via Chest Tube?Different calendar dates matter, but multiple instillations the same day...
  3. Winter Laceration Repair: How Do I Code For Dermabond?Warning: Your coding will vary depending on who’s getting the...

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February 7, 2010
Hot Coding Topics / modifier 25

Newborn Status Change Means Deciding Between Hospital Care Codes

Sort your normal, sick and intensive care options. Choosing the appropriate codes for initial newborn services can be difficult due to the large number of available codes and gray areas between the spectrum of illnesses. If you find yourself getting tripped up by the multiple categories, read on for expert tips and real-world examples that [...] Related articles:

  1. Must Hospital Admit Codes and Admission Show Same DOS? Overlook this rule, and risk leaving rightful E/M dollars on...
  2. Give Your Newborn Coding Skills a Checkup This directive stops the sending physician from committing an...
  3. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...

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February 4, 2010
E/M / Hot Coding Topics / modifier 25

Wound Closure Coding: Make the Simple, Intermediate Distinction

Accounting for depth is a tricky task when coding closure. Practices interested in ethically boosting their bottom line and getting $80 or more for the same closure repair need to walk the line that separates simple from intermediate. What Makes a Repair “Simple”? A wound closure is a simple repair if the procedure: is simple; is a single-layer closure involving [...] Related articles:

  1. Coding Education: Simple, Intermediate or Complex Closure?Correctly distinguish closure levels every time with this advice from...
  2. Simple Laceration Repair Code or E/M Code? Answer Could Cost Hundreds Not recognizing a laceration repair that’s included in an...
  3. Multi-Laceration Repair Coding Case StudiesDo you know when to code repairs that occur in...

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January 21, 2010
Coding Challenge / E/M / modifier 25 / modifier 50

How Do I Code a 2-Sided Nosebleed?

Heads up: 2 nosebleed codes are not the answer. Question: A patient reports to the ED after sustaining injuries during a soccer match; she was hit in the face with a ball, her nose is bleeding, and her right eye is blackened. The physician is not able to stop the bleeding with ice or pressure, so [...] Related articles:

  1. Is 30901 Your Nosebleed Code? Not So Fast?Hint: Look for these keywords in the note to select...
  2. Winter Laceration Repair: How Do I Code For Dermabond?Warning: Your coding will vary depending on who’s getting the...
  3. How Do I Code This Multiple Fracture Accident Patient?Question: A 30-year-old female presents to a rural ED with...

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January 19, 2010
Coding Challenge / modifier 25

Winter Laceration Repair: How Do I Code For Dermabond?

Warning: Your coding will vary depending on who’s getting the claim Question: A 60-year-old patient reports to the ED with a bandaged left hand. The patient says she was cleaning out the blades of her snow blower and cut her left index finger; the wound is wrapped in gauze, but it is reddening with blood. During [...] Related articles:

  1. Simple Laceration Repair Code or E/M Code? Answer Could Cost Hundreds Not recognizing a laceration repair that’s included in an...
  2. Coding Challenge: Dermabond for Laceration Repairs Question: The dermatologist treated an established patient with a...
  3. Does Dermabond Warrant Special Code? Question: A pediatrician uses Dermabond to close a patient’s...

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January 16, 2010
Coding Challenge / modifier 25

10060 Won’t Wash for Some I&Ds

Careful: A pilonidal cyst I&D is a separate animal. Question: A patient presents to the ED reporting pain in her spine. During the exam portion of a level-three E/M, the physician discovers that the painful area is red, and slightly warm to the touch. The patient also has a low-grade fever that she says she noticed about [...] Related articles:

  1. Winter Laceration Repair: How Do I Code For Dermabond?Warning: Your coding will vary depending on who’s getting the...
  2. Know What Separates FBR From E/M or Lose $80 in Pay Here’s why ‘incision’ with non-scalpel instrument could be an...
  3. Wound Closure Coding: Make the Simple, Intermediate DistinctionAccounting for depth is a tricky task when coding closure....

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January 14, 2010
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:

  1. Ophthalmology Coding: RT/LT or Modifier 50? Prevent Uni-Bi Reporting Errors With This Expert Insight Don’t...
  2. CIGNA Opens Black Box: Get Paid With Modifiers 25 & 59 You now have clear-cut policies to apply, including 1...
  3. Ophthalmology Coding: See Your Way to Clear Reimbursement for Eye Exams and Cataract SurgeryChoose the Right E/M or Eye Code to Optimize Reimbursement...

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October 31, 2009