Coding Challenge / ICD-9

What’s the Correct Diagnosis Code for a Urine Drug Test?

Question: What is the proper ICD-9 code when the lab performs a urine drug test? Answer: ICD-9 does not provide one specific code for a urine drug test. The correct diagnosis code to report when billing for the lab test depends on the signs, symptoms, patient condition, or other reason for the test, such as screening. [...] Related articles:

  1. Correct Coding for H1N1 (Swine Flu) Screening in the EDQuestion: A patient reports to the ED worried about a...
  2. Select the Correct V Code Every Time for Pediatric Well-ChecksDenials possible without separate ICD-9s for immunization admin, supply. Do...
  3. Should You Bill Injection With TB Test?Challenge: When a patient reports to the physician for a...

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October 19, 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
Coding Challenge

OB or Not OB: That’s the Ultrasound Coding Question

Question: For an ultrasound, the radiologist documented measurements of the uterus, endometrial complex, and ovaries. She noted no evidence of intrauterine pregnancy, no free fluid in the cul-de-sac, physiologic follicle formation, and positive Doppler flow in the ovaries. The patient had syncope but no confirmed pregnancy. Should I report an obstetric or nonobstetric ultrasound? Answer: Because the patient [...] Related articles:

  1. New From CPT Assistant: Help with Trunk Ultrasound Coding Do you know exactly what’s in the mediastinum? Your US...
  2. Double Ultrasound Codes Spell Double Trouble With AuditorsAuthorities scrutinize medical necessity for 76830 & 76856. The OIG...
  3. Which Ultrasound Code Is Best for Bladder Volume? Question: A urologist wants to bill for an ultrasound...

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October 17, 2009
Coder's Cranium

ASC Coding Education: Knee Diagnoses & Procedures

Choose this ICD-9 code if you see ‘jumper’s knee’ in the orthopedic surgeon’s note. Here’s a handy introduction to common ICD-9 codes related to the knee, along with examples of CPT codes for procedures physicians perform to treat knee diagnoses. Chondromalacia Patella Chondromalacia patella (717.7) is also known as “patellofemoral syndrome” or “runner’s knee.” This condition results when [...] Related articles:

  1. Orthopedic Coding Quick Start Guide: ASC Shoulder ProceduresShoulder ICD-9 and CPT codes you’ll most likely see in...
  2. Test Yourself: Total Knee Replacement (TKR) Coding Can you tackle an op note like this one...
  3. Anesthesia Coding Education: Sciatic Nerve Block & Same-Day General AnesthesiaQuestion: My anesthesiologist performed a sciatic nerve block for a...

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October 17, 2009
Toolkit

Toolkit: Chart Cardiology’s CCI 15.3 Changes At-a-Glance

Hang on to this handy table to avoid cath placement coding temptations. Correct Coding Initiative (CCI) 15.3 offered long lists of new edits, but we’ve boiled them down to the ones that affect cardiology coders and billers most. Cardiology Coders: A CCC™ Exam Prep Training Camp is coming to a city near you. Related articles:Take Heart, Cardiology Coders: CCI [...] Related articles:

  1. Take Heart, Cardiology Coders: CCI Deletions Overturn 93296 Denials Go back to the future. 3 months of denials...
  2. Glide Through Neoplasm Coding With This At-a-Glance GlossaryUnderstand primary and secondary malignancies before coding biopsies. Next time...
  3. Where Anesthesia Coders Go Wrong With CS Cath Placement   Your doc needs to do this to get...

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October 15, 2009
Hot Coding Topics / radiology

5 Lessons Radiology Coders Should Learn From CCI 15.3

Wonder if there’s a method to the 76001 madness? Here’s where to look for answers. The silver lining to the 18,000 Correct Coding Initiative (CCI) that just came rumbling in with CCI 15.3. Analyzing them can help you master radiology coding essentials — including follow-up CTs, fluoro, and more. Apply these five lessons to keep your claims looking [...] Related articles:

  1. CCI 15.0 Update for Radiology Coders 76942 and 78808 on a single claim needs a...
  2. What Interventional Radiology Coders Should Know About CCI 15.1 EXTRA–Radiology Reimbursement WEBINAR: Do you know the difference between...
  3. CCI 15.0 Update for Orthopedic Coders Consider Nerve Blocks, Injections Inherent to Most New Ortho...

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October 15, 2009
Audit / MAC / modifier GY / Provider News / RAC

A Physician Coder’s Guide to the 2010 OIG Work Plan

If your practice does lab panels, sleep studies, hospice visits and more, take heed. The HHS Office of Inspector General has published its 2010 Work Plan, which should give us all a heads up on what the watchdog agency will be auditing and evaluating this year. Why you should care: The 115-page document is like a map [...] Related articles:

  1. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...
  2. New PQRI, E-Prescribe Tool from CMS If your head is spinning with all of the...
  3. How Obama’s Medicare Cuts Hit Physician Reimbursement  The budget released Thursday suggests we cut $300 billion from...

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October 13, 2009
Coding Challenge

How Do You Code Sigmoidoscopy with Anoscopy, Biopsy?

Question: Notes indicate that the gastroenterologist performs a rigid sigmoidoscopy; during the encounter, he also performs an anoscopy without anesthesia and three biopsies of the mucous membrane. How should I report this episode? Can I report the exam separately with 46600? Answer: You can report a single code for these three services. On the claim, report 45305 (Proctosigmodoscopy, rigid; with biopsy, single or [...] Related articles:

  1. CPT 45380 Challenge: Endoscopy with BiopsyQuestion: My gastroenterologist performs mapping biopsies on patients who have...
  2. Looking for Tonsil Biopsy Code?Question: My physician did a punch excisional biopsy of the...
  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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October 13, 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:

  1. E/M Coding Focus: Geriatric Patients & DementiaDetermine HPI or ROS during assessment for geriatric patients. Your...
  2. Mid-Level E/M Coding BreakdownOur chart shows you how to choose among 99212, 99213 &...
  3. Test Your E/M Coding & Billing Savvy Are you an E/M Emeritus? Take this quiz to...

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October 12, 2009
Hot Coding Topics / modifier 54 / modifier 57

Fracture Care Coding: Mark Manipulation, Make $100+ More Per Encounter

No maybes here: Answer this question wrong and you will code incorrectly. When your ED physician performs fracture care for a patient, be ready to pounce on evidence of manipulation, as CPT often breaks fracture care codes along the manipulation line. The $kinny: Let’s say the physician performs closed treatment on a fractured collarbone; if she uses [...] Related articles:

  1. How Do I Code This Multiple Fracture Accident Patient?Question: A 30-year-old female presents to a rural ED with...
  2. Sort Out This ER, Then Assumed Care ScenarioQuestion: My orthopedist treated a patient who was first seen...
  3. Weber B Fracture Repair: 27786, 27788 or 27792?Question: Which CPT and ICD-9 codes should we report when...

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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...
  2. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...
  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
General

Revision of a Tricuspid Valve – Why is it necessary?

The tricuspid valve is the atrioventricular valve in the right hand section of the human heart, which regulates the flow of blood from the right atrium (top chamber) to the right ventricle (the bottom chamber).

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August 11, 2009
Provider News

More Health Care Services = Higher Costs

Private nursing homes now cost $10 more than it did last year.

You may have to allot more on long term care from your budget as the yearly survey by a financial firm has found its costs are continuously on...

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December 31, 1969