Provider News

CMS Changes Conversion Factor Yet Again

Plus: Look for an increase in your DEXA scan reimbursement.

The bad news: Your carrier won’t be paying your claims using the conversion factor of $36.0846 anymore.

The good news: CMS is only changing the conversion factor by less than a penny, making it $36.0791, according to CMS Transmittal 700, issued on May 10. MACs will use this 2010 conversion factor to calculate your payments, but keep in mind that after May 31, you’re still due to face a 21 percent pay cut unless Congress intervenes. Keep an eye on the Insider for more information on whether Congress steps in...

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May 16, 2010
Coding Challenge

Pay Attention to Button TURP Technique

Be careful — the similarity to a laser procedure may deceive you.

Question: My urologist is performing a new procedure called a “button TURP.” I thought 52601 or 53852 might be correct, but now I’m thinking an unlisted procedure code may be more appropriate. What code should I use for this procedure?

California Subscriber

Answer: You should report 52601 (Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete [vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included]) for the button transurethral resection of the prostate (TURP) procedure.
Why: The button TURP is a bipolar...

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May 13, 2010
Audit / Provider News

Auditors Review Your Notes Based on the Regs as of the Service Date

auditorIf you performed a consult in 2006, the auditor will use 2006 guidelines — not today’s rules.

Most Part B practices have grown accustomed to tucking consult regulations into the backs of their minds, since Medicare no longer pays for...

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May 12, 2010
Hot Coding Topics

Breathe Easy Knowing You’re Updated on Common Spirometry Tests

He's breathing easier!Hint: You might not need as many codes on the claim as you expect.

CPT 2010 lists several codes for spirometry testing under “Other Procedures” in the Medicine section. The next time you’re faced with determining the best code for...

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May 11, 2010
Medicare / Toolkit

Recognize a Write-Off in 6 Steps

Save this option for when other collection methods have failed.

You’ve offered discounts, payment plans, and more,but you still haven’t received payment from a patient. You may be forced to do a write-off at this point, says Steve Verno, CMMC,...

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May 9, 2010
Coding Challenge / E/M / modifier 25

Ensure Counseling Claims With Pointed Questions

This modifier is key to E&M and counseling codes cohabiting on your claim.

Question: Can I report alcohol cessation counseling codes along with E/M codes, or do I have to choose one or the other?

Idaho Subscriber

Answer: You can,...

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May 9, 2010
Anesthesiologist / Hot Coding Topics / modifier 52 / modifier 53 / modifier 73 / modifier 74 / Pain Management

Employ Modifier 53 For Discontinued Anesthesia Services

Pain management specialties might make use of modifier 52 as well.

The situation is bound to happen: A patient undergoing surgery has complications, and your anesthesiologist must stop his services. Are you prepared to recognize a situation that calls for...

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May 9, 2010
Provider News

AAPC National Conference Location Changed to Jacksonville, FL

Get the latest from the National AAPC CEO and President, Reed Pew.

To all registered AAPC conference participants:

We have chosen Jacksonville, Florida to relocate our conference due to the extent of the flooding in Nashville, TN. It will be...

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May 6, 2010
Anesthesia / Hot Coding Topics / ICD-9 / MAC

Unlock Pay With Anesthesia V Code Advice

Don’t be caught asleep: Patient history is one element of proper Dx coding.

Many coders hesitate to report V codes, or simply use them incorrectly, but sometimes this section of ICD-9 most accurately describes the reason for the patient’s condition....

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May 6, 2010
Coding Challenge / E/M / modifier 90

Medical Coders: Use 36415 for Lab Draws

You have two options depending on the next step.

Question: Our vascular office performs blooddraws and analysis for a local hospital. Can we bill for a lab draw in an office setting, and if so, what codes should we use?...

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May 5, 2010
CMS / Hot Coding Topics / ICD-9

CMS Announces Over 100 New ICD9 Codes, Effective Oct. 1

Get ready for the dawn of new jaw pain, BMI codes, among others.

If you’ve got high hopes that you’ll benefit from many new ICD-9 codes starting this fall, CMS delivers, with over 130 new diagnosis codes debuting on Oct....

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May 5, 2010
Coding Challenge / Medicare / modifier

Append Modifier Q6 for Fill-In Physician

Before using modifier Q6 for a non-Medicare patient, check with the commercial payer — here’s why.

Question: We hired a locum tenens for two weeks. Do we code the same for the replacement physician as for a full-time...

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May 2, 2010
Coder's Cranium

Watch Key Conditions to Scratch Eye Allergy Coding Itch

Get the specifics on eye irritation to find the most accurate diagnosis code.

The spring allergy snap will be here soon. Be prepared to treat and code eye irritations to recoup all your deserved reimbursement with this advice from the...

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May 2, 2010
Hot Coding Topics / modifier 25

3 Situations Boost Your Migraine Treatment Smarts

Acute episodes, check-ups are both routine for these patients.

When migraine headache coding comes up, ICD-9 codes typically dominate the conversation.

But what about the procedure codes those complicated migraine diagnoses are attached to? There are several common situations in...

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May 2, 2010