Medicare clears up confusion surrounding ‘8-hour rule.’
Reporting your FP’s observation services can be tricky business, as there is confusion about how, when, and why to choose from one observation code set or another.
Add to that a common misconception...
Don’t separately report a cursory H&P from the sleep code.
Question: If a nurse practitioner (NP) performed an H&P (history and physical exam) or a subsequent visit with a patient prior to a sleep study, can you bill the H&P...
Don’t let ‘wrong surgery’ modifier mistakes stall your reimbursement.
You use modifier TC for the technical component of a test. So logically, you should use modifier PC for the professional component, right? Wrong. But many coders are making that mistake...
Find out what steps Congress must take to delay the much feared 21.2 percent pay cut.If a new bill — already approved by the Senate — moves forward, you could have another six months before the 21.2 percent...
In MSP cases, non-consult code for both payers may be best.
If you have payers who didn’t play follow-the-leader with Medicare in cutting out consult codes, you have a dilemma on your hands. You have to decide what to do...
Measuring total removal lengths is a no-no … here’s why.
Your ED physician removes a pair of benign lesions from the patient’s left thigh; you add the repair lengths and code based on those numbers. You’ve coded correctly … right?…
Find out which you can report separately: a tunneled or a non-tunneled line.
Question: What code should we bill when we remove a central venous pressure (CVP) line and insert a Hickman catheter at a different site?
New York Subscriber…
Knowing how to use add-on codes can net you up to $258 in additional reimbursement.
CPT is full of “add-on” codes, additions to minor and major surgical procedures as well as to E/M services. Fortunately for urology there are not…
Attach your procedure notes and the OIG’s report to pack extra punch.
Even if you follow all of CMS’s rules in reporting modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the…
Make sure your documentation supports the additional substantial complexity of the hernia repair and mesh.
Question: A patient presented for a colectomy for colon cancer. The physician also discovered that the patient had a ventral incarcerated hernia that required a…
Bonus: Get exposure to ICD-10 coding equivalents.
Question: A mentally-challenged patient who delivered at home was admitted to the hospital for postpartum care. The patient delivered the placenta at home, and once admitted, she had no complications, but the ob-gyn…
Focus on form and drug to pinpoint the correct asthma supply code.
Are you clear on how to report asthma procedures and inhalers? Follow this advice, and you’ll breathe easy when it comes to asthma related claims.
Propellant-Driven Inhaler Falls…
A revised GA and new GX hope to clarify some of Medicare’s non-coverage policies.
At least one aspect of dealing with Advance Beneficiary Notice of Non-Coverage (ABN) forms is about to get a little simpler, thanks to two modifiers.
CMS…
You may need to append modifier 25, depending on payer policies.
Question: Our physician billed 90634, 90710, and 90606 for vaccines given to a 5-year-old patient. The insurance company denied payment and said they required a modifier. What should we…
Medicare’s elimination of payment for consultation services has caused mass confusion throughout the coding community, not just due to the changes it has caused in your billing procedures, but also due to lack of information from CMS.
In an apparent…
Understand ‘significant’ and ‘separate’ to earn a gold star.
Knowing when to report modifiers and choosing the best one for each situation can be an easy trip-up for coders. If you find yourself especially befuddled…