Toolkit

Keep All the Urodynamics Codes Straight With This Handy Cheat Sheet

Knowing the differences between the tests is your key to proper code choice. When your urologist says he performed urodynamics tests, you need to dig deeper into his documentation for clues about which code to report. Tack this overview up by your computer to help you quickly choose the right code every time. • In a simple [...] Related articles:

  1. Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics CodingUrodynamics income will go down by half, experts calculate. You will...
  2. CPT 2010 Update: Urogynecology CodingRemember, supervision requirements still apply to new codes. CPT 2010...
  3. Urology Coding: TURP, Urodynamics and Stone RemovalTURP 101: Use This Comprehensive Guide to Master TURP Coding...

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January 8, 2010
HCPCS / Oncology / Toolkit

Oncology Billing Toolkit: Factor 8 HCPCS Changes Into Your Superbill

Watch those Taxotere units, or kiss 95 percent of your reimbursement goodbye. A brand new list of HCPCS codes — including docetaxel and bevacizumab updates — goes into effect Jan. 1 and our 8-step superbill maintenance plan will stop denials in their tracks for 2010. Not using the proper codes will lead to claim rejection, which means “not receiving the proper [...] Related articles:

  1. 2 New HCPCS Codes for H1N1 Vaccine AdministrationPlus: New Bevacizumab code is effective Oct. 1. If you’re...
  2. Check New HCPCS Codes to Keep Pain Management Claims on TrackCatch the changes to botulinum toxin and neurostimulator electrode codes....
  3. Which HCPCS Code Should I Use for Eovist MRI contrast? Question: Which HCPCS code should I use to report...

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January 7, 2010
Audit / Hot Coding Topics / MAC / modifier 58 / modifier 78 / modifier 79

Global Billing: Document ‘Unrelated’ for Modifier 79 Services

MACs are looking for ‘red flags’ to halt additional global period pay Billing for additional services during a global surgery period is always tricky, but now you can expect special scrutiny for modifier 79 claims. After the OIG got wind of fraudulent surgery billing with modifier 79 (Unrelated procedure or service by the same physician during the postoperative period), CMS contractors have been on the hunt [...] Related articles:

  1. These 8 Services Are Not Part Of The Global Surgical PackageIf you’re not reporting these services separately, you’re losing money....
  2. Modifier Cheat Sheet: Banish Your E/M Modifier Phobias ForeverOnce you have this tool, you’ll never again wonder which...
  3. Bone Up On ASC Orthopedic Coding With These Global Period, Modifier Tips 3 ways your physician claim better look different than...

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January 7, 2010
Coding Challenge / radiology

Radiology Coding Challenge: Total Spine MRI Without Contrast

Question: Which CPT code should I use for a total spine MRI without contrast? Answer: You won’t find a single CPT code that describes a “total spine” MRI, but you may report a code for each region the radiologist examines: • 72141 — Magnetic resonance (e.g., proton) imaging, spinal canal and contents, cervical; without contrast material • 72146 — Magnetic resonance (e.g., [...] Related articles:

  1. Which HCPCS Code Should I Use for Eovist MRI contrast? Question: Which HCPCS code should I use to report...
  2. Radiology Coding Challenge: Rate Your Reformatting SkillsQuestion: My radiology report documents axial CT slices from the...
  3. Radiology Coding Challenge: Why is Medicare Denying a 38792, 78195 ClaimTip: Discover true meaning of 38792 note Question: The physician...

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January 5, 2010
Hot Coding Topics

CPT 2010 Update: Urogynecology Coding

Remember, supervision requirements still apply to new codes. CPT 2010 brings some big changes to urogynecology coding. Your urodynamics coding — and income — changes drastically as of Jan. 1. Get to Know These 3 New Complex Cystometrogram Codes You will have three new urodynamics codes to learn starting Jan. 1. CPT 2010 adds the following codes: • 51727 — Complex cystometrogram (ie, calibrated [...] Related articles:

  1. Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics CodingUrodynamics income will go down by half, experts calculate. You will...
  2. Keep All the Urodynamics Codes Straight With This Handy Cheat SheetKnowing the differences between the tests is your key to...
  3. 3 Mythbusters Overcome Your Urogynecology Bladder Scan Coding Troubles Uncover how you can bill a distinct E/M visit...

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January 5, 2010
Provider News

News from the Feds: Last-Minute MPFS Change & Proposed HITECH Rule

We’ve got the links you need to keep up with these bottom-line changers from HHS, CMS. While most of us were celebrating the last few days the Old Year and preparing to welcome the New Year, the federal regulators had one last, little rulemaking frenzy for 2009. The result is a 555-page proposed rule implementing the [...] Related articles:

  1. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open...
  2. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...
  3. ARRA Sharpens HIPAA’s TeethSurprise! The stimulus package gave us new HIPAA requirements that...

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January 5, 2010
Coding Challenge

How Do I Code An Arthroscopic To Open Ankle Surgery?

Question: Our surgeon attempted to remove a loose body in the ankle arthroscopically, but it was too large so he had to perform an open removal. Do I bill only for the open procedure, or include the arthroscopic attempt as a discontinued procedure? Answer: Because your surgeon completed the procedure as an open case, you’ll report [...] Related articles:

  1. 4 Tips Position Your ‘Multiple Scope’ Codes PerfectlyOrtho coders: Here’s what you should do when there’s no...
  2. Coding Challenge: Foot Foreign Body Removal Vs. Soft-Tissue FBRQuestion: Our physician performed a foreign-body removal (FBR) on a...
  3. Medicare Coverage for Bariatric Surgery: Do You Know These BMI Guidelines?Question: I heard that Medicare made some changes about diabetic...

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January 3, 2010
Coder's Cranium / ICD-10

A Medical Coder’s ICD-10 Resource Guide

We’ve got the link to a nifty ICD-9 to ICD-10 code translator. Maybe I’m getting old, but I just can’t believe we’re about to ring in the second decade of the 21st century. It seems like just yesterday I was toasting the new millennium and breathing a sigh of relief that “Y2K” wasn’t the big catastrophe [...] Related articles:

  1. The ASC Coder’s Resource Guide for 2010 Here’s a quick, handy way to get to all...
  2. A Coder’s Guide to Health Care ReformQuick way to show your practice you’re prepared for the...
  3. Medical Coder’s Modifier 25 Checklist Append 25 with the greatest of ease … Appending...

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December 30, 2009
CPT 2010 / Hot Coding Topics

2010 CPT General Surgery Coding Update: Changes for Lap, Abdominal Repair & Hemorrhoidectomy

Can you find codes in 2010’s resequencing mess? We show you how. Reporting your general surgeon’s service with an unlisted code means more documentation work and a payment guessing game — that’s why you’ll welcome CPT 2010’s more specific codes. General surgery can get all the details at this on-demand, specialty-specific audio update. But we won’t keep you in [...] Related articles:

  1. What’s the Code for Lap Hiatal Hernia Repair? Question: In accordance with the new laparoscopic hernia codes, does 49652...
  2. Multi-Laceration Repair Coding Case StudiesDo you know when to code repairs that occur in...
  3. Surgical Coding: Scar Revision on Previous Mastectomy SiteTip: Find mastectomy scar revision in wound repair Question: Our...

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December 30, 2009
Coding Challenge

How Do I Code Genetic Counseling By A Physician

Limit 96040 to Trained Counselor Question: May we report 96040 if our physician is performing genetic counseling? Answer: You should report 96040 (Medical genetics and genetic counseling services, each 30 minutes face-toface with patient/family) only for a trained genetic counselor’s services. (Currently, the American Board of Genetic Counselors [ABMG] certifies genetic counselors in the US and Canada.) [...] Related articles:

  1. E/M Coding: Support Higher-Level Family Counseling Sessions 7 V codes show why $55 more for a...
  2. How Do You Code for a Metastatic Tumor? Question: What is the difference between a primary and secondary...
  3. Time-Saving Forms for Coding Cessation CounselingWe’ve got the DAST, CAGE inks to help you make...

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December 20, 2009
Provider News / radiology

HCPCS 2010: Make Room for New MRI Contrast Codes A9581, A9583

AdreView gets its own ‘A’ code, too. You can leave confusing “not otherwise classified” codes behind for a few more of the contrast agents that you use. For services on or after Jan. 1, be sure you’re using the product-specific codes detailed below. Not using the proper codes will lead to claim rejection, which means “not receiving [...] Related articles:

  1. Which HCPCS Code Should I Use for Eovist MRI contrast? Question: Which HCPCS code should I use to report...
  2. HCPCS 2010: CMS Debuts New J CodesSynvisc, penicillin get new codes — along with injectibles for neurology,...
  3. Radiology Coding Challenge: Total Spine MRI Without Contrast Question: Which CPT code should I use for a...

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December 17, 2009
E/M / Hot Coding Topics / modifier AI

Ask 3 Questions to Head Off 2010 Consult Problems Before They Start

Ever used an unlisted E/M code? Get ready. By now, you’ve heard that CMS is doing away with all inpatient (99251-99255) and outpatient (99241- 99245) consultation codes in 2010 — but are you prepared for the issues this may cause, starting Jan. 1? Ask these three questions of your practice and payers, and you’ll fend off [...] Related articles:

  1. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...
  2. CMS Will Offer New Modifier to Denote Admitting Physician on ClaimsPop the champagne cork & get ready for brand new...
  3. OK to Code Debridement With Consult?Question: Can you charge for an inpatient consult and a bedside...

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December 17, 2009
Coding Challenge

Urology Reimbursement: Coding for MESA, TESA

Question: Could you please give me the most current coding guidelines for the MESA and TESA procedures? The last I was aware, we were to use unlisted procedure codes. Is that still correct? Answer: You should still use unlisted procedure codes to report microsurgical epididymal sperm aspiration (MESA) and testicular sperm aspiration (TESA, sometimes called TESE [...] Related articles:

  1. Urology Coding Challenge: Gold Seed Marker Placement Plus TRUS Question: How should I report the placement of gold...
  2. Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics CodingUrodynamics income will go down by half, experts calculate. You will...
  3. Wake Up Your Reimbursement By Capturing Sedation Pay Reporting CS with a ‘targeted’ service puts a denial...

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December 16, 2009
Medicare / Provider News

CMS Will Cover HIV Screening As Preventive Care Service

Bonus: Effective immediately! You’re probably accustomed to CMS taking away coverage for certain services, but in an early holiday gift to practices, CMS has actually added a preventive care service to its roster of covered screenings, effective immediately. CMS issued a final decision on Dec. 8 declaring that HIV testing will now be covered for Medicare beneficiaries [...] Related articles:

  1. Show Us the Money for Primary CareAlmost everyone agrees that federal and private insurers should reimburse...
  2. Colorectal Cancer Screening: A Medicare Coding & Billing FAQ Steer clear of G0121 denials with these tips. If...
  3. Good-Bye Fee-For-Service, Hello ‘Episodes of Care’It’s not like we’re going to go back to capitation...

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December 15, 2009
E/M / Hot Coding Topics / modifier 59

CCI 16.0: Now Allows a Modifier to Separate Hundreds of Edits

But other new bundles that 16.0 has in store might put a dent in your reimbursement. You may still be poring through your 2010 CPT manual, but the new edition of CCI, effective Jan. 1, is already looking to make some code pairings impossible. The Correct Coding Initiative (CCI) released version 16.0 earlier this week, revealing 24,060 [...] Related articles:

  1. CCI 15.1: Adhere to These Osteotomy, Laminectomy Edits You’ll need a modifier on this code pair to...
  2. CCI 15.2 Retracts Neurostimulator Edits from 15.1Look for new edits that affect eye exam codes, anesthesia,...
  3. CCI 15.3 Update: You Can Resubmit Dozens of Previously-Bundled 22526 ClaimsNewsflash: CCI 15.3 retroactively deletes hundreds of edit pairs, but...

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December 15, 2009
Coding Challenge / surgery

Surgical Coding: Scar Revision on Previous Mastectomy Site

Tip: Find mastectomy scar revision in wound repair Question: Our surgeon performed a scar revision on the site of a previous mastectomy. The procedure involved excising a 16.5 cm curved scar before performing a layered closure. How should we code this? Answer: You should use complex wound repair codes for the scar revision procedure that you describe. [...] Related articles:

  1. Surgical Coding Mysteries: The Case of the Separate MeshBeware Separate Mesh Removal Question: The surgeon performed the following:...
  2. Surgical Coding: Modifiers 58, 78, and 79SURGICAL MODIFIER CHOICES Surgery Modifier Choices are Key to Surgery...
  3. Partial Mastectomy Coding: 19302 Vs. 19301 Plus 38500 Here’s how you know when to include a lymph...

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December 14, 2009