CMS Will Offer New Modifier to Denote Admitting Physician on Claims

Pop the champagne cork & get ready for brand new inpatient coding rules. With the changes to consult coding in 2010, it will be more important than ever to report hospital visits properly. In the past, only the admitting physician reported initial hospital care codes (99221- 99223), and specialists who saw the patient separately often billed inpatient [...] Related articles:

  1. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...
  2. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  3. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...

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Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics Coding

Urodynamics income will go down by half, experts calculate. You will have three new urodynamics codes to learn starting Jan. 1. CPT 2010 adds the following codes: • 51727 — Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique • 51728 — … with voiding pressure studies (ie, bladder voiding pressure), any technique • 51729 — … [...] Related articles:

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Surgical Coding Mysteries: The Case of the Separate Mesh

Beware Separate Mesh Removal Question: The surgeon performed the following: Made 10 cm supraumbilical transverse incision with 15-blade scalpel carried down through subcutaneous tissue using Bovie. Used combination electrocautery and blunted dissection to isolate area of scar tissue on patient’s right side. Noted sutures from previous umbilical hernia repair and mesh from right-lower abdominal hernia repair. Excised [...] Related articles:

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Lab Fee G Codes Crosswalk to CPT

Question: Did you get any info at the CPT 2010 conference about the “Table of Drugs and the Appropriate Qualitative Screening, Confirmatory, and Quantitative Codes” on page 386 CPT? This is brand new, and I need to learn about it. Answer: CMS created lab fee G codes to substitute for CPT codes due to concern [...] Related articles:

  1. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...

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AMA Symposium Report: Low-Level Consult Reporting in 2010

Hey, Coding News readers! It’s your turn to weigh in on the consult controversy. Question: What should you do for Medicare 2010 coding if an inpatient consult on a patient’s initial hospital day does not support 99221? Answer: Kenneth Simon, MD, MBA, FACS, CMS, senior medical officer at the CPT symposium was very adamant that you [...] Related articles:

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  3. OK to Code Debridement With Consult?Question: Can you charge for an inpatient consult and a bedside...

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Medicare’s Consult Rule Trickle Down Effect

And what it means for pediatric practices. A report from AMA in Chicago. Although CPT clarifies the transfer of care definition, the fix came too late for Medicare, meaning your private payers may follow suit. Continued Errors Result in E/M Boon The Office of Inspector General found a high error rate on consultation codes. Different opinions on when [...] Related articles:

  1. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...
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  3. AMA Symposium Report: Low-Level Consult Reporting in 2010 Hey, Coding News readers! It’s your turn to weigh...

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ED Coding Question: Observation or Other E/M Code?

Question: A 42-year-old patient reports to the ED early on Tuesday morning for evaluation of uncontrollable shaking in her extremities and severe pain in her neck. The EP admits the patient to observation at 7 a.m. and orders blood tests and a CT scan — however, the shaking continues to worsen. The EP consults with a [...] Related articles:

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Neonatal Critical Care Coding: CPT 2010 Clarifies Resuscitation Guidance

Payers denying 99465-25? Here’s help straight from the AMA Symposium in Chicago. Question: There’s a notation in the CPT 2009 manual that the neonatal critical care codes include delivery room resuscitation. Is this true? Answer: No, a parenthetical note following 99465 (Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute [...] Related articles:

  1. Bust 4 Myths About Pediatric Critical Care Services MYTHBUSTER: Codes 99291, +99292 apply to infants, young pediatric...
  2. Coding Critical Care? What You Can’t Bill SeparatelyAlthough there are some physician services you can report separately...
  3. Critical Care Coding Checklist Certain patient conditions could indicate 99291 service. Given the...

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Pain Management Coding: Endoscopic Lumbar Nerve Decompression

Hint: Think ‘unlisted procedure.’ Question: One of our physicians is looking into “endoscopic lumbar spinal nerve decompression.” One of the medical device representatives indicated he could bill it like the lateral extraforaminal approach for lumbar decompression, but I haven’t found much information. What’s your advice? Answer: Despite what you physician might have heard, your most appropriate choice [...] Related articles:

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  3. Anesthesia & Pain Management Denials: Sweep Them Away Now ‘Good Housekeeping’ tips that reduce denials. Tip 1: Beware...

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CMS at AMA Chicago: We’re Reducing Consult Request Requirement

CMS auditors will look for 1 less thing in consult documentation. With Medicare’s invalidation of consultation codes 99241-99255 in 2010, your ICD-9 codes better prove why two MDs are necessary on the same patient’s hospital care or the physician better specify why in his note. Separate ICD-9 codes will help substantiate the medical necessity for providing consultative [...] Related articles:

  1. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  2. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  3. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...

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PQRI: No Coumadin Due to Fall Risk

Plus, experts at the AMA meeting in Chicago tell you what to do if you can’t get H1N1 vaccine for PQRI Measure 110 or other vaccine measures. Question: My internist decided not to put a patient on Coumadin because the patient has a higher risk of falling than from having a stroke. Our group participates in [...] Related articles:

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Medicare Changes to 2010 CPT Inpatient Consultation Codes

Prevent 99251-99245 denials in 2010 with this checklist. Multiple physicians using the same hospital codes sounds like a recipe for denials, but that’s what Medicare is instructing physician inpatient consultants and care coordinators to do. Whether carriers will kick out these submissions as coordination of care or inpatient admit limiting admit edits is contractor specific, Charles [...] Related articles:

  1. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...
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  3. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open...

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2010 Tumor Excision Coding: Lesion Vs. Chunk Size

Straight from the AMA in Chicago — answers to your lesion excision coding questions for 2010. Question: A thigh lesion measures 2 cm but requires a resection down to the subcutaneous layer of 4 cm. Which lesion excision code should I use? Answer: “You should use the larger of the subcutaneous codes,” says Albert E. Bothe, Jr, [...] Related articles:

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Medicare 2010 CPT Consultation Code Changes

New rules for consult coding straight from the AMA Meeting in Chicago — plus where your practice will gain and lose reimbursement. If you can’t figure out how to match a low level consult to an initial hospital care code, you’re not alone. Code 99251 doesn’t crosswalk to 99221, agreed William J. Mangold, Jr., MD, JD, Noridian [...] Related articles:

  1. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. Consultation 5 R’s Miss 1 element, and invite auditors to check out...

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Is 30901 Your Nosebleed Code? Not So Fast?

Hint: Look for these keywords in the note to select the correct nosebleed code. Question: The internist stops a patient’s nosebleed. Is this always a procedure? Answer: No, if a patient reports with a nosebleed and the physician stops the bleeding with basic methods, you’ll typically opt for the appropriate-level E/M code. E/M methods: Code minimal attempts at [...] Related articles:

  1. Can You Code ‘Buddy Taping’ Separately? Question: An established patient complains of pain in her...
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From the AMA in Chicago: CPT 2010 Out of Order Codes

Here’s where you can find a full list of resequenced codes. Notice that new sign in your CPT book? No, that hash mark’s not to delete a message or to sign into a conference; it’s to alert you to an out of order code. The “#” works like a flashing yellow light: Slow down, there might be [...] Related articles:

  1. 2010 Tumor Excision Coding: Lesion Vs. Chunk SizeStraight from the AMA in Chicago — answers to your lesion...
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