Coding Challenge / E/M / modifier 25

Ophthalmology Coding: GDX, VF, & Temp Plugs — How Many Modifiers?

Question: A patient came in for a GDX and visual field (VF) tests. During the same visit, the ophthalmologist put in temporary plugs. Can we get paid for all services on the same day? I know the office visit needs a modifier. Do I need to put one on the GDX & VF, too? Answer: Provided the [...] Related articles:

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October 31, 2009
Anesthesia / Coding Challenge / modifier 59

Anesthesia Coding Education: Sciatic Nerve Block & Same-Day General Anesthesia

Question: My anesthesiologist performed a sciatic nerve block for a patient with postoperative pain on the same day he provided general anesthesia for that patient’s knee surgery. How should I code this? Answer: Use modifier 59 (Distinct procedural service) when you need to show that your physician performed two distinct services on the same day. When [...] Related articles:

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  3. Plantar Digital Nerve Coding Education: 64455 & 64632With these 4 tips, you’ll code clean claims every time....

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October 21, 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:

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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:

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October 12, 2009