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
Coder's Cranium / modifier 22

2 Tips Lead to Modifier 22 Success Every Time

Watch frequency and provide documentation to rationalize extra pay.

Applying modifier 22 (Increased procedural services) can help increase reimbursement if your neurosurgeon documents a greater-than-usual effort during a surgical service. To ensure your claims’ success, surgeons and coders must also...

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April 15, 2010
Hot Coding Topics

Use Shared Visit to Capitalize on NPP/Physician Teamwork

Forget about incident-to in the facility, but consider this similar billing technique.

ED coders that have never heard of “incident-to” billing have nothing to worry about, as you cannot code for “incident-to” services in the hospital. Coders that don’t understand...

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March 25, 2010
CMS / Hot Coding Topics / modifier PA / modifier PB / modifier PC / modifier TC / Modifiers / surgery

Surgical Modifiers: Protect Yourself From Instant ‘PC’ Claim Denials

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...

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March 18, 2010
Coding Challenge

Pulmonology Coding Challenge: Why Are My 94664 Claims Getting Denied?

Before coding 94664, check off these items. Question: Under the direction of my pulmonologist I recently submitted 94664 for reimbursement for training time, but the bill was rejected? Can I challenge this? Answer: You can challenge training denials, provided your documentation supports the education’s reason. However, “not all payers will pay for 94664,” notes Gary N. Gross, [...] Related articles:

  1. Surgery Coding Challenge: Master Microsurgery Units With This AdviceCheck your EOB to make sure payers don’t apply a...
  2. 52214 Coding Challenge: Fulguration, Then TUIBNCQuestion: If my physician went to do a TUIBNC and...
  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 21, 2010
Toolkit

Test Yourself: ICD-9 2010 for Ob-Gyn Coders

Is your ob-gyn practice using the new codes correctly? 3 quick questions say for sure. This year, ICD-9 2010 brought new hyperplasia, mammogram, and fertility preservation codes. In some cases, these codes simply expanded on existing options, and it’sup to you to spot when you should report the new versus old alternatives. Dig in to [...] Related articles:

  1. What Diagnosis Code Do I Use for a Fern Test?Ob-Gyn Coding Tip: Scan for leukorrhea signs when fluid is...
  2. Are You Up For ICD-9 2010? Quick Quiz Says For Sure Surgery Coders: These 5 questions reveal if you need an...
  3. Prostate Specific Antigen (PSA) Test Coding Tips Make sure you know when to support your coding...

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November 29, 2009
CMS / CPT / Medicare / Provider News

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...
  2. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  3. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open...

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November 13, 2009
Coding Challenge / radiology

Radiology Coding Education: Is 76705 OK for Back?

Question: For a lower back ultrasound of a soft tissue mass, which CPT code is appropriate? Answer: Code 76705 (Ultrasound, abdominal, real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) is appropriate for this lower back ultrasound. Although the code descriptor states “abdominal” and not “back,” CPT Assistant (May 2009) clarifies that 76705 is appropriate [...] Related articles:

  1. New From CPT Assistant: Help with Trunk Ultrasound Coding Do you know exactly what’s in the mediastinum? Your US...
  2. Double Ultrasound Codes Spell Double Trouble With AuditorsAuthorities scrutinize medical necessity for 76830 & 76856. The OIG...
  3. 5 Lessons Radiology Coders Should Learn From CCI 15.3Wonder if there’s a method to the 76001 madness? Here’s...

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November 2, 2009
CPT / Hot Coding Topics

New CPT Codes for Cardiac CT, Imaging Appear for 2010

Plus: Say goodbye to two perfusion codes. If you’ve ever wondered whether Medicare actually pays attention to CPT’s Category III codes, the AMA offers an answer with the release of the new codes included in CPT 2010. First and foremost, CPT will delete the Category III cardiac computed tomography (CT) imaging codes 0144T-0151T and replace them with [...] Related articles:

  1. Cardiac Anesthesia Workshop: Coding for TEE Discover if your transesophageal echocardiography (TEE) anesthesia is payable...
  2. 2010 CPT Category II & III Codes You Might Miss Yes, our CPT books are fountains of knowledge, but...
  3. Break Down Outpatient ESRD Into These G-Code Mirroring Cat I Codes We tell you the inpatient dialysis codes that trigger...

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October 27, 2009
Toolkit

Toolkit: Chart Cardiology’s CCI 15.3 Changes At-a-Glance

Hang on to this handy table to avoid cath placement coding temptations. Correct Coding Initiative (CCI) 15.3 offered long lists of new edits, but we’ve boiled them down to the ones that affect cardiology coders and billers most. Cardiology Coders: A CCC™ Exam Prep Training Camp is coming to a city near you. Related articles:Take Heart, Cardiology Coders: CCI [...] Related articles:

  1. Take Heart, Cardiology Coders: CCI Deletions Overturn 93296 Denials Go back to the future. 3 months of denials...
  2. Glide Through Neoplasm Coding With This At-a-Glance GlossaryUnderstand primary and secondary malignancies before coding biopsies. Next time...
  3. Where Anesthesia Coders Go Wrong With CS Cath Placement   Your doc needs to do this to get...

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October 15, 2009
Hot Coding Topics / radiology

5 Lessons Radiology Coders Should Learn From CCI 15.3

Wonder if there’s a method to the 76001 madness? Here’s where to look for answers. The silver lining to the 18,000 Correct Coding Initiative (CCI) that just came rumbling in with CCI 15.3. Analyzing them can help you master radiology coding essentials — including follow-up CTs, fluoro, and more. Apply these five lessons to keep your claims looking [...] Related articles:

  1. CCI 15.0 Update for Radiology Coders 76942 and 78808 on a single claim needs a...
  2. What Interventional Radiology Coders Should Know About CCI 15.1 EXTRA–Radiology Reimbursement WEBINAR: Do you know the difference between...
  3. CCI 15.0 Update for Orthopedic Coders Consider Nerve Blocks, Injections Inherent to Most New Ortho...

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October 15, 2009