Coder's Cranium / ICD-9 / MAC

ICD-9 Coding: Stop Asking ‘Which Diagnosis Code Will Get My Claim Paid?’

Assigning an ICD-9 code merely to get your claim paid could land you in legal hot water. Medical coders face a lot of questions each day in the course of their work, but one question you should not be asking is “which diagnosis code should I put on this claim if I want to collect?” When [...] Related articles:

  1. What’s the Correct Diagnosis Code for a Urine Drug Test?Question: What is the proper ICD-9 code when the lab...
  2. 3 Pulmonary Diagnosis Coding TipsRemember to focus on acute conditions & exacerbations. Correctly reporting...
  3. Dx Coding Moves That Stop Denials for Chronic Pain ClaimsTip: Code prior conditions in these cases. Imagine your pain...

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February 21, 2010
Hot Coding Topics / modifier LT / modifier RT / Oig

Coding Compliance: OIG Targets Transforaminal Epidural Injections

Verify that you’re counting injections and levels correctly to keep claims clean. The Office of Inspector General (OIG) Work Plan for 2010 includes a closer look at Medicare payments for transforaminal epidural injections. The Work Plan specifically states, “We will review Medicare claims to determine the appropriateness of Medicare Part B payments for transforaminal epidural injections.” Stay [...] Related articles:

  1. Save Time Coding Facet Injections With This Coding Tool Hint: Location, number and substance are key. Several factors...
  2. Anesthesia Coding Education: Combined Spinal EpiduralQuestion: Our anesthesiologists sometimes mark our C-section tickets as “combined...
  3. Trigger Point Injection Coding: Count Targets, Not Shots Become the top TPI gun in your coding department...

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February 17, 2010
CPT / ICD-9 / modifier 22 / modifier 52 / modifier 59 / Modifiers / surgery / Toolkit

8 Simple Steps Organize Your Op Note Coding

This aspect of op note coding is the “horse that pulls the cart.” Stuck on how to tackle this op note or those sitting on your desk? Follow this advice, provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M. and co-presenter of the “Ob-Gyn Op Notes” session at the [...] Related articles:

  1. 3 Steps Take the Guesswork Out of Coding Vaginal Cuff Repairs Find out what colporrhaphy code you’ll use for an...
  2. Write an Appeals Letter That Works In 6 Simple Steps Transform the written word into reimbursement with these tips...
  3. Op Note Coding Clinic: Breast Reconstruction with AlloDermSurgeons now commonly use AlloDerm in a variety of surgeries,...

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February 11, 2010
E/M / Provider News

E/M Audits: MAC Sets Up Pre-Pay Edit for Code 99310

87 percent error rate leads to drastic measures. If you think CMS is only watching your E/M codes when it comes to the office or hospital, think again. One MAC recently reviewed nursing facility care claims and was stunned at the findings. NGS Medicare, a Part B payer in four states, announced on Jan. 26 that it [...] Related articles:

  1. The Truth About Self-AuditsAnd one crucial step you should never miss. How many...
  2. E/M Challenge: Can I Report 99214 and +99354?Counseling representing more than 50 percent of E/M visit? Choose...
  3. CMS Will Offer New Modifier to Denote Admitting Physician on ClaimsPop the champagne cork & get ready for brand new...

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February 2, 2010
CCI / Hot Coding Topics / modifier 59 / mutually exclusive

Ob-Gyn CCI 16.0: Hysterectomy Coding

Here’s where you can bypass the edits with modifier 59. The Correct Coding Initiative (CCI) version 16.0 didn’t overlook the hysterectomy, vaginal graft, and colpopexy codes — nor should you. To make sense of the deletions, break these additions into mutually exclusive and non-mutually exclusive. Note: In all these cases — except those involving the anesthetic injection [...] Related articles:

  1. Hysterectomy Coding Simplified: Look at Weight, Removal Severing these ligaments clues you into whether ob-gyn removed...
  2. CCI 15.2 Retracts Neurostimulator Edits from 15.1Look for new edits that affect eye exam codes, anesthesia,...
  3. 3 Steps Take the Guesswork Out of Coding Vaginal Cuff Repairs Find out what colporrhaphy code you’ll use for an...

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January 22, 2010
Hot Coding Topics / modifier 58 / modifier 78 / modifier 79 / surgery

Second Surgery Coding: Tips for Modifier 58, 78 Success

Don’t let ‘unplanned’ lead to ‘unpaid.’ The next time a patient takes an extra trip to the operating room, don’t let the added service throw your coding off track. Keep these tips in mind to know when to assign modifier 78 – or something else. Check for Surprise Versus Planned Two modifiers pertain to follow-up trips to the [...] Related articles:

  1. Bone Up On ASC Orthopedic Coding With These Global Period, Modifier Tips 3 ways your physician claim better look different than...
  2. Global Billing: Document ‘Unrelated’ for Modifier 79 ServicesMACs are looking for ‘red flags’ to halt additional global period pay...
  3. Decision Chart: Modifier 78, 58, or 79?Simplify your post operative service claims with this nifty tool....

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January 19, 2010
Toolkit

Checklist: Collect Surgical Deductibles Up Front to Improve A/R

This 3-step checklist will boost your bottom line. With fewer patients following through on procedures because of economic and financial struggles, and an increasing number of patients not paying their bills, your practice needs to find ways to improve your A/R and bring in deserved money. Adapting an up-front deductible collection policy is one proven way [...] Related articles:

  1. Front Desk Data Tracking ChecklistClean data means more than just a healthy bottom line....
  2. Medical Billers: Test Your Collections Know-How Here This nifty tool tells you if collections cluelessness is...
  3. Time Your Surgical Collections Right by Referencing Payer Contracts Find out if you’re legal in collecting patient portion...

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January 16, 2010
Hot Coding Topics

PQRI 2010: Tips That Boost Your Practice’s Revenue

Follow our links and advice to put more plusses in your claims column Back again for 2010 is Medicare’s incentive-driven physician quality reporting initiative (PQRI), aimed at tracking quality metric or patient care services that physicians provide. When the practice treats enough patients in the same category, some PQRI dollars might be only a few codes [...] Related articles:

  1. Smokin’ PQRI Pointers We’ve got the G codes you need to score...
  2. PQRI: No Coumadin Due to Fall RiskPlus, experts at the AMA meeting in Chicago tell you...
  3. Accurate Diabetes ICD-9 Coding = PQRI BonusInternal medicine providers interested in a year-end bonus from Medicare...

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January 9, 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
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
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 / 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
Cardiology / Hot Coding Topics

CPT 2010: Add New AV Shunt Codes to Your Toolbox

Initial vs. additional access matters in 2010. Love them or hate them, the trend toward guidance-inclusive codes doesn’t seem to be slowing. Case in point: CPT 2010 ousts 36145 (Introduction of needle or intracatheter; arteriovenous shunt created for dialysis [cannula, fistula, or graft]) and 75790 (Angiography, arteriovenous shunt [e.g., dialysis patient], radiological supervision and interpretation) and instead [...] Related articles:

  1. Neurosurgery Shunt Coding Chart Tip: You can report +62160 if your MD documents...
  2. What Interventional Radiology Coders Should Know About CCI 15.1 EXTRA–Radiology Reimbursement WEBINAR: Do you know the difference between...
  3. Where Anesthesia Coders Go Wrong With CS Cath Placement   Your doc needs to do this to get...

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December 13, 2009
HCPCS / Pain Management / Provider News

Check New HCPCS Codes to Keep Pain Management Claims on Track

Catch the changes to botulinum toxin and neurostimulator electrode codes. As a pain management coder, you’re facing new CPT codes for posterior intrafacet implants, paravertebral facet joint injections, and sacroplasty. While preparing to implement these additions, don’t overlook HCPCS changes for botulinum toxin injections and implantable neurostimulator electrodes. Pay Attention to Botox Units A new code for botulinum [...] Related articles:

  1. Botox Wastage: How Do I Code It Correctly? Question: My pain management physician treated a patient’s migraine...
  2. HCPCS 2010: CMS Debuts New J CodesSynvisc, penicillin get new codes — along with injectibles for neurology,...
  3. Pain Management Coding: TPI Do’s and Don’ts for Pay You Can KeepSample ICD-9 codes to support medical necessity for trigger point...

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December 8, 2009
CPT 2010 / Hot Coding Topics

CPT 2010 Update: Tally Up Common Audiology Code Groups Into Single Codes

Plus, add this new tympanometry code to your cache next year. One of CPT 2010’s initiatives is to move several codes typically performed together into one code. Check out these new audiology testing codes and understand the rationale before Jan. 1 hits. For instance, if your physician performs a vestibular evaluation in 2010, you will report new [...] Related articles:

  1. Diagnostic Radiology ICD-9 Code Update: New Mammo Code 793.82 New code 793.82 shakes up the whole 793.x range...
  2. Can a Sleep Study Code Describe an Awake Test? Question: A sleep study was ordered for a patient...
  3. Bundle of His Recording Coding ChallengeQuestion: How should I report right atrial pacing and recording...

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December 5, 2009