Coding Challenge / Pain Management

How Do I Code an Epidural Blood Patch on Same Day as L&D

Don’t forget to double-check these 2 things to find the correct code. Question: How do I code an epidural blood patch procedure on the same day as labor and delivery? Should I include a modifier? Answer: Administering a blood patch on the same day as labor and delivery is unusual because most physicians try to manage spinal [...] Related articles:

  1. 64450 or 64421: Which Code to Tap for TAP Block?Question: What exactly is a “tap block,” and what code...
  2. How Do I Code Blood Draw Plus E/M?Question: An established type II diabetic patient comes in for...
  3. Will S Code Pay Off for Cord Blood Collection?Question: My ob-gyn did cord blood collection. I have these...

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December 2, 2009
Coding Challenge / modifier 52 / multiple wake test

Can a Sleep Study Code Describe an Awake Test?

Question: A sleep study was ordered for a patient diagnosed with hypersomnolence. The neurologistincluded a multiple wake test in the sleep study. What CPT code should I use for the multiple wake test? Answer: You should use 95805 (Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during [...] Related articles:

  1. Protect Sleep Study Pay With These Documentation Essentials How to keep your polysomnography claims off Medicare’s hit...
  2. Sleep Study Reimbursement: How to Claim Your Piece of the Pie Medicare promises to cover facility and home-based testing —...
  3. CMS: Apnea is Key for Sleep Testing Coverage Medicare benes who suffer from obstructive sleep apnea (OSA)...

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November 29, 2009
Provider News

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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November 21, 2009
CPT 2010 / Hot Coding Topics

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:

  1. Urology Coding: TURP, Urodynamics and Stone RemovalTURP 101: Use This Comprehensive Guide to Master TURP Coding...
  2. Urology Coder’s ICD-9 2010 UpdateGet Ready Now for Urinary Diversion, Renal Disease Dx Changes...
  3. Is this Biopsy Mistake Costing Your Urology Practice $400 Per Claim? Tip: Look beyond the term ‘fulguration’ when you choose...

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November 21, 2009
BCBS / CPT / Hot Coding Topics / Medicaid

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...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. AMA Symposium Report: Low-Level Consult Reporting in 2010 Hey, Coding News readers! It’s your turn to weigh...

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November 18, 2009
Provider News

CMS Makes Key Changes to ABN Modifiers

We’ve got the new instructions you’ll need to follow. CMS will update the ABN modifiers effective April 1, according to MLN Matters article MM6563, dated Oct. 29. The ABN descriptors will read as follows: Modifier GA — Revised to read, “Waiver of liability statement issued as required by payer policy.” You’ll use this when a required ABN was issued. Modifier GX — [...] Related articles:

  1. CIGNA Opens Black Box: Get Paid With Modifiers 25 & 59 You now have clear-cut policies to apply, including 1...
  2. Still Using the Old ABN, NEMB Forms? Stop Now Surprise! Here’s when the new form puts you on...
  3. Got Multiple Modifiers? How To Sequence Them on the Claim Coders like to say that modifiers help them tell...

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November 10, 2009
Hot Coding Topics / modifier 26

Capture Separate CV Access Radiological Guidance

Don’t miss out on $20 per procedure when your surgeon performs central venous (CV) access device placements. If your physician uses fluoroscopic or ultrasonic guidance during the placement, you should separately report that service. We’ll show you how and tell you what modifier moves you need to make to prevent denials. Choose Between +76937 and +77001 If your [...] Related articles:

  1. Focus on Method to Ensure Proper Stereotactic Breast Biopsy CodingWatch out for the 77031 pitfall if the radiologist participates...
  2. Plantar Digital Nerve Coding Education: 64455 & 64632With these 4 tips, you’ll code clean claims every time....
  3. Cardiology Coding Question: Separate Reporting for 37204Question: Should I separately report right and left bronchial artery...

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November 4, 2009
Anesthesia / Hot Coding Topics / ICD-10 / Pain Management

Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010

Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready for a facet joint codes shift that preps for ICD-10. The 2010 version of CPT attempts to organize the facet joint injection codes by deleting 64470-64476 and debuting 64490- 64495 in their place, as follows: • 64490 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves [...] Related articles:

  1. MAC Auditors Will Stick It To Facet Joint Injection Claims We hook you up with CMS instructions for when...
  2. Audit Hot Spot: Facet Joint Injection ClaimsHere’s why the OIG wants to stick it to facet...
  3. Save Time Coding Facet Injections With This Coding Tool Hint: Location, number and substance are key. Several factors...

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October 28, 2009
CPT / modifier 22 / Provider News

Surgical Coding Update: 21930, 21931 & More Debut for CPT 2010

Tumor excision codes get specific. Will surgical oncology practices take a reimbursement hit? We’re starting to learn what new CPT codes we’ll be using come January 1, 2010. Coding News will keep you posted over the coming weeks, along with analysis from coding experts around the country so that you know what to expect for your practice’s [...] Related articles:

  1. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  2. 141 New ICD-9 Codes Debut for 2010 Like a passel of fresh-faced debutantes, the new ICD-9...
  3. Surgical Coding: Modifiers 58, 78, and 79SURGICAL MODIFIER CHOICES Surgery Modifier Choices are Key to Surgery...

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October 27, 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:

  1. 64450 or 64421: Which Code to Tap for TAP Block?Question: What exactly is a “tap block,” and what code...
  2. Anesthesia Coding: Unlisted Procedures, E/M and Nerve BlocksThere’s no denying that anesthesia coding is like no other...
  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
CMS / Hot Coding Topics / MAC

Medical Office Billing: 7 Ways to Escape Computer Claim Casualties

Pay attention to EOBs and keep talking to your MAC. You could be losing money to a computer glitch and not know it, experts say. If you don’t nip a computer glitch in the bud, you may be plagued with improper denials and other claim holdups. Here are seven things you can do to seek out and [...] Related articles:

  1. Coders: Watch Out for Claim-Denying Computer Glitches Don’t wait for your MAC to alert you to...
  2. Medical Office Billing: Benefits Verification, Copayment and Consolidated BillingIs Lack of Verification Costing Your Practice? Stop the Bleeding...
  3. Make Even Problem Payers Pay Up With These Tips From 2 ProsFollow this 3-step path and get results from every payer. At...

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October 21, 2009
Hot Coding Topics / modifier 54 / modifier 57

Fracture Care Coding: Mark Manipulation, Make $100+ More Per Encounter

No maybes here: Answer this question wrong and you will code incorrectly. When your ED physician performs fracture care for a patient, be ready to pounce on evidence of manipulation, as CPT often breaks fracture care codes along the manipulation line. The $kinny: Let’s say the physician performs closed treatment on a fractured collarbone; if she uses [...] Related articles:

  1. How Do I Code This Multiple Fracture Accident Patient?Question: A 30-year-old female presents to a rural ED with...
  2. Sort Out This ER, Then Assumed Care ScenarioQuestion: My orthopedist treated a patient who was first seen...
  3. Weber B Fracture Repair: 27786, 27788 or 27792?Question: Which CPT and ICD-9 codes should we report when...

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October 12, 2009
E/M / Hot Coding Topics

Watch Out for 3 Telephone Service Coding Pitfalls

Caution: You may need to incorporate the call into an in-office E/M service. If you’re reporting services your physician provides over the phone, but you’re not getting paid, the reason might be one of two things — you’re not following the coding rules surrounding the codes or your payer just isn’t paying for those services. Check out these [...] Related articles:

  1. Test Your E/M Coding & Billing Savvy Are you an E/M Emeritus? Take this quiz to...
  2. 5 Rules Pinpoint Date of Service for Laboratory ClaimsTip 3: Here’s DOS advice for archived samples. You can’t...
  3. This 4-Step Coding Process Grabs $125 Extra in Vasectomy-Related PaymentTurn to V25.x for your diagnosis code choice. Vasectomies are...

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October 10, 2009