What Lab Coders Need to Know About CCI 16.0

Look for transcutaneous hemoglobin limitations, and bundling for those new 2010 culture codes.
Think you’re ready to use all those brand new CPT lab codes? Not so fast. You better learn Correct Coding Initiative (CCI) restrictions first, before you start billing Medicare for services using new CPT 2010 codes.
CCI released version 16.0, effective Jan. 1, which includes 24,060 […]

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E/M Challenge: Can I Report 99214 and +99354?

Counseling representing more than 50 percent of E/M visit? Choose level based on time.
Question: I have a family physician who documented 60 minutes on an established patient’s office visit. The FP diagnosed the patient with morbid obesity (278.01). Since the patient was newly diagnosed and had some difficulty understanding the doctor’s orders, the FP spent […]

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Orthopedic Coding Clinic: Labral Tears

10-2:00 in the op note signals SLAP lesion repair.
Even experts can land on the wrong ICD-9 code for SLAP lesion repair, but visualizing the injury region as a clock will help you distinguish one type of SLAP (superior labral anterior posterior) tear from another.
Research Patient History for Accurate Diagnosis
Having a solid understanding of anatomy and […]

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Surgery Coding Challenge: Master Microsurgery Units With This Advice

Check your EOB to make sure payers don’t apply a multiple-procedure reduction to +69990.
Question: When my ENT uses a microscope during a procedure, what guidelines can I use for choosing between 92504 and +69990? Is there a rule governing how many times you can report the add-on code 69990?
Answer…
You can use 92504 (Binocular microscopy [separate […]

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Want to Integrate PQRI Measures Into Your Practice? Look Here.

Participation can put extra bread in your basket.
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 away.
If you know the basics […]

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How Should I Code a Fibrinolytic Agent Instillation Via Chest Tube?

Different calendar dates matter, but multiple instillations the same day do not.
Question: My pulmonologist inserted a chest tube and then instilled a fibrinolytic agent to break up multiloculations to free up an entrapped lung. Usually, I use 32560 for this procedure, which is for pleurodesis, not fibrinolysis. What code should I use for fibrinolytic agent […]

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Pick the Right ICD-9, ICD-10 Code for Postmenopausal Abnormalities

Do N95.0 and N95.2 look foreign? Get your ob-gyn ICD-10 equivalents now.
Spare yourself denial hot flashes by taking this three-part postmenopausal abnormality scenario challenge.
Fill In These Blanks Using Your ICD-9 Book
Question 1: Your ob-gyn sees a post menopausal patient with an inflamed vagina because the tissues are thinning and shrinking. The ob-gyn notes decreased vaginal […]

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Audits: HDI RAC Targets TC, Modifier 26 & More

Want to know what RAC contractors will be looking for next? Here’s the link.
Recovery audit contractors (RACs) are working hard to expand their lists of approved issues, and you should keep a close eye on your services in these areas as well.
Health Data Insights (HDI), the RAC contractor for Region D, posted 66 new approved […]

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Ophthalmology Coding Challenge: Flashers & Floaters

How’s Your EO Coding & Billing? Test Yourself With This Scenario.
Question: A patient reports flashes and floaters but the ophthalmologist does not find evidence of retinal pathology on routine ophthalmoscopy. Are we justified in billing for extended ophthalmoscopy (EO)?
Answer: If the ophthalmoscopy is a routine part of a patient’s eye exam, do not […]

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