Think You Understand the New Consult Rules? Find Out Fast

Test your 2010 consultation coding understanding with these questions.
Consultation coding has every practice on edge this year. Ensure that you’ve got a handle on this complicated coding and billing situation by trying your hand at this question.
Question: When a visit with a Medicare inpatient that would normally have been coded as a consultation does not […]

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Give Your Radiosurgery or Gamma Knife Surgery Coding a Check-Up

Improve your reimbursement chances by applying modifier 58 in this situation.
When your surgeon targets the brain or spine with stereotactic radiosurgery (also called gamma knife surgery) to treat multiple lesions over multiple sessions, you need to know two crucial things: what stereotactic radiosurgery codes to use and how many units to include.
Take this three-question challenge […]

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Ob-gyn Challenge: Take the Pressure Out of a 3D US Coding

No severe problems? You may have trouble with reimbursement.
Question: The ob-gyn performed and OB ultrasound (US) on a patient. Can I bill 76376 in addition to the ultrasound if the ob-gyn used 3D?
Montana Subscriber
Answer: Yes. You can report a 3D procedure with 76805 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, […]

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Counseling Must Dominate Exception Claims For Seamless Payment

Choose the service level using the documented history, exam, and MDM.
Question: A new patient with a chronic gastric ulcer meets the gastroenterologist for management of her condition. The gastroenterologist meets for 34 minutes with the patient, and performs an expanded problem focused history and exam and straightforward medical decision making. The note also indicate that […]

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Set the Record Straight: ICD Code Options for COPD

What your pulmonologist writes in the documentation matters.
The pulmonologist’s documentation, along with the patient’s medical record can make or break your chronic obstructive pulmonary disease (COPD) reporting. One key is making sure that your coding accurately identifies the patient’s specific pulmonary condition and any other associated acute condition (if necessary).
Background: According to the National Heart […]

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Get Paid for EM Visits: How Much ROS Documentation Is Enough?

Caution: Keep enough paperwork on hand to back up EHR.
Transitioning to the world of Electronic Health Records (EHR) can make your coding easier on many levels, but don’t take it for granted. Physicians often fall short in their review of systems (ROS) documentation whether you use paper charts or rely on EHR, but you can […]

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Surgery Coding: Narrow Your Options for Birmingham Hip Procedure

Include this term in Box 19 to indicate the type of implant.
Question: One of our surgeons says we should use a total hip code for Birmingham resurfacing even if he doesn’t complete a total hip procedure; another physician says to use an unlisted code . What’s the correct answer?
Washington Subscriber
Answer: Both of your physicians could […]

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Red Alert, Cardiology Coders: Expect EP Study + Ablation Denials Until April 1

CMS won’t fix CCI blunder until version 16.1, to be released in the spring.
If your heart skipped a beat when you saw that January’s Correct Coding Initiative (CCI) edits bundled catheter ablations with electrophysiology (EP) studies, you weren’t alone.
Good news: CMS has decided to delete the edits retroactively because their addition was a mistake, according […]

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CMS Delays Ordering/Referring PECOS Regulation Until 2011

Take the extra time to get your practice registered in PECOS — don’t wait until the end of the year, CMS reps say.
Practices that were busily struggling to find out whether their ordering/referring physicians’ national provider identifiers (NPIs) were in the PECOS system can relax a little bit — at least until next year.
If your physician performs […]

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OIG Hit List: Perfect Your 38220, 38221, and G0364 Usage

Don’t sweat reporting 38220-59 if you meet these Medicare-approved conditions.
If your oncologist takes both a bone marrow biopsy and a bone marrow aspiration, whether you’ll see Medicare reimbursement depends on the two guidelines below. But watch out: With OIG scrutiny and a HCPCS twist, these guidelines will put your coding savvy to the test.
Append 59 […]

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