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Heart Cath Coding Education That Stops Denials

1 simple ‘cross the aorta’ rule keeps 93510 denials at bay.
Matching “left heart catheterization” to 93510 (Left heart catheterization …) may seem like an easy day’s work. But not so fast. The cardiologist must meet and document a crucial left ventricle requirement for you to choose this code. Work your way through this case study […]

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‘Coding Error’ Fools 600 Vets Into Thinking They Had ALS

You already know correct coding is crucial, but here’s an unexpected reason to keep your coder’s cranium in top-notch condition.
Because of what the U.S. Department of Veterans Affairs describes as a ‘coding error,’ 600 vets received letters that incorrectly led them to believe they had Lou Gehrig’s Disease, reports Associated Press. Reading something like that […]

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How Do I Code Defibrillator (AICD) Firing?

Question: A patient presented in our office and said that his defibrillator was firing. What diagnosis code is appropriate for this?

Answer: You’ll need a little more information on the cause of the firing to choose the proper code. Here are some specifics you need to ask about or look for in the note.
If the firing resulted from […]

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5 Rules Pinpoint Date of Service for Laboratory Claims

Tip 3: Here’s DOS advice for archived samples.
You can’t afford to get the date of service (DOS) wrong on claims that undergo CMS edits — mistakes could mean you’ll face fraud charges. That’s because Correct Coding Initiative (CCI) edits and Medically Unlikely Edits (MUEs) control payment for procedures on the same DOS.
But for pathologists, choosing the date […]

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Got Multiple Modifiers? How To Sequence Them on the Claim

Coders like to say that modifiers help them tell the story of what happened in the operating room, hospital, or doctor’s office. But what if the story you have to tell is very long and complicated?
Bookmark these 4 modifier ordering tips from Becki Geraud, CPC, CEMC, RCC, who presented at the Otolaryngology Specialty Coding Conference […]

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Which HCPCS Code Should I Use for Eovist MRI contrast?

Question: Which HCPCS code should I use to report Eovist MRI contrast?
Answer: You should verify the appropriate code with your payer, but the most likely option is A9579 (Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified [NOS], per ml).
Here’s why: HCPCS doesn’t currently offer a specific Eovist (gadoxetate disodium) code for physician claims. (Code […]

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4 Tips Position Your ‘Multiple Scope’ Codes Perfectly

Ortho coders: Here’s what you should do when there’s no ‘base’ procedure.
This week is the 400th anniversary of Galileo’s telescope, so let’s celebrate in our own small coding way and get our own scope coding correct.
If your physician performs several knee arthroscopies on the same patient on the same day, you’ll need to understand the […]

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MAC Auditors Will Stick It To Facet Joint Injection Claims

We hook you up with CMS instructions for when to use +64472, +64476 and when to use modifier 50.

Thanks to a 2006 OIG audit, MACs are on the lookout for incorrectly-billed facet joint injections, so it’s time to scrutinize your claims. Medicare guidelines are very strict about when you can append modifier 50 (Bilateral procedure) to a facet joint injection code — so […]

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Do I Use a Chemo Code for Zevalin Therapy?

Question: When I looked up Zevalin, I found out it’s a monoclonal antibody. Does that mean I should report a chemotherapy administration code for Zevalin therapy? CPT guidelines say chemo admin codes are correct for monoclonal antibodies.
Answer: Zevalin is a monoclonal antibody, and CPT does say chemotherapy administration codes are correct for “certain monoclonal antibodies.” […]

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A Coder’s Guide to Health Care Reform

Quick way to show your practice you’re prepared for the unknowns ahead.
If anyone should be able to understand the complicated health care reform debate raging in Washington, it should be us coders and billers, right? After all, we’re closest to what’s at the center of the debate: dollars and cents.
So, if you’re like me, you’ve […]

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