CodingConferences Coding Changes Top Tips from Editor Leigh Delozier

600 coders, physicians, and office managers gathered in Orlando, Fla. for one and a half jam-packed days of education, networking, and shopping at the December 2011 Coding Update and Reimbursement Conference. Coders’ biggest struggle was absorbing all the information – and not overdoing the holiday buying. Experts offered the inside scoop on medical coding changes for 2011 and beyond. Here are my top picks:

  1. E-prescribing is here to stay – and is about to be more strictly enforced. Physicians need to e-prescribe at least 10 medications for patients during the first 6 months of 2011, or they’ll be added to the list for a 1% penalty hit in 2012. “The prescriptions can be for one patient ten different times, or can be spread out among different patients,” said Marvel Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, in “Take Steps Now to Prepare for 2011 Pain Management Changes”.  “For pain management practices, the prescriptions can be for any type of pain meds.”
  2. Three PQRI measures apply to anesthesia providers: timing of prophylactic antibiotic (measure 30); maximal sterile barrier technique (measure 76); and active warming/temperature (measure 193). You have three reporting options: measure 76 alone; measures 76 and 193; or measures 30 and 76 said Judith Blaszczyk, RN, CPC, ACS-PM. “You must report on 80% of qualifying cases,” she reminded during her workshop, “Take Steps Now to Prepare for 2011 Anesthesia Changes.”
  3. No matter how many years you’ve been coding, you’ve heard, “ICD-10 is on the way.” Now that it’s looming as a reality, take a deep breath and know that you’ll be OK. “We learned to use ICD-9, and we’ll learn to use ICD-10,” Kelly Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I, said in “Diagnosis Coding for Anesthesia”. “We can do this! We are not afraid.”

This…

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2 Tips Lead to Modifier 22 Success Every Time

Watch frequency and provide documentation to rationalize extra pay.

Applying modifier 22 (Increased procedural services) can help increase reimbursement if your neurosurgeon documents a greater-than-usual effort during a surgical service. To ensure your claims’ success, surgeons and coders must also…

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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 […]

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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 […]

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Pain Management Coding: TPI Do’s and Don’ts for Pay You Can Keep

Sample ICD-9 codes to support medical necessity for trigger point injections.
Counting the right items, knowing insurer-allowed diagnoses, and documenting affected muscles will get your trigger point injection (TPI) claims paid while protecting you from paybacks.
Further, knowing each insurers’ covered diagnoses for TPIs is vital to healthy coding.
√ Do Count Muscles Injected
Coders should report 20552 (Injection[s]; single […]

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