Modifier Cheat Sheet: Banish Your E/M Modifier Phobias Forever

Once you have this tool, you’ll never again wonder which modifier applies to minor vs. major procedures.
If you’re often mixing up your E/M modifiers, then print this post and hang it near your desk. You’ll be sure to apply the appropriate modifier every time.
Pick Modifier 24 for Post-Op Cases
When you report modifier 24 (Unrelated evaluation […]

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97597 or 11040 for Partial Thickness Excisional Debridement?

Question: Encounter notes indicate that the physician performed a partial thickness excisional debridement of a patient’s wound. Should I use 97597 or 11040 for this service?
Answer: Since the physician performed the debridement and the notes indicate that it was an excisional debridement, you should report 11040 (Debridement; skin, partial thickness) for the service.
Key: Physician role should […]

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Pssssssst. Payer Report Cards Are Out

If you know your payers’ strengths and weaknesses, you’re better equipped to fight denials and negotiate contracts that are in your best interest.
So check out the American Medical Association’s second annual National Health Insurer Report Card. The AMA has gathered data and rated large payers on criteria like payment timeliness, accuracy, claim edit sources and denials, […]

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Diabetes Coding Blunders That Cause Denials

Do you know the 5 fourth digits for 250.xx you should avoid?

A diabetes diagnosis code shows up on millions of dollars worth of claims each year, and that number is climbing rapidly. Make sure you code correctly to get every penny your practice deserves for managing the disease and treating manifestations and related conditions.
Diabetes […]

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Coding From Home

Medical coding is the process that involves allocation of different codes to procedures and diagnosis used by doctors and surgeons in the health care industry. These codes are very helpful in the process of reimbursement of doctors as well as patients.

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Coding Critical Care? What You Can’t Bill Separately

Although there are some physician services you can report separately from critical care, watch out. There are many services you can’t unbundle from critical care, including:

cardiac output measurements (93561, 93562)
chest x-rays (71010, 71015, 71020)
pulse oximetry (94760, 94761, 94762)
information data stored in computers (such as electrocardiograms, blood pressures, hematologic data, etc.)
blood gasses
gastric intubation (43752, 91105)
temporary transcutaneous […]

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