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New From CPT Assistant: Help with Trunk Ultrasound Coding

Do you know exactly what’s in the mediastinum? Your US coding depends on it.
Current payer policy on imaging guidance is especially strict, so you don’t want to miscode any ultrasound (US) services your ED physician provides. CPT Assistant has recently published a Q&A set that will help you get all the reimbursement you deserve for US […]

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  2. Coding Ovarian Cyst Removal: Are You Making These 4 Mistakes?Here’s how you could potentially add $184 to your bottom…
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87324 Alert: Capture Extra $17 for C. Diff Toxin A & Toxin B

Question: We’ve gotten denials when we bill 87324 x 2 for two EIA tests for C. diff toxin A and toxin B. Can our lab code for tests for both toxins if we use the same lab method for both tests?
Answer: Yes, you can bill for both Clostridium difficile toxin A and toxin B if a physician orders the […]

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  3. This 4-Step Coding Process Grabs $125 Extra in Vasectomy-Related PaymentTurn to V25.x for your diagnosis code choice. Vasectomies are…
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Create Your Own Medical Necessity Quick Reference Tool

If you want to keep denials and compliance problems at bay, your claims must support medical necessity.
So retrofit your own, customized medical necessity quick power-reference tool with these tips from Sandy Nicholson, who taught some classes at the recent E/M Coding & Billing Conference in Orlando.
Step 1: Identify services which you provide for which CMS […]

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Spinal Surgery Coding Challenge: Is Hemilaminectomy Bundled With Fusion?

Question: Our orthopedic surgeon turned in a note that says, “Performed a bilateral hemilaminectomy with discectomy and foraminotomy for nerve decompression.Then I did a lumbar decompression with posterior lumbar interbody fusion and posterior lateral transverse fusion with pedicular screws.”
How should I report this? Is the hemilaminectomy bundled with the fusion?
Answer: No, you shouldn’t consider the […]

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Conquer In-Office Coumadin Coding, Easy as 1-2-3

Tip: Watch how you support medical necessity for warfarin therapy. Here’s where many coders make the wrong ICD-9 choice.
Don’t get stuck with the bill for your physician’s in-office monitoring of Coumadin use — instead, learn the Coumadin coding ropes. One surefire way is to follow these 3 guidelines.
1. Put Proper Code to Periodic PT Test
“Physicians often use […]

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Snag Lab Test Reimbursement With These Swine Flu Fast Facts

Experts reveal the best ICD-9 coding move, plus what you need to do beginning October 1.
If you’re one of the many labs performing influenza testing spurred by the World Health Organization’s (WHO) June 11 pandemic declaration for novel influenza A (H1N1), you need to read this.
Despite the Centers for Disease Control and Prevention (CDC) guidelines […]

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How Do You Code for a Metastatic Tumor?

Question: What is the difference between a primary and secondary neoplasm? I’m confused about which code to use for a metastatic tumor once the original tumor has been removed.
Answer: Continue to report the metastatic tumor as “secondary” even if the primary tumor has been eradicated.
Primary: A primary neoplasm code indicates the original tumor site.
Secondary: A secondary neoplasm indicates a site […]

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Assessment Tool: Is Your Practice Ready for EHR?

Be a hero. Figure out how you can get an extra $44K per physician in your practice.
As a coder, you’re where the buck stops when it comes to the practice’s bottom line. So, you’re no doubt wondering whether your practice should go for the $44,000-per-physician bonus payment available to practices that adopt electronic medical records […]

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Coding Challenge: Dermabond for Laceration Repairs

Question: The dermatologist treated an established patient with a cut on her lip and used Dermabond to close the 1.8-cm laceration. Should I use a laceration repair code when the only adhesive he used was Dermabond?
Answer: Your code choice will depend on the patient’s insurance. Check out these two coding options:
Patient has Medicare: If the […]

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Select the Correct V Code Every Time for Pediatric Well-Checks

Denials possible without separate ICD-9s for immunization admin, supply.
Do diagnosis coding choices for your FP’s preventive medicine services drive you batty?
Turns out there’s a one-stop solution for ICD-9 coding for a preventive medicine service with screenings or immunization administration — V20.2 for all. Save time assigning V codes by checking out these case studies.
Link Check, Screening to […]

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