• 209-337-5705

How Do I Code This Multiple Fracture Accident Patient?

Question: A 30-year-old female presents to a rural ED with several injuries after the all-terrain vehicle she was driving overturned. During a level-five ED E/M service, the physician diagnoses a fractured metacarpal shaft in her left hand and a fractured left femur. The ED physician provides closed manipulative treatment for each fracture. How should I […]

Related articles:

  1. Weber B Fracture Repair: 27786, 27788 or 27792?Question: Which CPT and ICD-9 codes should we report when…
  2. Sort Out This ER, Then Assumed Care ScenarioQuestion: My orthopedist treated a patient who was first seen…
  3. Solve Op Note Mysteries With This Fracture Glossary CPT code selection is easier if you know your…
Read More »

Plantar Digital Nerve Coding Education: 64455 & 64632

With these 4 tips, you’ll code clean claims every time.
CPT 2009 introduced two new codes for plantar common digital nerve procedures, giving you better choices than the “other nerve” options you previously resorted to. Now that you have more specific codes in your arsenal, however, be sure you know their ins and outs for success.
1. […]

Related articles:

  1. Anesthesia Coding: Unlisted Procedures, E/M and Nerve BlocksThere’s no denying that anesthesia coding is like no other…
  2. 3 Painless Tips for Headache-Related Nerve BlocksWatch out with 64400 and 64405. Pain management coders: If…
  3. CCI 15.0 Update for Orthopedic Coders Consider Nerve Blocks, Injections Inherent to Most New Ortho…
Read More »

CCI 15.3 Update: You Can Resubmit Dozens of Previously-Bundled 22526 Claims

Newsflash: CCI 15.3 retroactively deletes hundreds of edit pairs, but institutes over 18,000 new bundles.
If you thought Correct Coding Initiative (CCI) had left no stone unturned in bundling moderate sedation, think again. CCI’s version 15.3, which takes effect Oct. 1, continues the trend, bundling 99148-99150 into most of the other CPT codes, and no modifier […]

Related articles:

  1. News Flash: Over 300,000 New Code Pair Edits from CCIExtra! CCI also creates a few welcome deletions. If you…
  2. CCI 15.1: Adhere to These Osteotomy, Laminectomy Edits You’ll need a modifier on this code pair to…
  3. CCI 15.2 Retracts Neurostimulator Edits from 15.1Look for new edits that affect eye exam codes, anesthesia,…
Read More »

CMS COVERAGE DECISIONS: MACs Can Make Exceptions to LCDs

RACs can make exceptions only to approve claims.
Coders know local coverage decisions are known as Medicare’s “final say. If the LCD makes a statement, you can count on your MAC to never veer from that rule. That’s about to change.
CMS has opened the door to giving MACs some wiggle room in adhering to LCDs. Transmittal 302, issued […]

Related articles:

  1. Sneak a Peek at the RACsWith the Recovery Audit Contractor (RAC) program back in business,…
  2. CMS Issues Corrections to 2009 Physician Fee Schedule Final RuleIt’s that time of year again — time to get…
  3. CMS: Apnea is Key for Sleep Testing Coverage Medicare benes who suffer from obstructive sleep apnea (OSA)…
Read More »

Podiatry Coding Education: 28293 For Joint Replacement for Hallux Limitus

Question: Our podiatrist performed a joint replacement for hallux limitus and thinks we should report 28293. I disagree because the patient does not have a bunion. How should we code this procedure?
Answer: CPT does not include a code for hallux arthroplasty with implant, so it’s time to turn to unlisted codes.
Your best option is to report 28899 (Unlisted […]

Related articles:

  1. Bone Up On ASC Orthopedic Coding With These Global Period, Modifier Tips 3 ways your physician claim better look different than…
  2. MAC Auditors Will Stick It To Facet Joint Injection Claims We hook you up with CMS instructions for when…
  3. Plantar Digital Nerve Coding Education: 64455 & 64632With these 4 tips, you’ll code clean claims every time….
Read More »

How Do I Code Suspected Lyme?

Question: Our lab processes a blood specimen using a direct probe technique for a patient with suspected Lyme disease from a tick bite. How should we code the case?
Answer: Report the lab test as 87475 (Infectious agent detection by nucleic acid [DNA or RNA]; Borrelia burgdorferi, direct probe technique), because Borrelia burgdorferi is the causative organism that you’d test […]

Related articles:

  1. Snag Summer Tick-Related Case Dxs With Insect Fast Facts Think a tick is venomous? That error will land…
  2. Coding Challenge: Prior Cancerous Biopsy, But No Residual Tumor Question: We received a mastectomy specimen based on a…
  3. Correct Coding for H1N1 (Swine Flu) Screening in the EDQuestion: A patient reports to the ED worried about a…
Read More »

Test Yourself: Total Knee Replacement (TKR) Coding

Can you tackle an op note like this one we got our hands on? Relax. We help you break it down into 3 steps.
Although you may be accustomed to TKR op notes, an unusual case might send you into a panic. Take a deep breath, and we’ll have you breezing through the challenges that atypical TKR […]

Related articles:

  1. Coder’s Anatomy: What does a knee arthroscopy LOOK like?Yes, it’s true. The feds have some goodies that can…
  2. PRC Coding: Put Your Finger on Proximal Row Bones Question: Our surgeon performed a proximal row carpectomy (PRC)…
  3. Steer Clear of This Modifier 22 Mistake Question: Our orthopedist did a right knee arthroscopy with…
Read More »

RAC Fact: Watch Out For Medicare’s Once-in-a-Lifetime Services

G0389 & the IPPE codes may be potential RAC targets
If you’ve been sweating it out, waiting for the recovery audit contractors (RACs) to announce where they’ll be focusing their audit efforts, you may or may not be relieved to know two RAC contractors have posted the areas they’ll have their eye on. More on that below …
Both lists include […]

Related articles:

  1. RAC Fact Did you know that those new RAC auditors out…
  2. Audit Fact Did you know that auditing for overpayments is a…
  3. Medicare Will Pay for Some Telehealth Services: The Lowdown on How to Report Them If you’re confused about whether Medicare covers telehealth services, look no…
Read More »

Gastroenterology Coding Education: Bravo Cap Placements

Question: A new patient reports to the gastroenterologist with complaints of frequent belching and heartburn. After performing a level-two E/M service, the gastroenterologist performs a diagnostic EGD.
During the EGD, she also inserts a Bravo capsule and performs a reflux test. Tests came back negative for both cancer and gastroesophageal reflux disease (GERD). How should I code this scenario?
Answer: You should be able […]

Related articles:

  1. Cardiology Coding Education: Pacemaker Lead Check Question: The cardiologist documented testing pacemaker leads using fluoroscopy…
  2. Coder’s Anatomy Double-Take: What is NERD? Question: In the doctor’s notes, it states the patient has…
  3. 3 Mythbusters Overcome Your Urogynecology Bladder Scan Coding Troubles Uncover how you can bill a distinct E/M visit…
Read More »

The Truth About Self-Audits

And one crucial step you should never miss.
How many ticking time bombs are waiting in your medical records?
If you don’t audit your charts regularly, you’ll never know. But even the most thorough set of audits could come to nothing if your staffers believe they’ll lose their jobs if you uncover a problem in an audit.
Reality: “Internal audits (or those conducted by the […]

Related articles:

  1. Audit Fact Did you know that auditing for overpayments is a…
  2. E/M Codes Top the List of CERT Mistakes, CMS SaysWith almost $600 million reported improperly, physicians didn’t document their…
  3. Got 9? Self-Audit ChecklistIf you don’t know quite where to begin when you…
Read More »
Share on facebook
Share on twitter
Share on linkedin
Share on whatsapp

Most Popular: