October 2009 – Page 2

Closed Treatment of Fracture Great Toe – Codes 28490

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Does CNS Count as NP for Time-Based Coding?

CNS = NP = PA for CPT, but Check State Law
Question: Does a certified nurse specialist (CNS) count as a nurse practitioner (NP) for reporting 99213 based on time?

Answer: Yes, for CPT purposes, a certified nurse specialist billing under his own provider number counts the same as a nurse practitioner or physician assistant. So if […]

Asthma Attack Coding: When To Use Prolonged or High-Level E/M Checklist deters payback requests for insufficient +99354…
E/M Coding Basics: MDM Maximizes Payup for Hepatitis Diagnosis4 ways to get what your practice really deserves for…
Mid-Level E/M Coding BreakdownOur chart shows you how to choose among 99212, 99213 &…

Nonphysician Providers and Incident-To: Your Coding Questions Answered

Here’s why you should keep your physicians’ work schedules on file.
Correctly billing your nonphysician practitioners (NPPs) incident-to services means the difference between 85 and 100 percent reimbursement. But if you bill incident-to haphazardly, you’re just waving a red flag at auditors.
And those auditors are jonesin’ to find incident to billing problems. Just check out this […]

Nonphysician Providers & Incident To ChecklistCheck state laws PLUS this crucial document. In last week’s…
Steer Your Incident-To Coding Using These 4 Questions 100 percent pay possible if NPP follows internist’s care…
Use This Incident-To Checklist to Breathe Easy During an Audit You don’t need to second-guess the way you bill…

Will a CLIA Waiver Help Our Practice’s Bottom Line?

Question: During a practice meeting last week, the subject of Clinical Laboratory Improvement Amendments (CLIA) waivers came up. We are currently not CLIA-waived, and we will discuss it again at next month’s meeting. I was wondering if you could offer any input? Should we apply for a CLIA waiver?
Answer: Whether or not the waiver is […]

POLs: Here Are the New ‘CLIA-Waived’ ProceduresEffective April 1, physician office labs will be able to…
Does CNS Count as NP for Time-Based Coding? CNS = NP = PA for CPT, but Check…
Can’t Locate an H. Pylori Lab Test Code? 2 Clues Point the Way Solve CLO test culture code dilemma and other mysteries….

Double Ultrasound Codes Spell Double Trouble With Auditors

Authorities scrutinize medical necessity for 76830 & 76856.
The OIG is watching your ultrasound orders and code combinations — and it doesn’t like what it sees. Take note of these problem spots to keep your claims in the clear.
An OIG audit of ultrasound services billed in 2007 found that nearly one in five ultrasound claims “had characteristics that raise […]

OB or Not OB: That’s the Ultrasound Coding QuestionQuestion: For an ultrasound, the radiologist documented measurements of the uterus,…
New From CPT Assistant: Help with Trunk Ultrasound Coding Do you know exactly what’s in the mediastinum? Your US…
OIG Auditors to Cardiologist: You’re Billing Medicare ProperlyReport reveals what he and his billing staff did right….