CMS at AMA Chicago: We’re Reducing Consult Request Requirement

CMS auditors will look for 1 less thing in consult documentation.
With Medicare’s invalidation of consultation codes 99241-99255 in 2010, your ICD-9 codes better prove why two MDs are necessary on the same patient’s hospital care or the physician better specify why in his note.
Separate ICD-9 codes will help substantiate the medical necessity for providing consultative […]

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PQRI: No Coumadin Due to Fall Risk

Plus, experts at the AMA meeting in Chicago tell you what to do if you can’t get H1N1 vaccine for PQRI Measure 110 or other vaccine measures.
Question: My internist decided not to put a patient on Coumadin because the patient has a higher risk of falling than from having a stroke. Our group participates in […]

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Medicare Changes to 2010 CPT Inpatient Consultation Codes

Prevent 99251-99245 denials in 2010 with this checklist.
Multiple physicians using the same hospital codes sounds like a recipe for denials, but that’s what Medicare is instructing physician inpatient consultants and care coordinators to do.
Whether carriers will kick out these submissions as coordination of care or inpatient admit limiting admit edits is contractor specific, Charles […]

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2010 Tumor Excision Coding: Lesion Vs. Chunk Size

Straight from the AMA in Chicago — answers to your lesion excision coding questions for 2010.
Question: A thigh lesion measures 2 cm but requires a resection down to the subcutaneous layer of 4 cm. Which lesion excision code should I use?
Answer: “You should use the larger of the subcutaneous codes,” says Albert E. Bothe, Jr, […]

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