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Checklist: Collect Surgical Deductibles Up Front to Improve A/R

This 3-step checklist will boost your bottom line.
With fewer patients following through on procedures because of economic and financial struggles, and an increasing number of patients not paying their bills, your practice needs to find ways to improve your A/R and bring in deserved money. Adapting an up-front deductible collection policy is one proven way […]

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10060 Won’t Wash for Some I&Ds

Careful: A pilonidal cyst I&D is a separate animal.
Question: A patient presents to the ED reporting pain in her spine. During the exam portion of a level-three E/M, the physician discovers that the painful area is red, and slightly warm to the touch. The patient also has a low-grade fever that she says she noticed about […]

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Radiology Coding: CPT 2010 Breathes New Life Into Your Respiratory Coding

Master 32561’s guidelines to prevent a major units gaffe.
Flip through the Surgery/Respiratory System section of your CPT 2010 manual, and you’ll see the coding committee has been hard at work adding to and revising your options. Discover the added cath removal code, the all new fibrinolytic agent instillation code, and the reshaped bronchoscopy descriptors, so […]

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ICD-9 Sequencing: Ace Late Effects Diagnosis Coding With This Flow Chart

Combination codes for stroke late effects won’t always cover all the details.
Proper sequencing is essential when coding for late effects, so use this handy chart to sequence your codes correctly every time.

Chart provided by Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates and CoDR — Coding Done Right in Denton, Texas.
For easy […]

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Payer Update: UHC Sticks With Consult Codes

Check with Medicaid plans, insurer warns.
You can breathe a sigh of relief — one major payer will stick with 99241-99255.
UnitedHealthcare (UHC) commercial plans will make no change in payment for consultation codes (99241-99255) at this time, according to a UHC e-mail alert. “Physicians may continue to submit claims for these services, and will be reimbursed according to United-Healthcare payment policies”.
Beware: One Medicaid […]

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CMS’s Refusal to Pay Consults Makes MSP Claims a Headache

If you bill consults to private payers, good luck collecting the balance from Medicare secondary payers.
Don’t even think about billing a consult to Medicare — even if it’s only a secondary payer claim. Medicare may have scratched consultations off of its list of payable services, but many other insurers did not follow suit. This leaves you in […]

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How Do I Bill For Follow-Up Visits After the Global?

Tip: Make sure the ICD-9 coding & documentation support follow-up visits after the global.
Question: Code 19101 has a 10-day global period, which means you cannot bill an E/M for anything related to that procedure within that time frame. If the patient continues to have follow-up visits outside the global period, should we then report the […]

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Radiology Coding Challenge: Why is Medicare Denying a 38792, 78195 Claim

Tip: Discover true meaning of 38792 note
Question: The physician performed a sentinel node injection with lymphoscintigraphy. A note with 38792 states to report 78195 for imaging. So why did Medicare deny a claim that included both codes?
Answer: You should report 78195 (Lymphatic and lymph nodes imaging) for this service and leave 38792 (Injection procedure; for […]

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PQRI 2010: Tips That Boost Your Practice’s Revenue

Follow our links and advice to put more plusses in your claims column
Back again for 2010 is Medicare’s incentive-driven physician quality reporting initiative (PQRI), aimed at tracking quality metric or patient care services that physicians provide. When the practice treats enough patients in the same category, some PQRI dollars might be only a few codes […]

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Keep All the Urodynamics Codes Straight With This Handy Cheat Sheet

Knowing the differences between the tests is your key to proper code choice.
When your urologist says he performed urodynamics tests, you need to dig deeper into his documentation for clues about which code to report. Tack this overview up by your computer to help you quickly choose the right code every time.
• In a simple […]

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