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Oncology Billing Toolkit: Factor 8 HCPCS Changes Into Your Superbill

Watch those Taxotere units, or kiss 95 percent of your reimbursement goodbye.
A brand new list of HCPCS codes — including docetaxel and bevacizumab updates — goes into effect Jan. 1 and our 8-step superbill maintenance plan will stop denials in their tracks for 2010.
Not using the proper codes will lead to claim rejection, which means “not receiving the proper […]

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Global Billing: Document ‘Unrelated’ for Modifier 79 Services

MACs are looking for ‘red flags’ to halt additional global period pay
Billing for additional services during a global surgery period is always tricky, but now you can expect special scrutiny for modifier 79 claims.
After the OIG got wind of fraudulent surgery billing with modifier 79 (Unrelated procedure or service by the same physician during the postoperative period), CMS contractors have been on the hunt […]

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Radiology Coding Challenge: Total Spine MRI Without Contrast

Question: Which CPT code should I use for a total spine MRI without contrast?
Answer: You won’t find a single CPT code that describes a “total spine” MRI, but you may report a code for each region the radiologist examines:
• 72141 — Magnetic resonance (e.g., proton) imaging, spinal canal and contents, cervical; without contrast material
• 72146 — Magnetic resonance (e.g., […]

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CPT 2010 Update: Urogynecology Coding

Remember, supervision requirements still apply to new codes.
CPT 2010 brings some big changes to urogynecology coding. Your urodynamics coding — and income — changes drastically as of Jan. 1.
Get to Know These 3 New Complex Cystometrogram Codes
You will have three new urodynamics codes to learn starting Jan. 1. CPT 2010 adds the following codes:
• 51727 — Complex cystometrogram (ie, calibrated […]

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News from the Feds: Last-Minute MPFS Change & Proposed HITECH Rule

We’ve got the links you need to keep up with these bottom-line changers from HHS, CMS.
While most of us were celebrating the last few days the Old Year and preparing to welcome the New Year, the federal regulators had one last, little rulemaking frenzy for 2009. The result is a 555-page proposed rule implementing the […]

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How Do I Code An Arthroscopic To Open Ankle Surgery?

Question: Our surgeon attempted to remove a loose body in the ankle arthroscopically, but it was too large so he had to perform an open removal. Do I bill only for the open procedure, or include the arthroscopic attempt as a discontinued procedure?
Answer: Because your surgeon completed the procedure as an open case, you’ll report […]

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