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ICD-9 Coding: Stop Asking ‘Which Diagnosis Code Will Get My Claim Paid?’

Assigning an ICD-9 code merely to get your claim paid could land you in legal hot water.
Medical coders face a lot of questions each day in the course of their work, but one question you should not be asking is “which diagnosis code should I put on this claim if I want to collect?”
When […]

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E/M Coding: Don’t Sell Yourself Short on Problem Sports Exams

Tip: Time-based E/M might be in line when managing diabetes, asthma, ADHD.
Overlooking time as the key factor on a camp or sports exam in which the patient has a problem could cut $30 per claim.
Opportunity: An office visit (99201-99215, Office or Other Outpatient Services) using time as the key factor might be appropriate, but keep […]

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Optometry Coding: Stop 92081-92083 Denials in Their Tracks

Record visual fields interpretation and report the right way.
Visual fields are a compliance hot spot. Optometrists should use the visual field interpretation and report (I&R) to record what their thinking process was at that moment by recording any changes noticed, how the field compares to other testing like OCT (92135, Scanning computerized ophthalmic diagnostic imaging, […]

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Migraine ICD-9 Codes: How Do I Get My 5th Digits Right?

Discover what the 5th digit represents and why you need it on your claim.
Question: A presents to the ED with complaints of a headache that’s worsening daily. He is experiencing visual blurring and nausea but no vomiting. This is the third headache of this nature in three weeks, and it has lasted “four or five […]

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Burn Coding: Calculate Total Body Surface Area (TBSA)

Investigate your physician’s documentation to determine the body area percentage actually debrided.
Question: My anesthesiologist administered anesthesia for a burn excision on the leg of a middle-aged adult male, but he didn’t give clear notes on the patient’s affected body surface area. How do I code for this?
Kansas Subscriber
Answer: You will start by coding 01952 (Anesthesia […]

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Coding Compliance: OIG Targets Transforaminal Epidural Injections

Verify that you’re counting injections and levels correctly to keep claims clean.
The Office of Inspector General (OIG) Work Plan for 2010 includes a closer look at Medicare payments for transforaminal epidural injections. The Work Plan specifically states, “We will review Medicare claims to determine the appropriateness of Medicare Part B payments for transforaminal epidural injections.”
Stay […]

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Physician Fee Schedule Update: An Extension for the Temporary Conversion Fix?

Fear not: The CF may stay until autumn, but the current snow storm is delaying the official word.
Practices that were looking for a permanent change to the sustainable growth rate (SGR) formula before March 1 may come up empty-handed. However, Congress appears to be planning to offer an extension of the pay cuts that you’re […]

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Neurosurgery Coding: Previous Injury Means Multiple Dx Options

Find out what additional information V codes provide to the payer.
Question: We have a patient with previous spinal injury that is now causing neck pain. How should I code the diagnosis?
North Carolina Subscriber
Answer: Document and code prior conditions that contribute to a patient’s current complaint — if they affect the management of the current condition. Prior trauma, […]

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Use This Podiatry Scenario to Perfect Your Emerging Technology Claims

Hint: If you try to use an unlisted code, be sure your OP notes include this information.
If you don’t know the ins-and-outs of coding cutting edge procedures, you risk getting left in the dust as medicine continues to evolve. A new techniques, however, doesn’t always mean a new, corresponding CPT code. Check out this podiatry […]

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Factor Location and Depth into Foreign-Body Removals

Explore these three “what if” scenarios to perfect your FBR claims.
Your foreign-body removal (FBR) coding can vary greatly depending on the type of foreign body, its anatomic location, and the depth from which the physician must remove it. Here are three case studies to help you find your way.
Case 1: No Incision Means No Separate […]

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