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Avoid Hospice Coding Headaches With Modifiers GV and GW

Differentiating between GV and GW is your first step.
If your urologist sees and treats hospice patients, you probably feel like you have to jump through hoops to get paid. The key to bringing in every hospice-related dollar your urologist deserves is ensuring you append the right modifier.
Base Modifier GV or GW Choice on Diagnosis
When reporting […]

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Oncology Coding: Day 1 of FOLFOX4 Regimen

Here’s the key to concurrent infusion coding.
Question: What are the appropriate codes for the first day of the FOLFOX4 regimen?
Answer: You should base your final coding decision on the documentation and the exact services your practice provides. But as a starting point, the FOLFOX4 regimen typically involves the patient receiving Oxaliplatin and folinic acid concurrently […]

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8 Simple Steps Organize Your Op Note Coding

This aspect of op note coding is the “horse that pulls the cart.”
Stuck on how to tackle this op note or those sitting on your desk? Follow this advice, provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M. and co-presenter of the “Ob-Gyn Op Notes” session at the […]

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Surgical Coding: Capture Extra Work for Choledochal Cyst

Discover these subsequent reconstruction codes.
Question: The surgeon treated a patient with a large choledochal cyst. The procedure involved an open cholecystectomy with en bloc excision of extrahepatic bile ducts (roux-en-Y reconstruction) with hepaticojejunostomy. What are the correct CPT and ICD-9 codes?
Answer: The correct ICD-9 code will depend on whether the patient has an acquired […]

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CMS Will Soon Issue Consult Code Replacement Advice, According to Open Door Forum

Plus: You can now download a list of all practitioners who can order/refer.
If you’ve been confused about how to report low-level hospital visits now that consult codes are gone, you aren’t alone. CMS intends to tackle this problem by issuing more specific guidance on the topic in the near future.
That’s according to a Feb. 2 […]

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Critical Care Coding FAQ: Become a Master of Time

Beware: CPT, CMS differ on ‘family discussion’ parameters.
When the physician treats a patient with a critical illness or injury, you need to know when to start and stop the critical care clock in order to avoid miscoding. Check out this FAQ to find out what’s part of critical care, what’s not, and how to correctly […]

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Collections: Banish Co-pay, A/R Problems

5 tips help you recover deserved pay.
Collecting money from patients, especially during a recession, can be challenging. If your front desk is responsible for collecting copays and sometimes old balances, its success or failure has a dramatic impact on the practice’s bottom line.
Check out five ways you can improve your front desk collection efforts:
1. When […]

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Gastroenterology Coding Challenge: Repositioning a G Tube

Reading 44373’s code descriptor is key to getting your G Tube claim right.
Question: The gastroenterologist goes to the hospital to treat a patient that had recently been admitted because his gastrojejunostomy tube had migrated to his stomach. After performing a problem focused interval history and exam, the gastroenterologist decides to perform an EGD to reposition the […]

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Oncology Coding: Update Your PET Claims With This New Guidance

Here are the requirements the exam must meet, according to Medicare.
If your PET claim meets certain requirements, you don’t need to append modifier Q0 (Investigational clinical service provided in a clinical research study that is in an approved clinical research study), according to MLN Matters article MM6753.
Effective for dates of service on or after Nov. […]

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Why Is the Co-Pay I Collected Short By $20?

Verify co-pay early to save time, money
Question: A patient came to our office for a routine exam with the same insurance card she’s had for years. We charged her the standard copay of record. Then I found out her employer changed the terms of the insurance, so the copay she paid was short by $20. […]

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