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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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Eye Surgery Coding Challenge: Denials for 15823 & 67904

Question: I started receiving denials for 15823 and 67904. To report this combo, should I use a modifier?
Answer: If the ophthalmologist performs the blepharoplasty (bleph) with excessive weight (15823, Blepharoplasty, upper eyelid; with excessive skin weighting down lid) on one eye and the blepharoptosis (ptosis) repair (67904, Repair of blepharoptosis; [tarso] levator resection or advancement, […]

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CCI 15.3 Update: You Can Resubmit Dozens of Previously-Bundled 22526 Claims

Newsflash: CCI 15.3 retroactively deletes hundreds of edit pairs, but institutes over 18,000 new bundles.
If you thought Correct Coding Initiative (CCI) had left no stone unturned in bundling moderate sedation, think again. CCI’s version 15.3, which takes effect Oct. 1, continues the trend, bundling 99148-99150 into most of the other CPT codes, and no modifier […]

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  3. CCI 15.2 Retracts Neurostimulator Edits from 15.1Look for new edits that affect eye exam codes, anesthesia,…
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4 Tips Position Your ‘Multiple Scope’ Codes Perfectly

Ortho coders: Here’s what you should do when there’s no ‘base’ procedure.
This week is the 400th anniversary of Galileo’s telescope, so let’s celebrate in our own small coding way and get our own scope coding correct.
If your physician performs several knee arthroscopies on the same patient on the same day, you’ll need to understand the […]

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