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Skull Biopsy, No Burr Hole: 61500 or 61563?

Question: Our surgeon biopsied a lesion from the skull, but did not perform a craniectomy or create a burr hole for the procedure; he made an incision over the lesion and obtained the biopsy. How should I code this?
Answer: Your best option is 61500 (Craniectomy; with excision of tumor or other bone lesion of skull) […]

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How Do I Code When My Doc Treats Nursing Home Patients?

Question: Our podiatrist treats many nursing home patients. One has foot pain and all her nails are mycotic, but her nails are not painful. How can we report our physician’s services for this patient when she doesn’t have nail pain or any systemic disease to give class findings?
Answer: Check your local carrier’s guidelines because some (such as […]

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The Truth About Self-Audits

And one crucial step you should never miss.
How many ticking time bombs are waiting in your medical records?
If you don’t audit your charts regularly, you’ll never know. But even the most thorough set of audits could come to nothing if your staffers believe they’ll lose their jobs if you uncover a problem in an audit.
Reality: “Internal audits (or those conducted by the […]

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MAC Auditors Will Stick It To Facet Joint Injection Claims

We hook you up with CMS instructions for when to use +64472, +64476 and when to use modifier 50.

Thanks to a 2006 OIG audit, MACs are on the lookout for incorrectly-billed facet joint injections, so it’s time to scrutinize your claims. Medicare guidelines are very strict about when you can append modifier 50 (Bilateral procedure) to a facet joint injection code — so […]

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  2. Save Time Coding Facet Injections With This Coding Tool Hint: Location, number and substance are key. Several factors…
  3. CMS Adds 5 New Codes Effective July 1, Changes Bilateral StatusYes. It’s true. Fireworks aren’t the only excitement you can…
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Laceration Repair Documentation Checklist

Sew Up Laceration Repair Coding With These 8 Elements
Unless you want to grapple with denials, the procedure notes that support your physicians’ laceration repair claims should contain these 8 elements. How do the physicians in your practice measure up?
• location
• length
AUDIO EXTRA: Secrets to optimal reimbursement for lesion excision, repair.
• layers
[…]

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