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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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What Diagnosis Code Do I Use for a Fern Test?

Ob-Gyn Coding Tip: Scan for leukorrhea signs when fluid is present.
Question: My physician performs a fern test on a patient, trying to rule out rupture of membranes. What diagnosis code applies?
Answer: If the test result proves positive, then you should report 658.13 (Premature rupture of membranes with antepartum condition or complications). Otherwise, use V89.01 […]

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What’s the Correct Diagnosis Code for a Urine Drug Test?

Question: What is the proper ICD-9 code when the lab performs a urine drug test?
Answer: ICD-9 does not provide one specific code for a urine drug test. The correct diagnosis code to report when billing for the lab test depends on the signs, symptoms, patient condition, or other reason for the test, such as screening. […]

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Are You Up For ICD-9 2010? Quick Quiz Says For Sure

Surgery Coders: These 5 questions reveal if you need an ICD-9 workout.
October 1 is just around the corner, and that means you’ll soon need to be up and running with the latest ICD- 9 changes. Are you wondering where you should focus your time and energy?
Time-saver: This quiz on the new codes and the basics of […]

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52214 Coding Challenge: Fulguration, Then TUIBNC

Question: If my physician went to do a TUIBNC and found bleeding of prostatic varices, fulgurated them, then did the TUIBNC, can I charge the 52214 for the fulguration of the prostatic varices?
Answer: Yes. You can report both the transurethral incision of the bladder neck contracture (TUIBNC) and the fulguration of the bleeding varices your […]

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Colorectal Cancer Screening: A Medicare Coding & Billing FAQ

Steer clear of G0121 denials with these tips.

If you slip up on screening colonoscopy claims’ frequency guidelines and eligibility requirements, Medicare will pay you zilch. But our colorectal cancer screening FAQ provides you the coding the know-how you need to soar through your coding duties with the greatest of ease.
Q: Who’s Eligible for Average-Risk Test?
Any Medicare patient […]

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How Do I Code Defibrillator (AICD) Firing?

Question: A patient presented in our office and said that his defibrillator was firing. What diagnosis code is appropriate for this?

Answer: You’ll need a little more information on the cause of the firing to choose the proper code. Here are some specifics you need to ask about or look for in the note.
If the firing resulted from […]

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Create Your Own Medical Necessity Quick Reference Tool

If you want to keep denials and compliance problems at bay, your claims must support medical necessity.
So retrofit your own, customized medical necessity quick power-reference tool with these tips from Sandy Nicholson, who taught some classes at the recent E/M Coding & Billing Conference in Orlando.
Step 1: Identify services which you provide for which CMS […]

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Diabetes Coding Blunders That Cause Denials

Do you know the 5 fourth digits for 250.xx you should avoid?

A diabetes diagnosis code shows up on millions of dollars worth of claims each year, and that number is climbing rapidly. Make sure you code correctly to get every penny your practice deserves for managing the disease and treating manifestations and related conditions.
Diabetes […]

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