Ensure you clear every ER/PR coding snag with these steps.
CPT codesets, CPT codes, Medical Coding
The adage to 'always report the most specifc CPT code' could ensnare your estrogen receptor (ER) and progesterone receptor (PR) coding for breast cases. Here our experts help you sort out the difference between specific analyte and specific method to ensure you select the right code every time.
Reserve 84233 and 84234 for assays
If you are searching for specific codes when a surgical pathology report references estrogen and/or progesterone receptor testing, you should not miss 84233 and 84234. However are those always the correct choice?
The 84233 and 84234 definitions create a confusion for medical coders reporting ER/PR tests. The question is whether you must report 84233/84234 as the definitions specify ER/PR, or if you can in its place report a generic immunohistochemistry code such as 88342 for certain ER/PR testing.
Codes 84233 and 84234 describe laboratory tests for estrogen and progesterone receptors that use a biochemical ligand-binding assay method like dextran-coated charcoal assay. However most labs evaluate ER/PR using immunohistochemistry as clinical studies have consistently shown the superiority of immunohistochemistry over biochemical assay methods for ER/PR testing.
Watch out for immunohistochemistry (IHC)
When the lab method involves immunohistochemistry for tissue specimens like evaluating breast tumors for ER and PR status, you should look to the following codes to describe the service: 88342, 88360, 88361.
Although these code definitions are 'generic' in the sense that they do not specifically identify estrogen or progesterone receptors, you should report them for an ER or PR (or any other) immunohistochemistry antibody strain.
Differentiate qualitative/quantitative codes
Choosing among 88342, 88360, or 88361 calls for knowing whether the immunohistochemistry analysis is qualitative or quantitative and whether quantification uses computer-assisted technology or “manual" counting, including visual approximation. You might choose to go for any of these three codes for ER, PR, Her- 2/neu, Ki-67, or any of various other IHC analyses
Count antibodies
You should report one unit of the right code for each antibody stain, irrespective of which antibody you are coding.
Wednesday, September 29, 2010
Watch HCPCS Codes to Clinch Clean
Codes you report should reflect the services and drugs provided and documented. Do not guess every case will merit the same HCPCS codes.
HCPCS codesets, hcpcs codes, Medical Coding
The Stanford V regimen covers seven basic drugs; however the patient won't be getting all of those drugs each treatment day. In order to keep your coding straight, take advantage of this outline of what to expect.
Remember: The codes you report should reflect the services and drugs provided and documented. Do not guess every case will merit the same HCPCS codes.
Background: The aim in developing the Stanford V regimen for Hodgkin's lymphoma was to provide chemotherapy regimen that received high remission rates with fewer side effects than ABVD like pulmonary damage and sterility.
Depending on the stage of the disease, the patient may have radiation therapy as well.
Day 1: Watch for Mechlorethamine, Doxorubicin, and Vinblastine on the first day of the treatment cycle, the patient normally receives three of the drugs in the regimen.
Day 8: Check for Vincristine and Bleomycin
Staff normally adminsters two of the regimen's drugs on day 8.
Day 15: Add Etoposide to Doxorubicin and Vinblastine
The normal day 15 routine is similar to day 1; however it is not exactly the same. The patient again gets doxorubicin (J9000) and vinblastine (J9360), however does not receive mechlorethamine.
In its place, intravenous etoposide, a DNA toxin, is used.
Day 16: Repeat etoposide infusion
On day 16, the patient gets one more etoposide (J9181) infusion.
Day 22: Expect same as day 8
The drugs administered on day 22 are the same as day 8, with the patient receiving short infusions of vincristine (J9370, J9375, J9380) and bleomycin (J9040).
Everyday: Pay attention to P.O. Prednisone
Article source:-http://www.supercoder.com/coding-newsletters/my-oncology-hematology-coding-alert/infusion-coding-part-1-watch-hcpcs-to-clinch-clean-article
HCPCS codesets, hcpcs codes, Medical Coding
The Stanford V regimen covers seven basic drugs; however the patient won't be getting all of those drugs each treatment day. In order to keep your coding straight, take advantage of this outline of what to expect.
Remember: The codes you report should reflect the services and drugs provided and documented. Do not guess every case will merit the same HCPCS codes.
Background: The aim in developing the Stanford V regimen for Hodgkin's lymphoma was to provide chemotherapy regimen that received high remission rates with fewer side effects than ABVD like pulmonary damage and sterility.
Depending on the stage of the disease, the patient may have radiation therapy as well.
Day 1: Watch for Mechlorethamine, Doxorubicin, and Vinblastine on the first day of the treatment cycle, the patient normally receives three of the drugs in the regimen.
Day 8: Check for Vincristine and Bleomycin
Staff normally adminsters two of the regimen's drugs on day 8.
Day 15: Add Etoposide to Doxorubicin and Vinblastine
The normal day 15 routine is similar to day 1; however it is not exactly the same. The patient again gets doxorubicin (J9000) and vinblastine (J9360), however does not receive mechlorethamine.
In its place, intravenous etoposide, a DNA toxin, is used.
Day 16: Repeat etoposide infusion
On day 16, the patient gets one more etoposide (J9181) infusion.
Day 22: Expect same as day 8
The drugs administered on day 22 are the same as day 8, with the patient receiving short infusions of vincristine (J9370, J9375, J9380) and bleomycin (J9040).
Everyday: Pay attention to P.O. Prednisone
Article source:-http://www.supercoder.com/coding-newsletters/my-oncology-hematology-coding-alert/infusion-coding-part-1-watch-hcpcs-to-clinch-clean-article
Tuesday, September 28, 2010
Coding for Cocaine Poisoning
ICD 9 codes 2011 go into effect on October 1, you can expect to see 970.81 available for when you need to report cocaine poisoning.
ICD 9 Codes 2011, medical coding
What do you do when the emergency department (ED) calls your cardiologist to care for a patient with cocaine poisoning? From October 1, 2010, a new code changes what you should report.
When ICD 9 codes 2011 go into effect on October 1, you can expect to see 970.81 available for when you need to report cocaine poisoning.
Get on top of this critical care scenario
Patients with cocaine poisoning can be very complex, extremely sick and are potential critical care cases.
Here's an example: A 22-year-old patient comes with acute chest pain and hypertension. History reveals that he inhaled four lines of cocaine within the past hour and has been abusing cocaine for the past year. The doctor carries out and documents a comprehensive history and exam.
Diagnostics include a cardiac panel and drug screen and an ECG, reveals ST elevation in the anterior leads. Lab work shows elevated CPK (creatine phosphokinase) and troponin. The doctor treats the patient with intravenous Valium and starts him on a nitroglycerin drip. The doctor then admits the patient to the critical care unit with anterior wall ST segment elevation myocardial infarction (STEMI) due to cocaine poisoning and hypertension. The doctor reports 45 minutes of critical care time.
Solution: You should report the following for this encounter: 99291, 970.81, 401.9
Check it out: For additional information on cardiology-related codes expected to go into effect October 1 and other ICD 9 codes 2011, sign up for a one-stop medical coding website. Such a site comes stocked with official guidelines and descriptors for ICD 9 codes. So sign up for one today!
Article Source :- http://www.supercoder.com/coding-newsletters/my-internal-medicine-coding-alert/icd-9-update-cocaine-poisoning-add-97081-to-your-coding-options-103141-article
ICD 9 Codes 2011, medical coding
What do you do when the emergency department (ED) calls your cardiologist to care for a patient with cocaine poisoning? From October 1, 2010, a new code changes what you should report.
When ICD 9 codes 2011 go into effect on October 1, you can expect to see 970.81 available for when you need to report cocaine poisoning.
Get on top of this critical care scenario
Patients with cocaine poisoning can be very complex, extremely sick and are potential critical care cases.
Here's an example: A 22-year-old patient comes with acute chest pain and hypertension. History reveals that he inhaled four lines of cocaine within the past hour and has been abusing cocaine for the past year. The doctor carries out and documents a comprehensive history and exam.
Diagnostics include a cardiac panel and drug screen and an ECG, reveals ST elevation in the anterior leads. Lab work shows elevated CPK (creatine phosphokinase) and troponin. The doctor treats the patient with intravenous Valium and starts him on a nitroglycerin drip. The doctor then admits the patient to the critical care unit with anterior wall ST segment elevation myocardial infarction (STEMI) due to cocaine poisoning and hypertension. The doctor reports 45 minutes of critical care time.
Solution: You should report the following for this encounter: 99291, 970.81, 401.9
Check it out: For additional information on cardiology-related codes expected to go into effect October 1 and other ICD 9 codes 2011, sign up for a one-stop medical coding website. Such a site comes stocked with official guidelines and descriptors for ICD 9 codes. So sign up for one today!
Article Source :- http://www.supercoder.com/coding-newsletters/my-internal-medicine-coding-alert/icd-9-update-cocaine-poisoning-add-97081-to-your-coding-options-103141-article
Make Smooth Transition from ICD 9 to ICD 10
Having issue while upgrade medical coding from ICD 9 to ICD 10. Use ICD 10 Bridge tool make smooth transition.
ICD 9 to ICD 10, ICD-10 bridge, ICD-9 codes, ICD 10 codes
2013 is still to come, but it's certainly not too early to start your ICD-10 preparations. Here are three things to keep in mind while making the change from ICD 9 to ICD 10.
Do not stall preparation as you expect a delay
Today isn't too early to gear up for the ICD 9 to ICD 10 transition. The more familiar you are with the changes, the easier the transition will be. You shouln't begin your intensive, in-depth ICD-10 training until six to nine months before implementation, but you can gear up in other ways now.
Get your physicians ready now
Presently, CMS publishes about 14,000 ICD-9 codes, however there'll be over 69,000 ICD-10 codes. These codes will make it possible for you to provide greater detail in describing diagnoses and procedures. As because ICD 10 codes will often be more detailed and specific than the ICD-9 codes you and your ophthalmologist are used to, you may need to encourage your doctor to begin being more detailed in his documentation.
Begin by speaking with your physicians now about improving their clinical documentation detail which will be the most important aspect for them and should be started before the change.
Reach out to vendors to ensure readiness
You should be involved when practices communicate with information system vendors about their plans for the new code set implementation.
You will need to work with your software vendors before time to confirm that no issues will exist with claims submissions using ICD-10. First you should check whether your vendors are ready for the transition to the new 5010 form, which is making way for the ICD-10 code set.
For more tips on ways to make the ICD 9 to ICD 10 transition, sign up for a one-stop medical coding update. Such a site comes stocked with an ICD-10 bridge to make the transition much easier!
ICD 9 to ICD 10, ICD-10 bridge, ICD-9 codes, ICD 10 codes
2013 is still to come, but it's certainly not too early to start your ICD-10 preparations. Here are three things to keep in mind while making the change from ICD 9 to ICD 10.
Do not stall preparation as you expect a delay
Today isn't too early to gear up for the ICD 9 to ICD 10 transition. The more familiar you are with the changes, the easier the transition will be. You shouln't begin your intensive, in-depth ICD-10 training until six to nine months before implementation, but you can gear up in other ways now.
Get your physicians ready now
Presently, CMS publishes about 14,000 ICD-9 codes, however there'll be over 69,000 ICD-10 codes. These codes will make it possible for you to provide greater detail in describing diagnoses and procedures. As because ICD 10 codes will often be more detailed and specific than the ICD-9 codes you and your ophthalmologist are used to, you may need to encourage your doctor to begin being more detailed in his documentation.
Begin by speaking with your physicians now about improving their clinical documentation detail which will be the most important aspect for them and should be started before the change.
Reach out to vendors to ensure readiness
You should be involved when practices communicate with information system vendors about their plans for the new code set implementation.
You will need to work with your software vendors before time to confirm that no issues will exist with claims submissions using ICD-10. First you should check whether your vendors are ready for the transition to the new 5010 form, which is making way for the ICD-10 code set.
For more tips on ways to make the ICD 9 to ICD 10 transition, sign up for a one-stop medical coding update. Such a site comes stocked with an ICD-10 bridge to make the transition much easier!
Monday, September 27, 2010
More Documentation Requirements add to Physician Burden
More Documentation Requirements add to Physician Burden
Medical Coders need to look on Medical coding because more documentation is requirements add to physician burden.
Medical Coding, Code lookup
Home health agencies will have less control over new doctor-related payment condition. Agencies are hoping for some big changes to one troublesome provision in the 2011 proposed payment rule – the face-to-face doctor encounter requirement.
The mandate for the face-to-face encounter was in the Patient Protection and Affordable Care Act health care reform law enacted this year. However, the CMS version of the requirement is more stricter than the law calls for.
For instance: The proposed rule also requires that the encounter be for the primary reason home care services are required and that doctors furnish 'unprecedented' physician documentation about the encounter and why the patient meets homebound criteria.
According to industry experts, the proposed face-to-face encounter requirement is riddled with problems for home health agencies. To start with, agencies have very little influence over whether their patients make it to a physician for a visit.
It is absolutely not proper to place a requirement on home health providers for which they have no control whatsoever, as a consultant puts it. “How is the staff of the home health provider supposed to ensure that the patient goes to the physician and that the physician documents right in her office records?"
One can make appointments for patients; however we cannot ensure they keep them; that their transportation is unfailing, that they feel well enough to make the trip. In fact, there are many reasons that patients fail to see the doctor despite the best efforts of the home care staff to make it happen.
For more on this, sign up for a one-stop medical coding website. Such a site comes with a code lookup tool that will help you in your coding.
Medical Coders need to look on Medical coding because more documentation is requirements add to physician burden.
Medical Coding, Code lookup
Home health agencies will have less control over new doctor-related payment condition. Agencies are hoping for some big changes to one troublesome provision in the 2011 proposed payment rule – the face-to-face doctor encounter requirement.
The mandate for the face-to-face encounter was in the Patient Protection and Affordable Care Act health care reform law enacted this year. However, the CMS version of the requirement is more stricter than the law calls for.
For instance: The proposed rule also requires that the encounter be for the primary reason home care services are required and that doctors furnish 'unprecedented' physician documentation about the encounter and why the patient meets homebound criteria.
According to industry experts, the proposed face-to-face encounter requirement is riddled with problems for home health agencies. To start with, agencies have very little influence over whether their patients make it to a physician for a visit.
It is absolutely not proper to place a requirement on home health providers for which they have no control whatsoever, as a consultant puts it. “How is the staff of the home health provider supposed to ensure that the patient goes to the physician and that the physician documents right in her office records?"
One can make appointments for patients; however we cannot ensure they keep them; that their transportation is unfailing, that they feel well enough to make the trip. In fact, there are many reasons that patients fail to see the doctor despite the best efforts of the home care staff to make it happen.
For more on this, sign up for a one-stop medical coding website. Such a site comes with a code lookup tool that will help you in your coding.
Coding & Billing: Clarify 'Present & Immediately Available'
'Physically present and available' can be one of the most difficult factors to determine when confirming medical direction.
Coding & billing, coding updates, coding updates
'Physically present and available' can be one of the most difficult factors to determine when confirming medical direction. You should keep these guides in mind when deciding whether your anesthesiologist's claim still merits medical direction modifiers QY or QK.
Think about individual circumstances
Vague medical direction rules like 'remains physically present and available for immediate diagnosis and treatment of emergencies' allow for individual interpretation.
Defining 'immediately available' accurately is more than looking at the hospital's blueprints to see how far your physician walks down the hall. Interpretation also takes each situation into account. For instance, the anesthesiologist needs to be more easily available to help during an emergency when he is medically directing an aneurysm repair versus a hernia repair.
Think about these three factors when trying to determine what qualifies as 'physically present and available' in your hospital.
OR Size:
Service location:
Patient condition:
Key determinant: Think how quickly the anesthesiologist could help the medically directed CRNA in the event of an emergency. If the anesthesiologist is away from the OR suite or outside the surgery department, is he 'immediately available' to return if required? If so, his work might still fit under the medical direction umbrella; if not, you might need to rethink his status.
Know how the factors impact coding & billing
The factors listed above will not change your code for the procedure itself, however can change the anesthesiologist's performance modifier and his reimbursement. If the anesthesiologist personally carries out a case, you know where he is for the entire procedure and report modifier AA with the procedure code. The carrier shells out money for the entire case.
Coding gets tougher when the anesthesiologist oversees other members of the team rather than personally performs cases. If he medically directs one CRNA, report modifier QY with the procedure code; if he directs from two to four anesthetists, report modifier QK instead. Doctors who medically direct cases split the procedure fee with the other anesthetist involved.
For more on this and other medical coding updates , sign up http://www.supercoder.com/.
Coding & billing, coding updates, coding updates
'Physically present and available' can be one of the most difficult factors to determine when confirming medical direction. You should keep these guides in mind when deciding whether your anesthesiologist's claim still merits medical direction modifiers QY or QK.
Think about individual circumstances
Vague medical direction rules like 'remains physically present and available for immediate diagnosis and treatment of emergencies' allow for individual interpretation.
Defining 'immediately available' accurately is more than looking at the hospital's blueprints to see how far your physician walks down the hall. Interpretation also takes each situation into account. For instance, the anesthesiologist needs to be more easily available to help during an emergency when he is medically directing an aneurysm repair versus a hernia repair.
Think about these three factors when trying to determine what qualifies as 'physically present and available' in your hospital.
OR Size:
Service location:
Patient condition:
Key determinant: Think how quickly the anesthesiologist could help the medically directed CRNA in the event of an emergency. If the anesthesiologist is away from the OR suite or outside the surgery department, is he 'immediately available' to return if required? If so, his work might still fit under the medical direction umbrella; if not, you might need to rethink his status.
Know how the factors impact coding & billing
The factors listed above will not change your code for the procedure itself, however can change the anesthesiologist's performance modifier and his reimbursement. If the anesthesiologist personally carries out a case, you know where he is for the entire procedure and report modifier AA with the procedure code. The carrier shells out money for the entire case.
Coding gets tougher when the anesthesiologist oversees other members of the team rather than personally performs cases. If he medically directs one CRNA, report modifier QY with the procedure code; if he directs from two to four anesthetists, report modifier QK instead. Doctors who medically direct cases split the procedure fee with the other anesthetist involved.
For more on this and other medical coding updates , sign up http://www.supercoder.com/.
Wednesday, September 22, 2010
CCI 16.3 to Reserve Edits Involving Vestibular Testing
Correct Coding Initiative (CCI) came down hard on practitioners who carry out vestibular testing; however a new correction.
CCI coding , CCI codes, CCI 16.3, 2010 CPT manual, Medical Coding
From october 1, you will be able to use a modifier to separate these services when they are carried out as distinct procedural services.
Earlier, the Correct Coding Initiative (CCI) came down hard on practitioners who carry out vestibular testing; however a new correction, with effect from October 1 this year should ease the restrictions and aid the otolaryngology practices that report these services.
The problem: Presently, CCI codes restrict practices from reporting 92541, 92542, 92544, and 92545 individually if three or less of the tests are carried out.
The solution: With effect from October 1, if two or three of these codes are reported for the same date of service (DOS) by the same provider for the same beneficiary, an NCCI-associated modifier may be used to bypass the NCCI edits.
Watch out for changes to vestibular testing descriptors
The root of the CCI problem started when the 2010 CPT manual was published, including new code 92540 and the subsequent codes following it, which make up the individual components of 92540. The clarification that resulted in the NCCI edits being lifted should be covered in the upcoming versions of the manual.
For the latest CCI codes(http://www.supercoder.com/coding-tools/cci-edits-checker/), sign up for a one-stop medical coding website. When you register yourself for one, you'll get the latest updates pertaining to these CCI codes. You'll also have access to a CCI coding tool that will offer you a fast solution to keep your claims compliant with NCCI. The tool will tell you if CCI bundles a code combination and if the edit allows a modifier.
CCI coding , CCI codes, CCI 16.3, 2010 CPT manual, Medical Coding
From october 1, you will be able to use a modifier to separate these services when they are carried out as distinct procedural services.
Earlier, the Correct Coding Initiative (CCI) came down hard on practitioners who carry out vestibular testing; however a new correction, with effect from October 1 this year should ease the restrictions and aid the otolaryngology practices that report these services.
The problem: Presently, CCI codes restrict practices from reporting 92541, 92542, 92544, and 92545 individually if three or less of the tests are carried out.
The solution: With effect from October 1, if two or three of these codes are reported for the same date of service (DOS) by the same provider for the same beneficiary, an NCCI-associated modifier may be used to bypass the NCCI edits.
Watch out for changes to vestibular testing descriptors
The root of the CCI problem started when the 2010 CPT manual was published, including new code 92540 and the subsequent codes following it, which make up the individual components of 92540. The clarification that resulted in the NCCI edits being lifted should be covered in the upcoming versions of the manual.
For the latest CCI codes(http://www.supercoder.com/coding-tools/cci-edits-checker/), sign up for a one-stop medical coding website. When you register yourself for one, you'll get the latest updates pertaining to these CCI codes. You'll also have access to a CCI coding tool that will offer you a fast solution to keep your claims compliant with NCCI. The tool will tell you if CCI bundles a code combination and if the edit allows a modifier.
Ensure you Clear Every ER/PR Coding Barrier
Use these ways to ensure you clear every MR/PR coding barrier.
CPT Assistant, CPT code, medical coding
The saying to 'always report the most specific CPT code' could ambush your estrogen receptor (ER) and progesterone receptor (PR) coding for breast instances. Here our experts will help you sort out the difference between specific analyte and specific method to ensure you select the right code each and every time.
Reserve 84233 and 84234 for Assays
If you are looking for specific codes when a surgical pathology references estrogen and/or progesterone receptor testing, you cannot miss 84233 and 84234. However are those always the right choice?
The 84233 and 84234 definitions create a dilemma for coders reporting ER/PR tests. The question is whether you must report 84233/84234 as the definitions specify ER/PR, or if you can instead report a generic immunohistochemistry code like 88342 for certain ER/PR testing.
Codes 84233 and 84234 talk of laboratory tests for estrogen and progesterone receptors that make use of a biochemical ligand-binding assay method like dextran-coated charcoal assay. However, most labs evaluate ER/PR using immunohistochemistry as clinical studies have consistently shown the superiority of immunohistochemistry over biochemical assay methods for ER/PR testing.
Be on the lookout for Immunohistochemistry
When the lab method involves immunohistochemistry (IHC) for tissue specimens like evaluating breast tumors for ER and PR status, you should look to the following codes to describe the service: 88342, 88360, 88361.
Differentiate qualitative/ quantitative codes
Choosing among 88342, 88360, or 88361 calls for knowing whether the immunohistochemistry analysis is qualitative or quantitative and whether quantification makes use of computer-assisted technology or “manual" counting, including visual approximation.
Count antibodies
You should report one unit of the appropriate code for each antibody stain, irrespective of which antibody you are coding.
For more CPT analysis , sign up for a one-stop medical coding website. Onboard such a site, you will have access to the CPT Assistant(http://www.supercoder.com/coding-references/code-connect) tool to help you in your coding.
CPT Assistant, CPT code, medical coding
The saying to 'always report the most specific CPT code' could ambush your estrogen receptor (ER) and progesterone receptor (PR) coding for breast instances. Here our experts will help you sort out the difference between specific analyte and specific method to ensure you select the right code each and every time.
Reserve 84233 and 84234 for Assays
If you are looking for specific codes when a surgical pathology references estrogen and/or progesterone receptor testing, you cannot miss 84233 and 84234. However are those always the right choice?
The 84233 and 84234 definitions create a dilemma for coders reporting ER/PR tests. The question is whether you must report 84233/84234 as the definitions specify ER/PR, or if you can instead report a generic immunohistochemistry code like 88342 for certain ER/PR testing.
Codes 84233 and 84234 talk of laboratory tests for estrogen and progesterone receptors that make use of a biochemical ligand-binding assay method like dextran-coated charcoal assay. However, most labs evaluate ER/PR using immunohistochemistry as clinical studies have consistently shown the superiority of immunohistochemistry over biochemical assay methods for ER/PR testing.
Be on the lookout for Immunohistochemistry
When the lab method involves immunohistochemistry (IHC) for tissue specimens like evaluating breast tumors for ER and PR status, you should look to the following codes to describe the service: 88342, 88360, 88361.
Differentiate qualitative/ quantitative codes
Choosing among 88342, 88360, or 88361 calls for knowing whether the immunohistochemistry analysis is qualitative or quantitative and whether quantification makes use of computer-assisted technology or “manual" counting, including visual approximation.
Count antibodies
You should report one unit of the appropriate code for each antibody stain, irrespective of which antibody you are coding.
For more CPT analysis , sign up for a one-stop medical coding website. Onboard such a site, you will have access to the CPT Assistant(http://www.supercoder.com/coding-references/code-connect) tool to help you in your coding.
Tuesday, September 21, 2010
Rid your Ovarian Cyst CPT Confusion
Ready to code for ovarian cyst removal, you should pay particular attention to the approach, whether it's vaginal, abdominal or laparoscopic.
CPT codes, CPT Coding, medical coding, CPT confusion
Coding for the removal/excision, aspiration or drainage of an ovarian cyst is not too difficult. We have broken down each approach to provide you all the tools you need to get your claim right every time.
Important concept: When you are ready to code for ovarian cyst removal, you should pay particular attention to the approach, whether it's vaginal, abdominal or laparoscopic. Cut into these ovarian cyst codes to excise an ovarian cyst means that the ob-gyn removes the cyst by cutting. If this is the case, you should use 58925.
Heads up: However, for a laparoscopic removal of an ovarian cyst, you need to choose the code based on the extent of the procedure.
For instance, when a laparoscopic ovarian cyst excision doesn't involve the removal of any additional ovarian tissue, the right code for the procedure would be 58662. When the cyst is large and tough to remove, the ob-gyn may have to remove part of the ovary at the same time. You should use 58661 to report this.
Documentation key: Coding for the cyst removal may be straightforward; however you need to ensure your documentation measures up for medical necessity.
Cyst aspiration may also cover US guidance
To 'aspirate' an ovarian cyst means that the ob-gyn removes fluids by means of a suction device; however the terms 'aspiration' and 'drainage' are synonymous in this case.
For more on ways to cut your ovarian cyst CPT codes confusion down to size and for other CPT coding know how, sign up for a one-stop medical coding website.
CPT codes, CPT Coding, medical coding, CPT confusion
Coding for the removal/excision, aspiration or drainage of an ovarian cyst is not too difficult. We have broken down each approach to provide you all the tools you need to get your claim right every time.
Important concept: When you are ready to code for ovarian cyst removal, you should pay particular attention to the approach, whether it's vaginal, abdominal or laparoscopic. Cut into these ovarian cyst codes to excise an ovarian cyst means that the ob-gyn removes the cyst by cutting. If this is the case, you should use 58925.
Heads up: However, for a laparoscopic removal of an ovarian cyst, you need to choose the code based on the extent of the procedure.
For instance, when a laparoscopic ovarian cyst excision doesn't involve the removal of any additional ovarian tissue, the right code for the procedure would be 58662. When the cyst is large and tough to remove, the ob-gyn may have to remove part of the ovary at the same time. You should use 58661 to report this.
Documentation key: Coding for the cyst removal may be straightforward; however you need to ensure your documentation measures up for medical necessity.
Cyst aspiration may also cover US guidance
To 'aspirate' an ovarian cyst means that the ob-gyn removes fluids by means of a suction device; however the terms 'aspiration' and 'drainage' are synonymous in this case.
For more on ways to cut your ovarian cyst CPT codes confusion down to size and for other CPT coding know how, sign up for a one-stop medical coding website.
Medical coding news: OIG Still Eyes Transforaminal Epidurals
OIG recently released its findings from its latest review of transforaminal epidural injections and this is certainly not a good tiding for pain management practitioners.
medical coding news, OIG
The OIG recently released its findings from its latest review of transforaminal epidural injections and this is certainly not a good tiding for pain management practitioners. According to the review, 34 percent of transforaminal epidural injection services that Medicare allowed in 2007 did not meet Medicare requirements. The mistakes resulted in approximately $45 million improper payments.
Most mistakes arose from errors in documentation, medical necessity, or coding. CMS plans to educate providers on correct documentation and strengthen safeguards against improper payments.
Understand what you are coding
Often, physicians adminster transforaminal epidurals laterally through the chosen neuroforamen under fluoroscopy. Once there, the doctor carries out an injection at the nerve root area to help relieve the patient's pain. The medication goes into the anterior epidural space, 'bathing' a specific spinal nerve as it exits the spinal cord.
CPT covers four codes to represent transforaminal epidural injections, which you select between based on the injection site and number of injections.
What you should do: You must encourage thorough documentation and know how to code the procedures properly if your providers administer transforaminal epidural injections. For more tips on correctly coding and documenting transforaminal epidural injections and other medical coding news, sign up for a one-stop medical coding website.
When you sign up for one, you'll stay tuned to all details on how to keep your claims clean. Onboard such a website, you'll have access to the latest medical coding articles that will help you code right for your practice. So sign up http://www.supercoder.com/
medical coding news, OIG
The OIG recently released its findings from its latest review of transforaminal epidural injections and this is certainly not a good tiding for pain management practitioners. According to the review, 34 percent of transforaminal epidural injection services that Medicare allowed in 2007 did not meet Medicare requirements. The mistakes resulted in approximately $45 million improper payments.
Most mistakes arose from errors in documentation, medical necessity, or coding. CMS plans to educate providers on correct documentation and strengthen safeguards against improper payments.
Understand what you are coding
Often, physicians adminster transforaminal epidurals laterally through the chosen neuroforamen under fluoroscopy. Once there, the doctor carries out an injection at the nerve root area to help relieve the patient's pain. The medication goes into the anterior epidural space, 'bathing' a specific spinal nerve as it exits the spinal cord.
CPT covers four codes to represent transforaminal epidural injections, which you select between based on the injection site and number of injections.
What you should do: You must encourage thorough documentation and know how to code the procedures properly if your providers administer transforaminal epidural injections. For more tips on correctly coding and documenting transforaminal epidural injections and other medical coding news, sign up for a one-stop medical coding website.
When you sign up for one, you'll stay tuned to all details on how to keep your claims clean. Onboard such a website, you'll have access to the latest medical coding articles that will help you code right for your practice. So sign up http://www.supercoder.com/
Friday, September 17, 2010
93270 calls for Minimum Transmission
You can report 93270 even when the only transmission was the test transmission.
CPT coding lookup, CPT Assistant, CPT coding
Sometimes, you may find yourself bowled over by questions such as this:
Question: Can you report 93270 even when the only transmission was the test transmission?
Answer: You should be able to report 93270 in the situation you describe, assuming you meet certain conditions.
According to CPT Assistant (August 2010), prior to reporting 93270, you should check for the following:
The patient got the monitor from the office or facility or through mail, such as from a monitoring center.
The doctor or facility coached the patient on proper monitor use ( inclduing hookup, recording and transmission).
The patient sent a minimum of one transmission. Reason: Patients must send a test transmission when the monitoring period starts to be sure the device is working.
Here's what we get to learn: When the patient receives both the device and instructions in the mail and the physician or facility staff never instructed the patient directly, you shouldn't go for 93270, as CPT Assistant points out.
What's more, you shouldn't use 93270 if the patient sends no transmissions. If no tracing is sent, then there can be no report and no reportable service has been provided even though the patient received a monitor for a month, states CPT Assistant.
CPT coding lookup, CPT Assistant, CPT coding
Sometimes, you may find yourself bowled over by questions such as this:
Question: Can you report 93270 even when the only transmission was the test transmission?
Answer: You should be able to report 93270 in the situation you describe, assuming you meet certain conditions.
According to CPT Assistant (August 2010), prior to reporting 93270, you should check for the following:
Here's what we get to learn: When the patient receives both the device and instructions in the mail and the physician or facility staff never instructed the patient directly, you shouldn't go for 93270, as CPT Assistant points out.
What's more, you shouldn't use 93270 if the patient sends no transmissions. If no tracing is sent, then there can be no report and no reportable service has been provided even though the patient received a monitor for a month, states CPT Assistant.
Stand to Gain from ICD 10 Codes
It is important to look ahead at the benefits of adoption and how ICD-10 implementation will benefit the entire health care industry.
medical coding updates, ICD 10 codes, ICD-10 bridge
Are you in tune with all medical coding updates pertaining to ICD 10 codes? Are you gearing up for the transition? While you are preparing for the new system, it's important to look ahead at the benefits of adoption and how ICD-10 implementation will benefit the entire health care industry.
Here are some advantages of transitioning to ICD 10 codes
The new codes will provide more accuracy: Health care providers will have a better ability to correctly describe diagnoses, including documentation of new diseases and more precisely describing existing ones.
There will be room for expansion: While the present system is outdated and does not allow for growth, the new ICD-10 coding system has room to accommodate new codes and progress in the healthcare industry.
It will bring about international compatibility: For many years, other countries have been using the ICD-10 coding system. With its implementation in the US, there'll be a uniform medical coding system, which will make it much more easier to share health information and increase compatibility.
There will be more specific codes: The increased depth and specificity of the coding system will enable patients' records to be more clear-cut and detailed. The ICD-10 code set has been expanded and covers codes tailored to current times with new terminology and clinical concepts that are more relevant today.
There will be a decrease in errors made: With the new system in place, healthcare providers will have access to codes that describe their patient's diagnoses.
There will be shorter claim cycle: The increased accuracy of the codes can indicate that fewer claims are sent back with a request for more information.
For more information on ICD 10 codes (http://www.supercoder.com/coding-newsletters/icd-10-coding-alert) and other medical coding updates, sign up for a one-stop medical coding website. Such a site offers ICD-10 bridge that'll help you make a smooth transition.
medical coding updates, ICD 10 codes, ICD-10 bridge
Are you in tune with all medical coding updates pertaining to ICD 10 codes? Are you gearing up for the transition? While you are preparing for the new system, it's important to look ahead at the benefits of adoption and how ICD-10 implementation will benefit the entire health care industry.
Here are some advantages of transitioning to ICD 10 codes
The new codes will provide more accuracy: Health care providers will have a better ability to correctly describe diagnoses, including documentation of new diseases and more precisely describing existing ones.
There will be room for expansion: While the present system is outdated and does not allow for growth, the new ICD-10 coding system has room to accommodate new codes and progress in the healthcare industry.
It will bring about international compatibility: For many years, other countries have been using the ICD-10 coding system. With its implementation in the US, there'll be a uniform medical coding system, which will make it much more easier to share health information and increase compatibility.
There will be more specific codes: The increased depth and specificity of the coding system will enable patients' records to be more clear-cut and detailed. The ICD-10 code set has been expanded and covers codes tailored to current times with new terminology and clinical concepts that are more relevant today.
There will be a decrease in errors made: With the new system in place, healthcare providers will have access to codes that describe their patient's diagnoses.
There will be shorter claim cycle: The increased accuracy of the codes can indicate that fewer claims are sent back with a request for more information.
For more information on ICD 10 codes (http://www.supercoder.com/coding-newsletters/icd-10-coding-alert) and other medical coding updates, sign up for a one-stop medical coding website. Such a site offers ICD-10 bridge that'll help you make a smooth transition.
Thursday, September 16, 2010
Watch out when using E-Codes
In ICD-9 Coding be familiar with E Codes. Remember these three warnings that will prevent your claim form getting tripped by denial.
ICD 9 codes, ICD-9 Coding, Medical Coding
Do you report injuries or poisonings? If so, you should be familiar with E codes. But prior to turning to these codes, see to it that you remember these three warnings that will prevent your claim from getting tripped by a denial.
1.Do not lose the purpose of E codes
E codes point to the external causes of injuries and poisonings as well as the adverse effects of drugs and substances. These are considered special ICD-9 diagnosis codes which you can normally use to report accidents, injuries or diseases. You can report E codes with regular ICD 9 codes .
Don't: You shouldn't report E codes as your primary code as they only point to the cause of injury/poisonings and not the resulting injury/condition. Always go fro E codes in addition to a numerical ICD-9 code that describes the injury itself. It may be required to assign more than one E code to explain each cause fully.
2.Be specific about your E codes
Boosting E code reporting can benefit auto insurance companies, disability insurers, health insurance plans, public payers, health care purchasers, employers, businesses, labor unions, schools and other entities keen on injury prevention and safety issues. However does it provide too much 'up-front' information about the patient's behavior/lifestyle?
3.Take more risks while reporting certain E codes
There are E codes for reporting surgical mishaps, including E876.6, E876.7. Although you could bill these codes, you would want to keep hoping you may never have to be face to face with these “need". The new codes describe situations that are considered 'never' events which means they represent surgical mistakes that should not take place.
To find out how E codes help insurance companies and other ICD 9 coding information, sign up for a one-stop medical coding website.
ICD 9 codes, ICD-9 Coding, Medical Coding
Do you report injuries or poisonings? If so, you should be familiar with E codes. But prior to turning to these codes, see to it that you remember these three warnings that will prevent your claim from getting tripped by a denial.
1.Do not lose the purpose of E codes
E codes point to the external causes of injuries and poisonings as well as the adverse effects of drugs and substances. These are considered special ICD-9 diagnosis codes which you can normally use to report accidents, injuries or diseases. You can report E codes with regular ICD 9 codes .
Don't: You shouldn't report E codes as your primary code as they only point to the cause of injury/poisonings and not the resulting injury/condition. Always go fro E codes in addition to a numerical ICD-9 code that describes the injury itself. It may be required to assign more than one E code to explain each cause fully.
2.Be specific about your E codes
Boosting E code reporting can benefit auto insurance companies, disability insurers, health insurance plans, public payers, health care purchasers, employers, businesses, labor unions, schools and other entities keen on injury prevention and safety issues. However does it provide too much 'up-front' information about the patient's behavior/lifestyle?
3.Take more risks while reporting certain E codes
There are E codes for reporting surgical mishaps, including E876.6, E876.7. Although you could bill these codes, you would want to keep hoping you may never have to be face to face with these “need". The new codes describe situations that are considered 'never' events which means they represent surgical mistakes that should not take place.
To find out how E codes help insurance companies and other ICD 9 coding information, sign up for a one-stop medical coding website.
CPT 2011: Drug Test Changes yet Again
Two new codes were proposed for urine drug testing in 2011 and you might need some help to sorting it out.
CPT 2011, CPT code, medical coding
This time two new codes were proposed for urine drug testing in the year 2011 and you might need some help sorting it out. Read on and get a preview of the 2011 codes and a run down of how current policy meshes with your lab's drug screen test method.
2011 codes close loopholes
CMS provided a low down on new lab test codes for CY 2011. You will need to be familiar with the following two new codes for drug testing next year.
801XX
GXXX1 With identical definitions, 801XX will replace G0430, which was new in 2010.
Problem: Apparently, CMS intends new code GXXX1 to close a loophole in how labs use another code introduced this year.
Loophole closed: By making the unit of service the 'specimen' for GXXX1, labs can only list multiple units if the patient provides multiple urine specimens. The 'per specimen' wording should essentially prevent labs from billing GXXX1 for each drug class dipstick as they could for G0431.
Follow current drug screen rules
Until new codes go into effect in 2011, you will need to continue to report drug screening tests using G0430 and G0431 along with the following codes: 80100, 80101.
CMS came up with the two G codes this year to operate in place of and alongwith existing CPT code 80100 and 80101 as some providers were not using those codes correctly.
CPT 2011, CPT code, medical coding
This time two new codes were proposed for urine drug testing in the year 2011 and you might need some help sorting it out. Read on and get a preview of the 2011 codes and a run down of how current policy meshes with your lab's drug screen test method.
2011 codes close loopholes
CMS provided a low down on new lab test codes for CY 2011. You will need to be familiar with the following two new codes for drug testing next year.
Problem: Apparently, CMS intends new code GXXX1 to close a loophole in how labs use another code introduced this year.
Loophole closed: By making the unit of service the 'specimen' for GXXX1, labs can only list multiple units if the patient provides multiple urine specimens. The 'per specimen' wording should essentially prevent labs from billing GXXX1 for each drug class dipstick as they could for G0431.
Follow current drug screen rules
Until new codes go into effect in 2011, you will need to continue to report drug screening tests using G0430 and G0431 along with the following codes: 80100, 80101.
CMS came up with the two G codes this year to operate in place of and alongwith existing CPT code 80100 and 80101 as some providers were not using those codes correctly.
Wednesday, September 15, 2010
Apply UHC Latest Thermal RFA Policy
Practice participates with United HealthCare (UHC), you will want to take note of UHC’s recent policy update on ablative treatment of spinal pain.
CPT coding, medical coding
If your practice participates with United HealthCare (UHC), you will want to take note of UHC’s recent policy update on ablative treatment of spinal pain. Although UHC has a limited coverage policy for a number of spinal pain and facet joint pain procedures, you have some opportunity of reimbursement if you are aware of the rules.
Ablation method and frequency matter
Among the changes are revised coverage policies for how often the thermal radiofrequency ablation can be carried out and reimbursed. According to the policy, that thermal RFA is covered when carried out at three months or greater frequency, provided there has been a 50 percent or greater documented reduction in pain.
For instance: On May 15, 2010, the doctor carries a repeat thermal radiofrequncy (RF) ablation on the right L4 and L5 paravertebral facet joint nerves on a patient with right lumbar facet joint pain. You would report codes 64622 and +64623.
Reimbursement difficult for thermal RF treatment
At first glance, UHC’s policy toward thermal radiofrequency ablation can seem disheartening at first glance. The policy’s coverage rationale points out a number of conditions for which treatment for spinal or orthopedic pain is not covered.
Fluoroscopic guidance called for
One such guideline is the necessity of fluoroscopic guidance when a physician carries out these procedures.
Pulsed radiofrequency, other ablations not covered
Practices that make use of emerging techniques to tend to chronic spinal pain will also be in for some disappointments. The updated UHC policy considers pulsed RF therapy, cryoablation, alcohol ablation, and laser ablation to be unproven for spinal/facet joint pain and as such, not covered.
However, the coverage climate could be changing. If future studies showcase the safety and efficacy of laternative methods of destructive neurolysis, it’s possible that third-party payers may reconsider their non-coverage decision. The rapid growth of these types of procedures using a number of methods is leading more payers to examine the published medical evidence for a particular method, with subsequent revision of prior coverage polices.
Source URL :- http://www.supercoder.com/coding-newsletters/my-neurosurgery-coding-alert/cpt-64622-64627-prevent-denials-by-applying-uhcs-latest-thermal-rfa-policy-article
CPT coding, medical coding
If your practice participates with United HealthCare (UHC), you will want to take note of UHC’s recent policy update on ablative treatment of spinal pain. Although UHC has a limited coverage policy for a number of spinal pain and facet joint pain procedures, you have some opportunity of reimbursement if you are aware of the rules.
Ablation method and frequency matter
Among the changes are revised coverage policies for how often the thermal radiofrequency ablation can be carried out and reimbursed. According to the policy, that thermal RFA is covered when carried out at three months or greater frequency, provided there has been a 50 percent or greater documented reduction in pain.
For instance: On May 15, 2010, the doctor carries a repeat thermal radiofrequncy (RF) ablation on the right L4 and L5 paravertebral facet joint nerves on a patient with right lumbar facet joint pain. You would report codes 64622 and +64623.
Reimbursement difficult for thermal RF treatment
At first glance, UHC’s policy toward thermal radiofrequency ablation can seem disheartening at first glance. The policy’s coverage rationale points out a number of conditions for which treatment for spinal or orthopedic pain is not covered.
Fluoroscopic guidance called for
One such guideline is the necessity of fluoroscopic guidance when a physician carries out these procedures.
Pulsed radiofrequency, other ablations not covered
Practices that make use of emerging techniques to tend to chronic spinal pain will also be in for some disappointments. The updated UHC policy considers pulsed RF therapy, cryoablation, alcohol ablation, and laser ablation to be unproven for spinal/facet joint pain and as such, not covered.
However, the coverage climate could be changing. If future studies showcase the safety and efficacy of laternative methods of destructive neurolysis, it’s possible that third-party payers may reconsider their non-coverage decision. The rapid growth of these types of procedures using a number of methods is leading more payers to examine the published medical evidence for a particular method, with subsequent revision of prior coverage polices.
Source URL :- http://www.supercoder.com/coding-newsletters/my-neurosurgery-coding-alert/cpt-64622-64627-prevent-denials-by-applying-uhcs-latest-thermal-rfa-policy-article
Pediatric Coding: 2011 ICD 9 additions for your practice
Pediatric Coding: 2011 ICD 9 additions for your practice
2011 ICD 9 codes will go into effect pretty soon. If you are a pediatric coder, you have a few welcome additions to your practice.
2011 ICD 9 codes, ICD 9 2011, Medical Coding
The 2011 ICD 9 codes will go into effect pretty soon. If you are a pediatric coder, you have a few welcome additions to your practice. Here are some examples of new diagnoses you will find yourself reporting on a regular basis.
Attention deficit options provide a better starting point
ICD 9 2011 adds the 799.5x family to the 'III defined and unknown causes of morbidity and mortality category.
The new series will be useful for symptoms and signs as a diagnosis prior to the physician establishes a definitive diagnosis. Pediatricians tend to children with concerns regarding attention or activity. You do not have enough information after the first visit for an offical diagnosis; however you still need something to report.
For instance: The doctor tends to a child who has an attention problem; however doesn’t yet meet diagnostic criteria for attention deficit disorder. Earlier, you could not report coding choices 314.00 or 314.01 until the doctor established a definitive diagnosis. Starting October 1, you could submit 799.51 until tests confirm a diagnosis.
Add fifth digit to incontinence codes
Four new diagnoses expand the 787.6 code family. The expansion makes the series of codes applicable to pediatricians. Moving from a four-digit series to a five-digit series provides codes that involve more granularity or specificity.
V codes address retained fragments
ICD 9 2011 also comes up with a series of V codes for different types of retained fragments. The series (V90.10-V90.9) address objects ranging from metal, plastic or wood to animal quills or spines, glass, teeth, and other specified foreign bodies.
For the latest on the ICD 9 2011 codes, sign up http://www.supercoder.com/
2011 ICD 9 codes will go into effect pretty soon. If you are a pediatric coder, you have a few welcome additions to your practice.
2011 ICD 9 codes, ICD 9 2011, Medical Coding
The 2011 ICD 9 codes will go into effect pretty soon. If you are a pediatric coder, you have a few welcome additions to your practice. Here are some examples of new diagnoses you will find yourself reporting on a regular basis.
Attention deficit options provide a better starting point
ICD 9 2011 adds the 799.5x family to the 'III defined and unknown causes of morbidity and mortality category.
The new series will be useful for symptoms and signs as a diagnosis prior to the physician establishes a definitive diagnosis. Pediatricians tend to children with concerns regarding attention or activity. You do not have enough information after the first visit for an offical diagnosis; however you still need something to report.
For instance: The doctor tends to a child who has an attention problem; however doesn’t yet meet diagnostic criteria for attention deficit disorder. Earlier, you could not report coding choices 314.00 or 314.01 until the doctor established a definitive diagnosis. Starting October 1, you could submit 799.51 until tests confirm a diagnosis.
Add fifth digit to incontinence codes
Four new diagnoses expand the 787.6 code family. The expansion makes the series of codes applicable to pediatricians. Moving from a four-digit series to a five-digit series provides codes that involve more granularity or specificity.
V codes address retained fragments
ICD 9 2011 also comes up with a series of V codes for different types of retained fragments. The series (V90.10-V90.9) address objects ranging from metal, plastic or wood to animal quills or spines, glass, teeth, and other specified foreign bodies.
For the latest on the ICD 9 2011 codes, sign up http://www.supercoder.com/
Wednesday, September 8, 2010
2011 ICD-9: Train Eyes on These Fecal Incontinence Symptoms
2011 ICD-9 will delete 787.6 starting October, so you will no longer to report it. Use one of the following new codes 787.60, 787.61, 787.62 and 787.63.
2011 ICD-9, ICD 9 codes online, Medical Coding
When reporting fecal incontinence this fall, you will get to be a whole lot more specific. The single code 787.6 will give way to four new options that describe fecal incontinence problematic symptoms like fecal smearing, fecal urgency and incomplete defecation.
Starting October 1, you will no longer be able to report 787.6 as 2011 ICD-9 will delete it. In place of this code, you will use one of the following new codes: 787.60, 787.61, 787.62 and 787.63.
Do not miss: Incomplete defecation is distinct from constipation and fecal impaction. Rectum and anal sphincter problems (including rectoceles) can lead to these problems; however presently, you do not have to specify these symptoms. The 2011 ICD-9 has a new code 560.32, for fecal impaction. Earlier, this condition was included in 560.39.
The just-in fecal incontinence 787.60 is a change that we’ll have to remember. The new code for fecal impaction excludes constipation, which can still be reported using a code from the 564.0X series.
There’ll be more specific pain DX in 2011
When the doctor diagnoses jaw pain post October 1, coders can select 784.92 for the encounter. Earlier, consideration included 526.9, which does not illustrate the complaint.
Advantage: The more specific jaw pain code could help support some complaints that may be related to dental problems.
For more on the 2011 ICD 9 codes and to get these ICD 9 codes online, sign up for a one-stop Medical Coding website. When you get onboard one, you will be clear on which new code has come in, which has been deleted and which has been revised.
2011 ICD-9, ICD 9 codes online, Medical Coding
When reporting fecal incontinence this fall, you will get to be a whole lot more specific. The single code 787.6 will give way to four new options that describe fecal incontinence problematic symptoms like fecal smearing, fecal urgency and incomplete defecation.
Starting October 1, you will no longer be able to report 787.6 as 2011 ICD-9 will delete it. In place of this code, you will use one of the following new codes: 787.60, 787.61, 787.62 and 787.63.
Do not miss: Incomplete defecation is distinct from constipation and fecal impaction. Rectum and anal sphincter problems (including rectoceles) can lead to these problems; however presently, you do not have to specify these symptoms. The 2011 ICD-9 has a new code 560.32, for fecal impaction. Earlier, this condition was included in 560.39.
The just-in fecal incontinence 787.60 is a change that we’ll have to remember. The new code for fecal impaction excludes constipation, which can still be reported using a code from the 564.0X series.
There’ll be more specific pain DX in 2011
When the doctor diagnoses jaw pain post October 1, coders can select 784.92 for the encounter. Earlier, consideration included 526.9, which does not illustrate the complaint.
Advantage: The more specific jaw pain code could help support some complaints that may be related to dental problems.
For more on the 2011 ICD 9 codes and to get these ICD 9 codes online, sign up for a one-stop Medical Coding website. When you get onboard one, you will be clear on which new code has come in, which has been deleted and which has been revised.
Serology isn’t the Only HLA Cross Match
Stuck with 86805-86822 for human leukocyte antigen (HLA) testing, you need to be aware of the CPT 2010 changes that provide some new options.
CPT coding website, CPT Assistant, CPT 2010, Medical Coding
After years of being stuck with 86805-86822 for human leukocyte antigen (HLA) testing, you need to be aware of the CPT 2010 changes that provide some new options.
Read on and let our experts guide you through the maze of new codes and altered CPT instructions that change how you should report HLA typing and crossmatch for transplant patients.
Be aware of HLA typing – the old fashioned way
CPT 2010 provides the following four codes for HLA typing using serologic methods, which labs have been used for years: 86812, 86813, 86816, and 86817.
Bring up to date your HLA typing codes for molecular diagnostics
Many labs now carry out HLA typing using molecular diagnostics methods instead of serologic testing. How would you report these tests?
Problem: Until last year, AMA direction published in CPT Assistant indicated that you should continue to report 86812-86817 even if the lab carried out HLA typing by molecular diagnostics techniques such as high resolution polymerase chain reaction (PCR).
Solution: Last year’s CPT added the following instruction following code 86822. For HLA typing by molecular techniques, look at 83890-83914 with appropriate genetic testing modifiers 4A-4G. That instruction frees your lab to garner more appropriate pay by choosing the molecular diagnostics codes that describe each step of a specific HLA typing test.
Source URl :- http://www.supercoder.com/coding-newsletters/my-pathology-lab-coding-alert/cpt-2010-welcome-86825-82826-serology-isnt-the-only-hla-crossmatch-article
CPT coding website, CPT Assistant, CPT 2010, Medical Coding
After years of being stuck with 86805-86822 for human leukocyte antigen (HLA) testing, you need to be aware of the CPT 2010 changes that provide some new options.
Read on and let our experts guide you through the maze of new codes and altered CPT instructions that change how you should report HLA typing and crossmatch for transplant patients.
Be aware of HLA typing – the old fashioned way
CPT 2010 provides the following four codes for HLA typing using serologic methods, which labs have been used for years: 86812, 86813, 86816, and 86817.
Bring up to date your HLA typing codes for molecular diagnostics
Many labs now carry out HLA typing using molecular diagnostics methods instead of serologic testing. How would you report these tests?
Problem: Until last year, AMA direction published in CPT Assistant indicated that you should continue to report 86812-86817 even if the lab carried out HLA typing by molecular diagnostics techniques such as high resolution polymerase chain reaction (PCR).
Solution: Last year’s CPT added the following instruction following code 86822. For HLA typing by molecular techniques, look at 83890-83914 with appropriate genetic testing modifiers 4A-4G. That instruction frees your lab to garner more appropriate pay by choosing the molecular diagnostics codes that describe each step of a specific HLA typing test.
Source URl :- http://www.supercoder.com/coding-newsletters/my-pathology-lab-coding-alert/cpt-2010-welcome-86825-82826-serology-isnt-the-only-hla-crossmatch-article
Monday, September 6, 2010
ICD-9 2011 Solves Partial Removal Stumper
ICD-9 2011 help you to solve partial removal stumper.
ICD-9 2011, ICD-9 code, ICD 9 codes online, medical coding
When you cannot get all of a splinter out, there will be a new diagnosis code series that’ll tell you the story. Family Physicians are familiar with foreign body removal that gets only a part of the object – and come this fall, they will have a diagnosis code that explains the condition.
During foreign body removal, pieces of wood, glass or bullet shrapnel might be left in. The fragment may either break or split, thus making removing the entire foreign body impossible.
This condition has put to test many a family physician. Sometimes, with a wood splinter removal, the procedure does away with some foreign body; although not all of it.
Is the FBR ICD-9 code still apt? In the event, the patient had further FBR done at one more encounter, would using the FBR diagnosis at the initial FBR encounter mean future claims using the same ICD-9 code would be shorn of?
Add these V90 codes to your diagnosis charge ticket
ICD 9 2011 provides a solution to both dilemmas. With effect from October 1, you can indicate a foreign body was partially removed. You can even indicate a follow-up check for infection after complete removal with a new code for personal history of retained foreign body fully removed (V15.53).
Family physicians might use ICD 9 codes for retained fragments of:
FPs Animal quills or spines - V90.31, Glass - V90.81, and the like.
Source URL :- http://www.supercoder.com/coding-newsletters/my-family-practice-coding-alert/coding-changes-icd-9-2011-solves-partial-removal-stumper-102526-article
ICD-9 2011, ICD-9 code, ICD 9 codes online, medical coding
When you cannot get all of a splinter out, there will be a new diagnosis code series that’ll tell you the story. Family Physicians are familiar with foreign body removal that gets only a part of the object – and come this fall, they will have a diagnosis code that explains the condition.
During foreign body removal, pieces of wood, glass or bullet shrapnel might be left in. The fragment may either break or split, thus making removing the entire foreign body impossible.
This condition has put to test many a family physician. Sometimes, with a wood splinter removal, the procedure does away with some foreign body; although not all of it.
Is the FBR ICD-9 code still apt? In the event, the patient had further FBR done at one more encounter, would using the FBR diagnosis at the initial FBR encounter mean future claims using the same ICD-9 code would be shorn of?
Add these V90 codes to your diagnosis charge ticket
ICD 9 2011 provides a solution to both dilemmas. With effect from October 1, you can indicate a foreign body was partially removed. You can even indicate a follow-up check for infection after complete removal with a new code for personal history of retained foreign body fully removed (V15.53).
Family physicians might use ICD 9 codes for retained fragments of:
FPs Animal quills or spines - V90.31, Glass - V90.81, and the like.
Source URL :- http://www.supercoder.com/coding-newsletters/my-family-practice-coding-alert/coding-changes-icd-9-2011-solves-partial-removal-stumper-102526-article
CPT Codes Online: New Tobacco Cessation Counseling Coverage Expansion
Tobacco users with Medicare coverage were denied access to evidence-based tobacco cessation counseling. Most Medicare beneficiaries want to do away with their tobacco use.
CPT codes online, medical coding
Are you writing off tobacco cessation counseling as non-payable? If so, it’s time to change your gear.
Previously, CMS only covered 99406-99407 for a beneficiary with a tobacco-related disease or with symptoms of one. However, the agency recently announced that under new coverage, any new smoker covered by Medicare will be able to get tobacco cessation counseling from a qualified doctor or other Medicare-approved practitioner who can work with them to prevent them from using tobacco.
For quite some time, many tobacco users with Medicare coverage were denied access to evidence-based tobacco cessation counseling. Most Medicare beneficiaries want to do away with their tobacco use. At present, older adults and other Medicare beneficiaries can get the help they require to overcome tobacco dependence successfully.
The just-in tobacco cessation counseling coverage expansion will apply to services under Medicare Part B and Part A. The new benefit will encompass two individual tobacco cessation counseling attempts a year. Each attempt may cover up to four sessions, with a total annual advantage, thus covering up to eight sessions per Medicare patient who makes use of tobacco.
Older adults and other Medicare beneficiaries can be doing well in their fight to put a stop on tobacco as long as they have the proper resources available. CMS’ decision will assure that beneficiaries can access that help from physicians and other Medicare-recognized practitioners.
For more information on CPT codes online (http://www.supercoder.com/cpt-codes) and to stay up to date on Medicare coverage issues, sign up for a one-stop medical coding website.
CPT codes online, medical coding
Are you writing off tobacco cessation counseling as non-payable? If so, it’s time to change your gear.
Previously, CMS only covered 99406-99407 for a beneficiary with a tobacco-related disease or with symptoms of one. However, the agency recently announced that under new coverage, any new smoker covered by Medicare will be able to get tobacco cessation counseling from a qualified doctor or other Medicare-approved practitioner who can work with them to prevent them from using tobacco.
For quite some time, many tobacco users with Medicare coverage were denied access to evidence-based tobacco cessation counseling. Most Medicare beneficiaries want to do away with their tobacco use. At present, older adults and other Medicare beneficiaries can get the help they require to overcome tobacco dependence successfully.
The just-in tobacco cessation counseling coverage expansion will apply to services under Medicare Part B and Part A. The new benefit will encompass two individual tobacco cessation counseling attempts a year. Each attempt may cover up to four sessions, with a total annual advantage, thus covering up to eight sessions per Medicare patient who makes use of tobacco.
Older adults and other Medicare beneficiaries can be doing well in their fight to put a stop on tobacco as long as they have the proper resources available. CMS’ decision will assure that beneficiaries can access that help from physicians and other Medicare-recognized practitioners.
For more information on CPT codes online (http://www.supercoder.com/cpt-codes) and to stay up to date on Medicare coverage issues, sign up for a one-stop medical coding website.
Friday, September 3, 2010
CPT codes: Gear up for Drug Test Changes
CPT Codes -With two new codes proposed for urine drug testing in the coming year, you might need some help sorting it all out
CPT code list, CPT coding website, CPT codes, CPT Assistant
With two new codes proposed for urine drug testing in the coming year, you might need some help sorting it all out. Get a lowdown on the 2011 codes and a rundown of how current policy meshes with your lab's drug screen test method.
2011 codes close loopholes
CMS provided a sneak peak at new lab test codes for CY 2011. You will need to be familiar with the following two just-in codes for drug testing next year:
801XX
GXXX1
With identical definitions, new code 801XX will replace G0430, which was new in 2010.
Problem: It appears that CMS intends new code GXXX1 to close a loophole in how labs use another code introduced in 2010. What happened in response to G0431 is that many labs switched to manufacturers' drug screen kits that use a single analyte strip or paddle for each drug class -- dipped in a single urine specimen. This allowed labs to code each drug class as a single unit of G0431.
Loophole plugged: By making the unit of service the specimen for GXXX1, labs can only list multiple units if the patient provides multiple urine specimens. The ‘Per specimen' wording should materially prevent labs from billing GXXX1 for each drug class dipstick as they could for G0431.
For more on this and for all the CPT code list (http://www.supercoder.com/cpt-codes)and changes, sign up for a CPT coding website. Such a site comes stocked with official descriptors and guidelines for all CPT codes. In fact, onboard such a site, you can even have access to the CPT Assistant to help you in your coding career.
CPT code list, CPT coding website, CPT codes, CPT Assistant
With two new codes proposed for urine drug testing in the coming year, you might need some help sorting it all out. Get a lowdown on the 2011 codes and a rundown of how current policy meshes with your lab's drug screen test method.
2011 codes close loopholes
CMS provided a sneak peak at new lab test codes for CY 2011. You will need to be familiar with the following two just-in codes for drug testing next year:
801XX
GXXX1
With identical definitions, new code 801XX will replace G0430, which was new in 2010.
Problem: It appears that CMS intends new code GXXX1 to close a loophole in how labs use another code introduced in 2010. What happened in response to G0431 is that many labs switched to manufacturers' drug screen kits that use a single analyte strip or paddle for each drug class -- dipped in a single urine specimen. This allowed labs to code each drug class as a single unit of G0431.
Loophole plugged: By making the unit of service the specimen for GXXX1, labs can only list multiple units if the patient provides multiple urine specimens. The ‘Per specimen' wording should materially prevent labs from billing GXXX1 for each drug class dipstick as they could for G0431.
For more on this and for all the CPT code list (http://www.supercoder.com/cpt-codes)and changes, sign up for a CPT coding website. Such a site comes stocked with official descriptors and guidelines for all CPT codes. In fact, onboard such a site, you can even have access to the CPT Assistant to help you in your coding career.
Boost Your Seizure and Cognitive Testing Coding
Boost seizure and cognitive testing coding with the new ICD-9 codes and to get all 2011 ICD-9 code changes.
2011 ICD-9 code changes, ICD-9 Codes, Medical Coding
However, you should keep using 724.3 for spinal stenosis.
Do not overlook the 2011 ICD-9 code changes that may affect how your neurosurgery practice uses cognition codes later this year. Read on and stay ahead.
724.03 puts more detail into EMG testing
The 2011 ICD-9 code changes expand disease subcategories to provide more specific descriptions. New diagnosis codes that provide additional specificity can certainly be considered a positive for medical coders on the lookout to provide more accurate claims.
One such instance is with new code 724.03
Neurosurgeons may carry out diagnostic neuromuscular electrodiagnostic tests to determine whether the symptoms in a patient's extremities can be classified as neurogenic claudication due to stenosis.
At present, ICD-9 doesn't include a specific diagnosis for neurogenic claudication. Until October 1, you will need to discuss the case with your doctor to get a better understanding of the condition so that you can select the most accurate diagnosis.
The new proposed ICD-9 code offers a more specific diagnosis that'll allow differentiation between the two types of claudication. There was no good way to code this often-documented diagnosis previously other than to capture only the lumbar spinal stenosis.
Source Article :- http://www.supercoder.com/coding-newsletters/my-neurosurgery-coding-alert/icd-9-2010-update-improve-your-seizure-and-cognitive-testing-coding-with-new-icd-9-codes-article
2011 ICD-9 code changes, ICD-9 Codes, Medical Coding
However, you should keep using 724.3 for spinal stenosis.
Do not overlook the 2011 ICD-9 code changes that may affect how your neurosurgery practice uses cognition codes later this year. Read on and stay ahead.
724.03 puts more detail into EMG testing
The 2011 ICD-9 code changes expand disease subcategories to provide more specific descriptions. New diagnosis codes that provide additional specificity can certainly be considered a positive for medical coders on the lookout to provide more accurate claims.
One such instance is with new code 724.03
Neurosurgeons may carry out diagnostic neuromuscular electrodiagnostic tests to determine whether the symptoms in a patient's extremities can be classified as neurogenic claudication due to stenosis.
At present, ICD-9 doesn't include a specific diagnosis for neurogenic claudication. Until October 1, you will need to discuss the case with your doctor to get a better understanding of the condition so that you can select the most accurate diagnosis.
The new proposed ICD-9 code offers a more specific diagnosis that'll allow differentiation between the two types of claudication. There was no good way to code this often-documented diagnosis previously other than to capture only the lumbar spinal stenosis.
Source Article :- http://www.supercoder.com/coding-newsletters/my-neurosurgery-coding-alert/icd-9-2010-update-improve-your-seizure-and-cognitive-testing-coding-with-new-icd-9-codes-article
Wednesday, September 1, 2010
Medical coding news : How to avoid H1N1, Fecal Incontinence
Medical Coder preparing for ICD-9 2011 doesn’t forget to give attention to medical coding news. It will help you how to avoid H1N1, fecal incontinence.
Medical Coding, ICD-9 2011, medical coding news, ICD 10 codes, ICD-9 coding
Even if you’re preparing for ICD 10 codes, you shouldn’t let rumors of few ICD-9 2011 changes blindside you to top family medicine changes. Minus the scoop on expansion to the 488, 784 and 787 categories, denials for invalid codes will derail your claims.
In ICD-9 2011, codes remain to be more and more specific necessitating a provider to document clearly and thoroughly to allow for selection of the most specific and spot on codes.
Good tidings: Updating your ICD-9 coding by October 1 this year does not have to be a chore. Follow these guidelines to start using your new choices in no time.
When assigning ‘swine flu’ Dx, look at manifestation
When a patient has H1N1, pay attention to two details this winter. The medical record will have to identify the correct influenza and you’ll have to capture the appropriate manifestation to select the codes to the degree of specificity now required.
With the change, category 488 would mirror the structure of category 487. The present 488.x sub-category did not provide the level of detail that category 487 does.
Change: There’ll be tremendous expansion of the H1NI category. ICD-9 2011 does away with 488.0 and 488.1 and adds six new five-digit codes. Just-in codes 488.0x and 488.1x allow you to uniquely capture pneumonia, other respiratory manifestations and other manifestations occurring with these types of influenza.
Beginning October 1, you will assign the right 488.xx code based on the type of comorbid manifestation the avian or H1N1 influenza involves:
Do not forget: As with 487.0 when you code 488.01 or 488.11, you will use an additional code to identify the type of pneumonia.
For more on this and other medical coding news, sign up for a one-stop medical coding website and stay up to date.
Medical Coding, ICD-9 2011, medical coding news, ICD 10 codes, ICD-9 coding
Even if you’re preparing for ICD 10 codes, you shouldn’t let rumors of few ICD-9 2011 changes blindside you to top family medicine changes. Minus the scoop on expansion to the 488, 784 and 787 categories, denials for invalid codes will derail your claims.
In ICD-9 2011, codes remain to be more and more specific necessitating a provider to document clearly and thoroughly to allow for selection of the most specific and spot on codes.
Good tidings: Updating your ICD-9 coding by October 1 this year does not have to be a chore. Follow these guidelines to start using your new choices in no time.
When assigning ‘swine flu’ Dx, look at manifestation
When a patient has H1N1, pay attention to two details this winter. The medical record will have to identify the correct influenza and you’ll have to capture the appropriate manifestation to select the codes to the degree of specificity now required.
With the change, category 488 would mirror the structure of category 487. The present 488.x sub-category did not provide the level of detail that category 487 does.
Change: There’ll be tremendous expansion of the H1NI category. ICD-9 2011 does away with 488.0 and 488.1 and adds six new five-digit codes. Just-in codes 488.0x and 488.1x allow you to uniquely capture pneumonia, other respiratory manifestations and other manifestations occurring with these types of influenza.
Beginning October 1, you will assign the right 488.xx code based on the type of comorbid manifestation the avian or H1N1 influenza involves:
Do not forget: As with 487.0 when you code 488.01 or 488.11, you will use an additional code to identify the type of pneumonia.
For more on this and other medical coding news, sign up for a one-stop medical coding website and stay up to date.
Check CPT& CCI about conscious sedation
Always check CPT coding and CCI edits because CPT guidelines and correct coding initiative edits will keep you from reporting conscious sedation with most cardiac catheterization codes.
CPT coding, CCI edits, CPT assistant, Medical Coding, CPT manual
As a cardiology coder, you may be bowled over by various CPT coding questions. For instance, you may find yourself bowled over by questions such as:
Is it ok to report conscious sedation for a cardiac catheterization?
The answer: CPT guidelines and correct coding initiative (CCI) edits will keep you from reporting conscious sedation with most cardiac catheterization codes.
CPT: CPT makes use of a symbol that looks like a circle with a dot in the center – in order to identify codes which CPT considers to include sedation as part of the procedure. As a consequence, you shouldn’t report moderate sedation alongside the service. If you check the cardiac catheterization section of CPT, you will see the symbol beside 93501 and 93505-93530 as well as all of the injection procedure codes.
CCI edits: CCI edits(http://www.supercoder.com/coding-tools/cci-edits-checker/) bundle 99143-99145 into the same cardiac cath codes as showed in the CPT manual.
Term tip: According to CPT guidelines, moderate or conscious sedation is a ‘drug-induced depression of consciousness’ that allows patients to maintain their airways and ability to respond to stimulation or verbal commands.
CPT coding, CCI edits, CPT assistant, Medical Coding, CPT manual
As a cardiology coder, you may be bowled over by various CPT coding questions. For instance, you may find yourself bowled over by questions such as:
Is it ok to report conscious sedation for a cardiac catheterization?
The answer: CPT guidelines and correct coding initiative (CCI) edits will keep you from reporting conscious sedation with most cardiac catheterization codes.
CPT: CPT makes use of a symbol that looks like a circle with a dot in the center – in order to identify codes which CPT considers to include sedation as part of the procedure. As a consequence, you shouldn’t report moderate sedation alongside the service. If you check the cardiac catheterization section of CPT, you will see the symbol beside 93501 and 93505-93530 as well as all of the injection procedure codes.
CCI edits: CCI edits(http://www.supercoder.com/coding-tools/cci-edits-checker/) bundle 99143-99145 into the same cardiac cath codes as showed in the CPT manual.
Term tip: According to CPT guidelines, moderate or conscious sedation is a ‘drug-induced depression of consciousness’ that allows patients to maintain their airways and ability to respond to stimulation or verbal commands.
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