Welcome Car Seat Testing Codes Effective Jan. 1

Plus: You'll find explanation on developmental testing codes 96110-96111.

Previous year, coders got a good dose of updates--and confusion--with the inclusion of numerous new vaccine administration codes. CPT 2012 goes lenient on pediatric practices with a few modifications to the code set which will generate the necessity for updates, but not overhauls. Read this article for stress-free and accurate medical coding.

At the top of the list this year, you'll find the following new CPT codes for car seat testing:

94780 – (Car seat/bed testing for airway integrity, neonate, with continual nursing observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes)

+94781 – {...each additional full 30 minutes (List separately in addition to code for primary procedure)}

The car seat testing services will mainly be done in facility settings; however will be valued with facility and non-facility payment amounts. These tests are usually essential before premature or at-risk babies (with conditions such as heart disease or congenital malformations) are discharged home from NICU settings.

There are occasions where follow-up testing may be indicated. "This would normally be provided in a neonatal follow-up clinic, however could be carried out in the office setting, in case the setup is complete to offer all the necessities for the code. As more services shift to the medical home, this could happen more in the future. Having the CPT codes and the anticipated relative value payments should facilitate the process.

For More Information :- http://isupercoder.blogspot.in/2011/12/welcome-car-seat-testing-codes.html

Developmental 'Testing' Modifies to 'Screening'

New CPT codes are always great to find in CPT®, however occasionally you'll find changes that make significant explanations to present codes. Such is the case with existing developmental testing CPT codes 96110-96111. The new descriptors for these codes are listed below:

96110 – (Developmental screening, with interpretation and report, per standardized instrument form)

96111 – (Developmental testing, (includes assessment of motor, language, social, adaptive, and/or cognitive functioning by standardized developmental instruments), with interpretation and report)

Medical Coding Tip: Take Note of Vaccine Revisions

Last year, in pediatric medical coding, CPT® threw many practices for a loop with the adding of several new vaccine administration codes, which most payers finally began processing efficiently within the last few months. Luckily, such a main overhaul has not taken place this year. Instead, CPT® makes slight adjustments to how you'll report your vaccines for accurate medical coding.

For instance: CPT® will change meningococcal conjugate vaccine code 90644 to get rid of mention of "Hib-MenCY-TT." In its place, the new code descriptor reads "Meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza B vaccine (Hib-MenCY), 4-dose schedule, when administered to children 2-15 months of age, for intramuscular use.

Tips to Ensure a Successful CABG Coding

Here are some tips to ensure a pain-free CABG (coronary artery bypass graft) coding:

You should make it a point to examine the code choices. During CABG procedures, there are three CPT codes for anesthesia: 00562, 00566, and 00567.

The associated base units differ as per the procedure.

You should watch for pump documentation. The first question you need to answer when coding anesthesia during CABG is whether the anesthesiologist used a pump oxygenator during the procedure.

An 'off pump' case takes place when the surgeon operates on the patient's still-beating heart. The physician is required to document 'off pump' before you can report the codes with higher base unit values. It can be worth approximately $85 more for an average Medicare case; however see to it that your anesthesiologist has earned it before you code it.

And just as in any other type of procedure, the key to reimbursement is documentation.

You shouldn't always add qualifying circumstances

Some payers let coders report "qualifying circumstances" codes that explain aspects of the patient's situation that complicated the anesthesiologist's work. Three of these codes - 99100, 99116, and 99135 – might apply to cardiovascular cases.

You shouldn't include these codes with all CABG procedures. Often, Hypothermia is included in the anesthesia code and shouldn't be reported separately in those cases.

You should look for notes that add units

Documentation can sometimes justify extra base units; as such you should read your anesthesiologist's notes and the operative report carefully.

For instance, if the surgeon sews a graft during an off-pump procedure, the anesthesiologist is due one additional unit owing to the increased risk. Also, you can shift from 18 base units with 00567 to 20 base units with 00562 if the CABG procedure includes another heart procedure like valve placement or if the patient is having a re-do CABG more than one month after an original CABG surgery.

To get the full picture, you need to look at the operative note along with the anesthesia record to get the complete picture. If something is mentioned in the surgical note that counts as documentation, you can use in your anesthesia coding.

CPT Codes for Skin Replacement and Skin Substitute Grafts

Revised CPT instruction clarifies coding.

Although the codes and rules for reporting skin replacement and skin substitutes are not new, ever since 2011 CPT codes added a couple of new introductory sections it certainly looks clearer. Read on and take some lessons on ways to report skin replacement and skin substitute grafts:

When you shouldn't use these codes

There are over 50 codes that describe the various surgical steps and types of skin replacement/substitute procedures in the range 15002 - +15431.

So questions may arise whether you should report the proper codes from this range every time your surgeon makes use of a skin replacement or skin substitute to heal a wound. Well, in this case you shouldn't code a skin replacement or skin substitute application if the surgeon just applies skin replacement/substitute to the wound, even if he makes it stable by dressing.

Instead here's what you should do: You should use these codes only when the skin substitute/graft is anchored using the surgeon's option of fixation. Say for instance it might include adhesives, sutures, or staples.

You should look for documentation of fixation in the op note before you make use of any skin replacement or skin substitute codes.

Be familiar with what ‘application' services include

Many a time surgeons carry out skin replacement or skin substitute grafts post other surgical treatment for distressing wounds, burn eschar, or necrotizing infection. When the surgeon applies and fixes skin or a skin substitute you will need to understand which services you should and should not code in apart from the proper graft code.

You should include dressing: As per CPT instruction, when you report a skin or skin substitute graft, you should not code routine dressing supplies separately. Supplies like A6453 are included in the skin application charge.

2012 CPT Code Changes for Clinical Lab Codes

CPT 2012 brings new codes for HIV Antigen and NMPP22 – check them out.

On January 1 next year, 2011 CPT codes will be replaced by new codes. So if your lab runs a single-result test for HIV-1 antigens and HIV-1/HIV-2 antibodies, you will have a new code to report the service next year. This is one of the two new CPT codes that made an entry at the annual CMS laboratory public meeting for pricing new test codes for payment on the clinical laboratory fee schedule.

Even though there are no new codes on the horizon, this year's meeting featured much discussion about drug test coding.

Two new clinical lab test codes in CPT 2012

This time, CPT 2012 codes will bring these two clinical lab test codes: 863XX, 873XX. Both these codes will provide more specific reporting for newer tests you may have added to your menu recently.

Drug Testing Leads ‘Reconsideration'

Apart from pricing recommendations for the new codes, Centers for Medicare & Medicaid (CMS) heard public comments for reconsideration requests for these 2011 CPT codes : G0434, G0435, 83861, 86481 and 87906.

Drug screen

Many commentators suggested changing G0434 to cover only CLIA waived tests, while coding up with a new code for moderate complexity tests priced at four times G0434. The present grouping under G0434 comes down hard on clinical labs that carry out these tests while using instrumented moderate complexity systems. The moderate complexity instruments come with some clinical advantages - say for instance higher specificity that commentators said shouldn't be discouraged by coding and reimbursement.

Pricing Proposal & Comment

The agency received industry input during the July 18, 2011, public meeting for the new codes. It'll post final payment determinations on the same Website in October 2011.

Even though payment method for codes can be either crosswalk or gap-fill, almost all presenters at the public meeting recommended crosswalks for the just-in codes.