Three warnings you need to watch out for when using E codes

E codes point to the external causes of injuries and poisonings as well as the adverse effects of drugs and substances.

If you report injuries or poisonings, then you certainly need to be familiar with E codes. But before you turn to these codes, make it a point to keep these three things in mind that will prevent your claim from getting tripped.

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. They are thought of as special ICD-9 codes which you can generally use to report accidents, injuries or diseases. You can report E codes with regular ICD 9 codes.

This is a no no: You shouldn't report E codes as your primary code as they only indicate the cause of injury/poisonings and not the resulting injury/condition. Like always, report E codes in addition to a numerical ICD-9 code that describes the injury itself. It might be needed to assign more than one E code in order to explain each cause fully.

Be specific about your E codes Increasing 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 interested in injury prevention and safety issues. However does it provide too much 'up-front'know how about the patient's behavior/lifestyle?

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 when the need arises, you would want to keep hoping you may never have to come face to face with these 'need'. These two just-in codes describe situations that are considered 'never' events, which means they represent surgical mistakes that should never happen.

For more information on E codes and other ICD 9 codes information, sign up for a one-stop medical coding (http://www.supercoder.com/) website.

We provide you simple, instant connection to official code descriptors & guidelines and other tools for 2010 CPT code, HCPCS lookup that help coders and billers to excel in the work they do every day.

ICD 9 codes, medical coding, E codes

Match your 35475, 35476 Coding to the Latest Change

Latest CCI Codes versions have lot of changes for angioplasty of arteriovenous dialysis grafts. Match your 35475, 35476 coding to the latest change.
CCI Edits, CCI Edit, CCI Codes, Medical Coding

2010 has been a year of changes for coding angioplasty of arteriovenous dialysis grafts. The latest CCI codes version, that went into effect on October 1, 2010, adds to the list with a column swap that could be good news for your practice.

Begin with the 35475, 35476 edit facts

The codes involved in the edit are the following:

35475, 35476

Old way: Until October 1, CCI's edit for 35475 and 35476 resembled something like this:

Column 1 Column 2

35476 35475

As a result, 35475 (arterial) was bundled into 35476 (venous).

Know how column change impacts fee

As per CCI rules, if you report both codes in a column 1/column 2 edit pair to Medicare or another payer who adopts CCI edits, the payer will reimburse you for the code in the column 1 position only. Medicare's national rate for 35475 is more than 35476; as such the column swap places the higher valued code in the column 1 position.

Compare CCI edit to coding recommendations

This new CCI edit column swap comes on the heels of other key 2010 changes for coding percutaneous transluminal angioplasty (PTA) of arteriovenous (AV) grafts and fistulas.

For more on the latest CCI edits(http://www.supercoder.com/coding-tools/cci-edits-checker/), sign up for a one-stop medical coding website. Such a site comes with a CCI tool that helps you keep your claims compliant with the NCCI. This tool tells you whether CCI bundles code combination and if the edit allows a modifier. Sign up for one today and see the difference it brings to your practice reimbursements!

Let Add-on Codes Add to Your 92980 Bottom Line

CPT's parenthetical notes following 92980-+92981 offer rules for proper reporting that you cannot afford to miss.
CPT codes lookup, CPT Code list, CPT Assistant, Medical Coding

Prior to making your coding decision, identify the vessels involved.

CPT's parenthetical notes following 92980-+92981 offer rules for proper reporting that you cannot afford to miss. The notes reveal the following key points on what is and is not included.

Include these same-artery services

CPT's parenthetical notes following 92980-+92981 offer rules for proper reporting that you cannot afford to miss. The notes reveal the following key points on what is and is not included.

Include these same-artery services

CPT states that coronary angioplasty and/or atherectomy in the same artery as the stent placement is not separately reportable for the same encounter.

Separate vessel could mean separately reportable

If your cardiologist carries out stenting in one coronary vessel, and angioplasty or atherectomy procedures in a different coronary vessel, the angioplasty or atherectomy is not included in the stent code. As such, you may report those services separately.

Article Source :- http://www.supercoder.com/coding-newsletters/my-cardiology-coding-alert/stent-coding-let-add-on-codes-add-to-your-92980-bottom-line-article 

Important: When coding interventions on more than one coronary vessel during the same session, the first code should be for the highest level procedure carried out on any vessel.

The hierarchy is stenting before atherectomy prior to balloon angioplasty.

Bonus tip: Remember that proper reporting for the above two-vessel instance calls for reporting the ‘single vessel' stent code 92980 with ‘additional vessel' code 92982 as the codes represent two different types of procedures. However CPT guides you to the right codes by stating under the stent codes. To report additional vessels treated by angioplasty or atherectomy only during the same session. That apart, CPT Assistant (December 1996) indicates that 92980 with +92984 is proper coding for stent placement in one vessel and angioplasty in another.

For more on this and the entire CPT code list, sign up for a one-stop medical coding website. Such a site comes with a CPT codes lookup tool to assist you in your coding and help you get the rightful reimbursements.

Specificity in Diagnosis Coding is Important in ICD-9 Codes

Specificity in Diagnosis Coding is always important in ICD-9 Codes. Should know the appropriate Codes that can help you handle the situation.
ICD-9 coding, ICD-9-Codes, ICD-9 changes, Medical Coding

Your interventional radiologist may be tending to more patients complaining of chronic pain. Trouble crops up when you don't see documentation of a definitive diagnosis for the visit. You should know the appropriate codes that can help you handle the situation:

Why specificity in diagnosis coding matters

Specificity in diagnosis coding is always important; however it's increasingly vital as third party payers are establishing more stringent coverage criteria for therapies and procedures and are using automated edits to deny claims based on the lack of a covered diagnosis.

Using a non-specific diagnosis code which may be 'close' – however not exact – may mean you won't be paid for a service due to a Medicare LCD or a third-party medical policy. If you opt for non-specific codes, it might also mean you receive payment for a service that would not be covered under the right diagnosis.

Both these situations come up with different problems. Making use of the most specific diagnosis for the patient and ensuring it's well documented in the medical record will help ensure the right reimbursement for the provider and appropriate coverage for the patient.

The reality is: Using the wrong diagnosis may limit coverage or may get you paid for the services that are not covered, which increases your risk during audit.

For more on this, sign up for a one-stop Medical Coding website. Onboard such a site, you can get all the just-in ICD-9-codes under one roof. Pretty soon, you'll realize that staying tuned to the ICD-9-Changes is an easy thing.

Rid 'uncertain behavior' confusion with sure-success tips on 238.2 use

To reduce denials follow experts tips and see it that you are choosing right diagnosis code for all your claims.
updated codes, stop denials, reduce denials, CPT code, Medical Coding

If you always use diagnosis code 238.2 when reporting 11100 for a biopsy procedure your dermatologist carries out, you are setting your practice up for disaster. The key to knowing when to use the 'uncertain behavior diagnosis code is understanding what that code descriptor really means. Follow these expert tips to reduce denials and to see to it that you are choosing the right diagnosis code for all your 11100 claims.
Wait for pathology prior to selecting a code

When your dermatologist carries out as biopsy, you should always wait until the pathology report comes back to select the proper diagnosis and procedure codes to report even though this'll not always have an impact on the CPT code you will choose.

Know the meaning behind 'uncertain' codes

When you report 238.2 as the diagnosis for a biopsy procedure, you are telling the payer what the pathologist said in his path report – that he was uncertain as to the morphology of the lesion. Uncertain behavior doesn't mean that the coder is not certain or that the doctor thinks the lesion looks suspicious although it might be benign.

Uncertain behavior means that a specimen has been examined by a pathologist and that the cells are of mixed types.

Do not rush coding just to get paid

You shouldn't code just to make sure you will be paid for a procedure. In the case of a biopsy, waiting to code until you have the pathology report shouln't affect your reimbursement anyway. You may have to wait a bit longer to get the reimbursement if you need to hold a claim while you wait for the pathology report; however your coding will be more spot on. If you biopsy a lesion and the results come back as precancerous, this is exactly the diagnosis you would use so that it is a perfectly payable diagnosis. On the other hand, insurers are looking for more reasons to deny payment. If you had carried out a biopsy and indicated that the patient has hyperplasia and then the physician found out that the biopsy indicated melanoma and the patient returned to have excision of the melanoma and the insurer ever compared the documentation there could be problems.

CCI Edits 16.3: Include Wound Repair In Free-Flap Grafts or Risk Denials

Latest CCI edits addresses another aspect of your skin graft coding with a new edit bundling 11040 as a component of 15002.
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The latest CCI edits 16.3 that went into effect on October 1 this year creates a coding bundle naming simple wound repair codes 12001-12007 and 12041-12047 as intrinsic components of 15756, 15757, 15758.

What does this mean? In the above pairings, CCI lists the wound repair codes as column 2 codes, which means they are considered components of the comprehensive codes (15756-15758) under Column 1.

Do not miss: These bundles have a modifier indicator of one; as such you may use a modifier like 59 to override the edit if the clinical circumstances merit separate reimbursement like a separate encounter on the same date, a separate anatomical site or a separate indication.

Catch this debridement/site prep bundle

The latest CCI edits addresses another aspect of your skin graft coding with a new edit bundling 11040 as a component of 15002. This edit indicates that Medicare considers debridement to be an essential component of site prep procedures. But CCI has also marked these bundles with modifier indicator 1 so you may report 11040 along with 15002 or 15004 under appropriate clinical circumstances with an appropriate modifier.

New edits target hematoma, nail repair

From October 1, CPT code 11740 includes 11730. As with other CCI edits, these bundles are marked with modifier indicator '1', allowing separate reporting if clinically necessary, with the right modifier appended to the component (column 2) code.

These would not be used together on the same site. They would have to be carried out on different nails.

For more on the latest CCI edits, sign up for a one-stop Medical Coding website. Such a site comes with a CCI Tools(http://www.supercoder.com/coding-tools/cci-edits-checker/) that tells you whether CCI bundles a code combination and if the edit allows a modifier, among a host of other information pertaining to CCI edits.

Differentiate Wound Repair versus Tissue Transfer to Achieve Proper Coding

Surgeon carries out a wound repair closure, could be miscoding if turn to 12001-13160 automatically.
CPT Code list, CCI guidelines, Medical Coding

When your surgeon carries out a wound repair closure, you could be miscoding if you turn to 12001-13160 automatically. You need to dig deep into the surgeon's documentation to see if the tissue transfer code is more apt. However knowing the difference between wound repairs and tissue transfers is only the start. See to it that your surgeon gets the reimbursement he deserves:

Know the difference between transfers and repairs
For wound closure procedures, you will first need to decide between wound repair codes 12001-13160 and adjacent tissue transfer codes 14000-14300.

Determine overall area and location
According to CPT instructions, once you determine that your surgeon carried out a tissue transfer, you will need to narrow down your code selection by determining the total area of the primary and secondary defects.

After adding up the affected area, look at the repair's anatomical location to narrow your choices further.

Skip separate lesion removal coding

You shouldn't separately report any lesion removals your surgeon carries out during a tissue transfer procedure. The excision of the benigh lesion or of the malignant lesion is not separately reported with the tissue codes. This guidance is reinforced by both CPT and CMS/CCI guidelines.

Exception: If your surgeon carries out an excision on a separate day from the tissue transfer, you may go on to report the procedures separately. You might stand witness to this scenario if your surgeon is waiting for the pathology report to be sure the lesion margins are clear prior to closing the operative wound. If the tissue transfer takes place during the excision's 10-day global period, go for modifier 58 to the tissue transfer code.

Article Source :- http://www.supercoder.com/coding-newsletters/my-general-surgery-coding-alert/wound-repair-differentiate-wound-repair-vs-tissue-transfer-to-achieve-proper-coding-in-just-3-steps-article