CPT 2010 adds More Options to Your Vaccine Administration Coding

Earlier Editions of CPT include vaccine administration codes (90465-90468) for children younger than eight years of age. Now CPT 2011adding more options to your Vaccine Administration.

As winter sets in, CPT 2011 will bring some welcome additions to your observation care and vaccine administration coding options. These vaccine administration codes are expected to help boost physicians' bottomlines.

Earlier editions of CPT included vaccine administration codes (90465-90468) for children younger than eight years of age when the physician counseled the patient/family. This time, CPT introduces two administration codes that expand the concept to include adolescents and teens and does away with the distinction based on route administration:

90460 -- Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoid component

90461 -- each additional vaccine/toxoid component (List separately in addition to code for primary procedure).
You could find yourself relying frequently on 90460 and 90461 if your physician often provides counseling with vaccinations for patients 18 or under. Perhaps part of the supposed need for these codes was the increasing prevalence of multicomponent vaccines. The physician needs to counsel regarding each component; but the coding did not distinguish that higher amount of counseling from counseling for a single component. The switch allows physicians to get credit for each component on which they counsel, and not the number of shots given.

Note: Components drive vaccine descriptors

The new immunization administration codes this time are based on the number of components in the vaccine.

Get a sneak peek on these vaccine administration codes as well the entire CPT code list (http://www.supercoder.com/cpt-codes) for the coming year by signing up for a medical coding guide like Supercoder!

Correct Date of Service is Imperative

OIG released the results of its audit 'Review of Medicare Parts A and B Services Billed With Dates of Service After Beneficiaries' Deaths

On September 23 this year, the OIG released the results of its audit 'Review of Medicare Parts A and B Services Billed With Dates of Service After Beneficiaries' Deaths', which revealed that CMS paid approximately $8.2 million in benefits for claims with dates of service after the beneficiaries' deaths.

The OIG noted that Medicare will only shell out money for expenses 'reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member as medically necessary items or services can't be provided after beneficiaries'deaths, no items or services are allowable' thereafter.

Since the OIG is tracking dates of service by investigating the date the patient passed away, you should make it a point to ensure your ob-gyn practice records the correct date of service (DOS) on your Medicare claims. In many instances, some practices are still charging for services long after their patients died, and it is costing the Medicare system big money.

Correct date of service is very important : Even though many practices might be surprised to find that they've made a mistake like this, the OIG found some problems with claims for over 69,000 deceased beneficiaries between Parts A and B over a two-year period.

Safeguard your practice by following this advice

Watch your date protocol: Sometimes there are errors where practice employees misinterpret the dates that the physician writes down. If the physician notes down '06-04-10,' he might mean June 4, 2010, while someone else might interpret that as April 6, 2010 as the date is written differently by different people."

Advice: If you enter the DOS into the patient's claim form manually, be sure and have a uniform way of writing the date at your practice, between all providers and back office staff members. To add to it, you should cross-reference the DOS against the records for all deceased patients to ensure that you have recorded all dates correctly.

Follow through with other data: If you are making errors on deceased patients' records, it is likely that you have also applied the wrong date on other patients' claims as well. Ensure that everyone in your practice is using the same criteria to apply DOS. If some doctors still write the date with the numbers for the month and year transposed, it might be a good idea to ask all the practitioners to begin writing out the month instead. For example, instead of 06-04-10, you might have to ask everyone to start writing out June 4, 2010.

For more tips on ways to write the correct DOS and for other medical coding news pertaining to this, sign up for a medical coding guide like http://www.supercoder.com/

93270 Calls for Minimum Transimission

As per CPT Assistant if you going to report 93270 you should have check some conditions.


Often, you may be confused over questions such as this: Question: Should you report 93270 even when the only transmission was the test transmission?


The answer is that you should be able to report 93270 in the situation you describe, assuming you meet certain conditions.



As per 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 instructed the patient on proper monitor use (including hookup, recording, and transmission).

The patient sent at least one transmission; the reason being: Patients must send a test transmission when the monitoring period starts to ensure the device is working.
Lesson learned: According to CPT Assistant, when the patient (1) gets both the device and instructions in the mail and (2) the physician or facility staff never instructed the patient directly, you shouldn't report 93270.


You also shouldn't report 93270 if the patient sends no transmissions. CPT Assistant states, “If no tracing is sent, then there can be no report and no reportable service has been provided although the patient received a monitor for a month.

For more updates on this, sign up for a one-stop medical coding website. Onboard such a site, you can even subscribe to a CPT Assistant to get hands on information that can help you bring in the reimbursements. Here, you'll get the annual CPT Assistant newsletter, along with access to CPT assistant back issues (1990 to 2009), at a good discount.

Myths about MUEs

Beware of MUEs as they occur, and you cannot use ABNs to transfer responsibility for payment to the beneficiary.

See to it that you are not letting medically unlikely edits (MUEs) play havoc on your urology practice's coding and reimbursement by unraveling the truth about four aspects of these edits.

The first myth is that MUE edits do not affect your practice

Some practices think that they do not need to worry about MUEs. However, we should be aware of MUEs as they occur.

The second myth is that you can bill the patient to overcome MUE limits

Some practices think that by having the patient sign an advance beneficiary notice (ABN), you can pass on the cost of procedures you know will be denied owing to MUEs. The reality is that you cannot use ABNs to transfer responsibility for payment to the beneficiary.

The third myth is that you can never override an MUE

Do not think that even if your doctor carries out a legitimate, medically necessary procedure that violates MUE edits, you cannot override the edits.

According to CMS, MUEs reflect the maximum number of units the large majority of properly reported claims for a particular code would have; as such you don't need to override them often. However, you can overide an MUE when your doctor carries out and documents a medically necessary number of services that exceed the limit.

Ignorance as far as medically unlikely edits are concerned could be causing you medical coding(http://www.supercoder.com/) claim denials. To know more about medically unlikely edits and to stop denials, sign up for a one-stop medical coding website. Such a site will ensure that you stay updated on all coding know how.

CPT 2011 - Check out just in CT Codes 74176-74178 AMA just released the CPT code list CT Codes 74176-74178. You will see a collection of stent and ang

AMA just released the CPT code list CT Codes 74176-74178. You will see a collection of stent and angioplasty codes.
CPT code lookups, CPT 2011, CPT Code list, Medical Coding

January 2011 is just round the corner. As a radiology coder, you are likely to witness new CT codes 74176-74178. In addition to it, you will see a collection of stent and angioplasty codes for the coming year.

So for those tired of cluttering up your claims with both abdominal and pelvic CT codes, CPT 2011 has the solution you crave. The AMA has just released the CPT code list that you can expect to go into effect on January 1, 2011.

The CPT code list includes the following:

74176 -- Computed tomography, abdomen and pelvis; without contrast material

74177 -- with contrast material(s)

74178 -- without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions.
For more details on this, sign up for a one-stop medical coding website. Such a site will provide proper use of these codes as well as just-in codes for nonvascular extremity ultrasound, revised codes for stent placement, endovascular iliac artery repair, and angioplasty RS&I, and lots more.

Such a site comes with CPT code lookups to assist you in your coding. What's more, when you get onboard such a website, you will stay up to date with all the code changes – be it CPT, ICD-9 or HCPCS codes(http://www.supercoder.com/hcpcs-codes). Keeping such a site handy will also ensure you stay away from claim denials. Such a site doesn't cost you much either. So register yourself for one today and see the difference it brings to your practice.

Anticipate 4th and 5th digit changes for ICD-10

CMS has pointed out that the need to change from ICD 9 to ICD 10 will be effective. You will have to get used to selecting codes with definitions that may differ from what you are used to.
ICD 9 to ICD 10, ICD 9 codes, ICD 10 2010, ICD-10 bridge, Medical Coding

CMS has pointed out that the need to change from ICD 9 to ICD 10 will be effective from October 1, 2013. When that takes place, you will have to get used to selecting codes with definitions that may differ from what you are used to.

Start researching and preparing a minimum of six months prior to implementation of ICD-10. There is a lot for most of us to learn as there are lots of differences; however the payoff will be much greater specificity. One step you can take as of now is to look at the ICD-10 2010 codes that apply to diagnoses you report most often. Remember whether they require different information than their ICD-9 counterparts, and share that information with providers so that they can get used to including that information in their documentation prior to the transition.

For instance: Here's a list of the ICD-10 2010 codes for Hodgkin's lymphoma:

C81.0

C81.1

C81.2

C81.3

C81.4
Excludes1: Nodular lymphocyte predominant Hodgkin lymphoma (C81.0-)

C81.7

C81.9
Even though ICD 10 as published presently lists all codes individually with the full description ( as opposed to the present ICD-9 tabular format), you can witness that like ICD-9, the ICD-10 2010 Hodgkin's codes call for a fifth character for each of the above classifications. The ICD-10 options are pretty similar to ICD-9 codes, except that that you'll have separate ICD-10 options for unspecified site (0) and extranodal and solid organ sites (9). In ICD-9, the two are lumped together under 0.

Compare ICD 9 to ICD 10: There are various one-stop medical coding websites that offer educational materials that you can review; as such there's a lot of good quality yet free information available. Such a site also offers you an ICD-10 bridge to help you make a smooth transition from ICD 9 to ICD 10.

How to Report Cocaine Poisoning

Know how to report cocaine poisoning in ICD 9 Codes 2011.

What will you do when the emergency department calls your cardiologist to care for patient with cocaine poisoning? Well, a just-in code effective October 1, 2010 changes what you should report. Now, post the ICD 9 codes 2011 changes, there is 970.81 which is available 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 a detailed example: A 22-year old patient presents 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 physician carries out and documents a thorough history and exam.

Diagnostics cover a cardiac panel and drug screen, and an electrocardiogram (ECG) reveals ST elevation in the anterior leads. Lab work shows elevated CPK and troponin. The doctor tends to 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) owing to cocaine poisoning and hypertension. The doctor reports 45 minutes of critical care time.

Here's the solution: You should report the following for this particular encounter: 99291, 970.81 and 401.9.

For more information on cardiology-related codes that went into effect on October 1, sign up for a one-stop medical coding website. So if you're looking for all the ICD 9 codes(http://www.supercoder.com/icd9-codes/) 2011 changes that went into effect recently, this is the place to be!



ICD-9, ICD 9 Codes 2011, Medical Coding