In Coding
Feb 21st, 2018
A hypertensive crisis is a severe increase in blood pressure that can lead to stroke, organ damage, heart attack, and more. The Mayo Clinic defines extreme high blood pressure as  “a top number (systolic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or ...
In Coding
Feb 21st, 2018
Pharyngitis (more commonly called sore throat) is inflammation of the pharynx. Sore throat typically is caused by bacterial or viral infections, and is a common reason people go to see their doctor. Coding is straightforward, so long as the provider documents whether the problem in acute or chronic, and the causative agent (e.g., streptococcus), if ...
Feb 21st, 2018
Sometimes coders are confused when they should apply modifier 58 Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period and modifier 78 Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure ...
In Audit
Feb 20th, 2018
A specimen validity test performed on the same day as a urine drug test for the same person should be a rare occurrence because specimen validity testing is included in the description of HCPCS Level II codes for urine drug tests. Billing both tests separately is like double-dipping. And yet, Medicare paid 4,180 clinical laboratories and physician offices ...
In Billing
Feb 19th, 2018
Effective Jan. 1, 2018, newly approved biosimilar biologicals with a common reference product are no longer grouped into the same billing code. This change was finalized in the 2018 Medicare Physician Fee Schedule final rule. Q5102 Replaced with Two New Codes The April 2018 update to the Medicare Physician Fee Schedule Database (MPFSD) includes three ...