In Coding
Apr 21st, 2019
Pain management during the global period of a procedure, if related to that procedure, is not separately reportable. If a provider other than the operating provider performs follow-up care, you must be careful to avoid “unbundling” of that follow-up care. The global period, or global surgical package, bundles all care typically related to surgical service ...
In Coding
Jan 18th, 2019
CPT® add-on codes, such as +10004 Fine needle aspiration biopsy, without imaging guidance; each additional lesion (List separately in addition to code for primary procedure), describe procedures always provided “in addition to” a more extensive, primary procedure code (there is one exception). Often, a parenthetical note will identify the primary code(s) with which the add-on code ...
In Coding
Jan 17th, 2019
Critical care coding is complex. You need to be certain that documentation supports that the patient has a critical illness or injury. You must be sure that the time reported as critical care does not include separately-billable services. But critical care reporting is truly exceptional for one reason: critical care code 99292 Critical care, evaluation ...
In CMS
Dec 14th, 2018
Incident to billing allows non-physician providers (NPPs) to report services “as if” they were performed by a physician. The advantage is that, under Medicare rules, covered services provided by NPPs typically are reimbursed at 85 percent of the fee schedule amount; whereas, services properly reported incident to are reimbursed at the full fee schedule value. ...
In Coding
Dec 13th, 2018
Modifier 59 Distinct procedural service is an “unbundling modifier.” When properly applied, it allows you to separately report—and to be reimbursed for—two or more procedures that normally would not be billed or paid independently during the same provider/patient encounter. For example, per CPT Assistant(Jan. 2018): Code 20680 [Removal of implant; deep (eg, buried wire, pin, screw, metal band, ...