In Billing
Dec 8th, 2014
Duplicate claim submitted — Claims are often denied as duplicates for the following reasons: The claim was previously processed (i.e., no payment made, allowed amount applied to deductible on the initial claim). The provider re-files the claim to “correct” it. The second claim submitted is considered a duplicate because the initial claim was processed correctly. ...
In Billing
Nov 13th, 2014
When dealing with Medicare patients, if the physician discovers a polyp during what begins as a screening colonoscopy, you should retain the initial V code (for instance, V76.51 Special screening for malignant neoplasms; colon) as the primary diagnosis. “Whether or not an abnormality is found, if a service to a Medicare beneficiary starts out as ...
In Coding
Oct 15th, 2014
Robotic surgery is covered by routine and customary laparoscopic CPT® and ICD-9-CM coding practices, existing medical policies for advanced laparoscopic surgery, and current payer contract rates. The primary surgical procedure remains laparoscopic: You should not report unlisted procedure codes or modifier 22 Increased procedural services for robotic assistance (except perhaps, for instance, there ...
Oct 8th, 2014
If you’ve been paying attention to the news lately, you’ve probably heard of enterovirus D68 (EV-D68). EV-D68 is one of many non-polio enteroviruses. Initially isolated in California in 1962, it was reported rarely before 2005. In recent months, however, the United States has experienced a nationwide outbreak of EV-D68, associated with severe respiratory illness. From mid-August ...
In Billing
Sep 12th, 2014
The Centers for Medicare & Medicaid Services (CMS) Change Request (CR) 8877 updated Medicare hospice manual instructions for acceptable principal diagnosis codes and timely filing of Notice of Election (NOE), as well as coding guidance for skilled versus non-skilled nursing facilities. Changes are effective October 1. Hospice Principal Diagnosis Coding Guidance The coding instructions in ...