In Coding
Sep 3rd, 2019
CPT® code selection comes down to knowing what to look for in the note and asking the right questions. Fractures are common but coding them isn’t always easy. Correct coding relies on you knowing how to identify both the presentation and treatment of the fracture. To differentiate between the type of fracture and the type ...
In Coding
Apr 1st, 2018
Look at what kind of fracture it is, then decide whether it’s restorative or definitive care. By Jeannie Dean, CPC, COC, CPMA, CEMA, CEDC, CPC-I There is a common misconception that you cannot bill for fracture care in the emergency department (ED). In fact, emergency physicians regularly provide fracture care. To determine if fracture care ...
In Coding
Oct 24th, 2016
If you think of modifier 57 as the “decision for surgery” modifier, it’s time to change your mind. Modifier 57 applies when the physician determines the need for any major procedure—whether surgical or non-surgical. “Major” Means 90-Day Global Period The CPT® manual doesn’t define “major” or “minor” procedures, but the Centers for Medicare & Medicaid ...
In Billing
Nov 23rd, 2015
Per CPT® guidelines, a history and physical performed subsequent to the decision for the surgical procedure is included in the global surgical package. Do not report a separate evaluation and management (E/M) service for the history and physical unless the decision for the surgery is made at the same encounter, on the day of or ...
In Billing
Mar 19th, 2015
Modifier 24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period shows that the E/M being billed is not part of the global surgical package and therefore is separately reimbursable. To further indicate that the procedure is unrelated, it is recommended to assign a diagnosis ...