In Coding
Jun 13th, 2018
Bone marrow aspiration and biopsy codes received updates in CPT® 2018 that significantly change how the services are reported. Existing codes 38220 and 38221 were revised: 38220 Bone Diagnostic bonemarrow; aspirationonly(s) 38221 Bone Diagnostic bonemarrow; biopsy, needle or trocar(ies) Note: To demonstrate the updates for 2018, new text is underlined and deleted text is struck ...
In Billing
Jan 6th, 2015
By Dorothy Steed, CPC-H, CPCO, CPMA, CPC-I, CEMC, CFPC Electronic billing systems usually have built-in claim scrubbers to prompt billers to enter claim information. Providers should not assume that the scrubber will eliminate the need for quality billing skills. The biller should be well trained and knowledgeable about multiple payer requirements. Regardless of whether the ...
In CMS
Aug 26th, 2014
The Centers for Medicare & Medicaid Services (CMS) is establishing four new Healthcare Common Procedure Coding System (HCPCS) modifiers to define subsets of the -59 modifier, which is used to designate a “distinct procedural service.” Modifier 59 is the most widely used HCPCS modifier: It is defined for use in a wide variety of circumstances, and ...
In Coding
Aug 21st, 2014
When a procedure begins by laparoscopic approach, but for any reason must be converted (and completed) by open approach, you should report only the open approach. As described in chapter 1 of the National Correct Coding Initiative (NCCI) Policy Manual: If a procedure utilizing one approach fails and is converted to a procedure utilizing a ...
In Billing
Aug 21st, 2014
When providers report more than a single (non-evaluation and management) procedure during a single encounter, payers typically will reimburse only the highest-valued procedure at full fee schedule value, and will reduce payment for the second and subsequent procedures. This occurs because payers reason that many of the component services that comprise the physician’s work (such ...