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Internal Medicine Coding Alert

CPT 2003:
Lesion Measurement,Finger Sticks Top List of Changes for Internists
Updating your encounter forms for next year won't take long, because few of the change... Read more
Dont Get Pinched by the Wrong Injection Code
Many coders are stuck on 90782 as a catchall code for injections, but this is the wro... Read more
Pinpoint an Injection or an E/M
You generally cannot bill an injection code and an E/M visit on the same day. Determine ... Read more
Get on the Right Beat in MI Coding
Coding a myocardial infarction (MI) can test your endurance because you often have to go... Read more
Keep a Pulse on Other MI-Related Codes
Coders may occasionally see documentation of "Dressler's syndrome" in the chart. This is... Read more
Reader Question:
Prolonged Services Require Thorough Documentation
Question: What are the documentation criteria for using prolonged services codes? My doc... Read more
Reader Question:
Know When to Report Critical Care With Admission
Question: A patient is admitted for chest pain and later takes a turn for the worse and... Read more
Reader Question:
Bill Only One Code for Same-Day Discharge
Question: I saw a patient in the hospital and coded 99233 (Subsequent hospital care ...... Read more
You Be the Coder:
Cardioversion With Consultation
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Reduce Pressure With a Hypertension Coding Checkup
Hypertension diagnosis coding can be a quagmire, but you can get your stress level and ... Read more
Careful Recordkeeping Is Key to ABPM Reimbursement
Medicare now covers ambulatory blood pressure monitoring (ABPM) for patients with suspe... Read more
BP Spike, Pregnancy-Related Hypertension Get Different Treatment
When a patient who has not been diagnosed with hypertension has an elevated blood pressu... Read more
Navigate Place-of-Service Codes Carefully to Avoid Denials
Where you perform a service is just as important for coding as what was done (CPT code) ... Read more
Reader Question:
Anodyne Therapy System
Question: How should I code for an anodyne therapy system for our diabetic peripheral ne... Read more
Reader Question:
Reduced Price for -52
Question: When using modifier -52, should I reduce the price of the service that I am bi... Read more
Reader Question:
HIV Patient Visit
Question: If a patient is HIV-positive, should a physician code this as part of the patie... Read more
Reader Question:
IV Infusion Therapy
Question: How should I report IV infusion therapy in the office? I know I am billing i... Read more
You Be The Coder:
Second Day of Observation
Test your coding knowledge. Determine how you would code this situation before looking ... Read more
CPT:
You CAN Go Home Again (to the Patient's Home,That Is) and Get Paid
House calls may not be as common as they were a century ago, but Medicare and many private... Read more
ICD-9:
Don't Let Your Diabetes Coding Get Out of Control
Diagnosis coding for diabetes may seem straightforward,... Read more
Get Paid for Prolonged Home Visits
When patients require longer-than-normal physician visits, you can use prolonged servi... Read more
Rule Out Other Types of Diabetes
Coders need to pay special attention to information recorded in the chart to ensure that... Read more
News Brief:
Medicare Covers Foot Exams for Diabetics With LOPS
Medicare will now pay for regular foot examinations for diabetic patients wh... Read more
Reader Question:
Repeat Treatment of Wart
Question: A physician's assistant in the office saw a patient for a plantar wart. The wa... Read more
Reader Question:
Discharge of Dead Patients
Question: The local nursing home sent me notification to go there and complete charts ... Read more
Reader Question:
Hospital Versus Outpatient Code
Question: We sent a patient to the hospital to have a blood transfusion, and then his PC... Read more
You Be the Coder:
Modifiers With Joint Injections
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
2003 ICD-9 Update
Small Changes in Digits Add Up to Big Changes in Coding ICD-9 coding changes that aff... Read more
Diagnosis Code Changes for 2003
Selected new ICD-9 codes that may affect internists are listed below. 040.82 Toxic sh... Read more
Use -GY,-GZ Modifiers to Speed Medicare Denials
Many coders are confused about how to use the -GY and -GZ modifiers that CMS created... Read more
Reader Question:
Nursing Home POS 31 or 32
Question: I am confused about whether to use place of service (POS) code 31 or 32 for bi... Read more
Reader Question:
Asymptomatic Patient in Fear of STD
Question: A healthy patient came to the clinic with no complaint or symptom (absolutely ... Read more
Reader Question:
Home Colorectal Screening
Question: Our doctor likes to send home a colorectal screening kit with patients. The p... Read more
You Be the Coder:
Venipuncture and Lab Charges
Test your coding knowledge. Determine how you would code this situation before lookin... Read more
Is Your Office Getting Stuck? Increase Reimbursement With a Coumadin Coding Checkup
Coding differs when practices use in-office finger stick devices rather than outside la... Read more
Coumadin Coding Varies in Less Common Scenarios
Occasionally, a Coumadin patient sees the physician instead of the nurse or requires re... Read more
Avoid the Top Five Coumadin Coding Errors
Mistakes in coding for Coumadin monitoring can cause denials or, even worse,... Read more
Correctly Code the INs and OUTs of Nursing-Home Patients
When a patient is discharged from a hospital and admitted to a nursing facility on the s... Read more
ICD-9 Coding A Screening Is a Screening Is a Screening
Many coders are unsure what to do when a screening test turns up a problem in a pati... Read more
Reader Question:
Patient Not Seen on Admission Day
Question: Our physician was called at home by the hospital late at night to OK an admit... Read more
Reader Question:
Second Opinion on DNR
Question: How should I code an inpatient consultation requesting a second opinion on a D... Read more
Reader Question:
PCP Referral Without Exam
Question: A patient has insurance coverage that requires her to go to her primary-care ... Read more
Reader Question:
Two Providers,One Lesion
Question: Two providers (one an MD, the other a nurse practitioner) worked together to r... Read more
Reader Question:
Multiple Visits During Global Period
Question: We performed an I&D on a sebaceous cyst and used CPT code 10060. This code... Read more
You Be the Coder:
TPN Coding by Physician
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
One Code Tells the Story When Detailing Late Effects of CVA
It's easy to get tripped up when coding the late effects of a cerebrovascular accident... Read more
When Is It a Late Effect?
The key issue in determining whether an aftereffect of a stroke has become a late effec... Read more
438 Series Documents the Late Effects of Stroke
The 438.0-438.9 series (Late effects of cerebro-vascular disease) is used to document l... Read more
Answer Three Questions to Solve 99211 Puzzle
Coders are probably more confused about how to use 99211 than any other code in the E/M... Read more
The Code
99211 Office or other outpatient visit for the evaluation and management of an establish... Read more
News Brief:
New E Codes Created to Track Terrorism Injuries
The National Center for Health Statistics (NCHS) has developed a new series of E codes ... Read more
Reader Question:
Follow-Up for Patient on Antidepressant
Question: A patient came in for a follow-up visit after being prescribed an antidepressa... Read more
Reader Question:
Allergic Reaction of Unknown Cause
Question: We recently treated a patient for an allergic reaction, and the doctor did not... Read more
Reader Question:
Discharge After Nursing-Home Patients Death
Question: My physician wants to code a discharge summary when a patient dies in a nursi... Read more
Reader Question:
Physician Visit to Patient in Skilled Bed
Question: Some people have told me that if a patient is in a skilled bed and is being co... Read more
Reader Question:
DOT Exam
Question: Which CPT code should I use for a patient who was referred by his employer for... Read more
Reader Question:
Nurse Use of Telephone Codes
Question: Our nurses usually give lab results to patients and call in prescriptions to t... Read more
You Be the Coder:
Screening Colonoscopy Cannot Be Completed
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
ICD-9 Codes Document Medical Necessity for Pre-op Exams
When a Medicare patient with a chronic disease is referred to the internist for a preopera... Read more
Rules Released on Use of New MNT Codes
Effective in 2002, Medicare began paying for medical nutrition therapy (MNT) for diabet... Read more
Reader Question:
Psychiatric Medication Management
Question: What is the proper use of 90862? Is it just for follow-up of already diagnosed... Read more
Reader Question:
Initial Visit With Starred Procedure
Question: A new patient presented to have an infected tongue ring removed. We removed th... Read more
Reader Question:
Anesthesia by Surgeon,Conscious Sedation
Question: We removed six papillomas from a patient, and we administered three different ... Read more
Reader Question:
X-Ray Coding
Question: If we take five x-rays of a patient's hand, should I code 73120 (Radiologic ex... Read more
You Be the Coder:
Nosebleed Cautery
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Tips for Properly Coding Nursing Home and Assisted Living Center Visits
Visits to long-term-care facilities can present coding challenges even to ex... Read more
Pocket Card Can Alleviate Confusion
The complexity of the nursing home codes has prompted MeritCare Health Systems, a North ... Read more
Traditional,High-Tech and High-Touch Resources Help Coders
Internal medicine coders will find it easier to do their jobs efficiently if they have ... Read more
Reader Question:
Late Effects
Question: When a patient is being treated for a condition that is the late effect of a ... Read more
Reader Question:
Laxative Abuse
Question: We saw an obese patient who has been abusing laxatives to lose weight. The ph... Read more
Reader Question:
Chest X-Ray
Question: I just got an EOB where the physician evaluated a patient with upper respirat... Read more
Reader Question:
Completing Disability Paperwork
Question: A patient came in to have papers completed for Social Security benefits. The p... Read more
You Be the Coder:
Cauliflower Ear
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Bury a Popular Misconception:
Internists CAN Code an ED Visit Along with the ED Physician (and Get Paid by Medicare)
One of the chief misconceptions among coders is that internists and other primary care ph... Read more
Know Thy Payer to Code Starred Procedures Correctly
For many coders, a star beside a procedure in CPT represents profound mystery. Many are c... Read more
Reader Question:
Admit Coding
Question: Occasionally, a patient will be admitted to the hospital late in the evening and... Read more
Reader Question:
Clarifying the New Health & Behavior Codes
Question: I realize health and behavior assessment/ intervention codes (96150-96155) were... Read more
Reader Question:
Using Time to Assess E/M Code
Question: If a patient comes in to see the internist but the physician only discusses whet... Read more
You Be the Coder:
Cardiac Arrest
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Payment for Cerumen Removal Depends on the Reason for a Visit
Many internists and their coders are confused about how to code for impacted... Read more
Medicare Settles on Final Diagnosis Coding Guidelines
"Determining whether to code the result of a lab or radiology test or the reason the te... Read more
Reader Question:
E/M or Burn Treatment?
Question: A patient was recently seen in our office because she had become dizzy while co... Read more
Reader Question:
History Requirements
Question: Our physician was recently called to the hospital to consult on a patient who wa... Read more
Reader Question:
Emergency Debridement
Question: A patient came in on an emergency basis with a second-degree burn on her foot su... Read more
Reader Question:
Aspiration Codes
Question: I was just entering some of the new 2002 codes in our system when I thought of a... Read more
Reader Question:
Billing for Travel Time
Question: One of our elderly patients with multiple medical problems was traveling throug... Read more
Reader Question:
Multiple Diagnostic Tests
Question: A diabetic patient presented to the office complaining of weakness, tremors and ... Read more
Reader Question:
Preventive Care Guidelines by Age
Question: In the Preventive Care section of CPT, are there guidelines directing physician... Read more
You Be the Coder:
Diagnosis Codes for Blood Tests
Test your coding knowledge.  Determine how you would code this situatio... Read more
Trigger Point Injections Become More Precise
Changes in the 2002 CPT manual for trigger point injections mean that the days of billin... Read more
Coding for Diagnosis and Care of the Emphysema Patient
When a patient presents with symptoms of emphysema, many procedures are commonly perform... Read more
Reader Question:
Reciprocal Billing Arrangements
Question: Our physician has to cut back temporarily on his work schedule while recovering ... Read more
Reader Question:
Dialysis Billing Guidelines
Question: What are the guidelines for billing dialysis? Do the rules for teaching assistan... Read more
Reader Question:
Fracture Care
Question: One of our patients whom we follow regularly for diabetes and hypertension compl... Read more
Reader Question:
Medicare and Family Counseling Visits
Question: The daughter of one of our Medicare patients made an office appointment to discu... Read more
You Be the Coder:
ECG in a Nursing Home
Test your coding knowledge.  Determine how you would code this situation before look... Read more
Cut Through the Confusion of Lesion Excision
The integumentary section of the CPT manual can be tricky for internal medicine coders ... Read more
Complex Diagnosis Drives Management of Presbycusis
Age-related hearing loss, presbycusis, also called presbyacusis (388.01), is estimated to ... Read more
Free Anthrax Coding Report on Web
Physicians and other healthcare professionals who provide services to any patients with ... Read more
Reader Question:
Pre-Admit Tests
Question: Our internist is regularly asked to conduct ECGs for pre-admission testing. Whic... Read more
Reader Question:
Expired Patient Coding
Question: One of our patients expired in the hospital before our physician could see him... Read more
Reader Question:
ED Versus Outpatient Codes
Question: Some of our internists are called to see patients in the local hospital emergenc... Read more
You Be the Coder:
After-Hours Coding
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Available Years:  2002  2001  2000  1999  1998