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Internal Medicine Coding Alert

2012 CPT® Updates:
Learn CPT® 2012 Updates in Next Two Months
Updates to vaccine, E/M, Dermatology procedures. CPT® 2012 goes into effect in a ... Read more
Rural Health:
Revalidation Letters and Diagnostic Imaging Requirements Affect payment
Understand how CMS changes affect healthcare serviceCMS officials discussed several issues... Read more
Platform 5010:
Last Minute Look Through for 5010 Electronic Transactions Implementation
Buffer time required to handle glitchesAre you ready to say goodbye to forms 4010/4010A1 f... Read more
E/M Update:
99218-99220 Will Have Typical Times in 2012
Rumor has it the revisions could add options for reporting these observation codes.Have yo... Read more
ICD-10:
Malignant and Benign Hypertension: 404.0x Differs From I13.
4 ICD-10-CM for hypertensive heart and CKD.You can expect ICD-10-CM to provide you with co... Read more
Reader Question:
Turn to 99214 to Give Credit for Extra Time
Question: Our physician spends lot of time discussing treatment options, imaging results, ... Read more
Reader Question:
For E/M Services, 3 'Vitals' Equals 1 Exam Bullet
Question: Would you please explain how taking the vital signs contributes to determining t... Read more
Reader Question:
Glucose Monitoring with 95250, 95251
Question: What is the best way to bill for continuous glucose monitoring? Do we bill for t... Read more
Reader Question:
Add Lacerations Only If Found at Same Site and Level
Question: A patient with a 1.5-cm laceration on his eyebrow presented to our practice. Our... Read more
Reader Question:
E Code for Initial Fall Visit
Question: An established patient came to the office complaining of back pain related to a ... Read more
You Be the Coder:
HCPCS for Kenalog Injections
Question: How should I report an intra-epidiymal injection of Kenalog? South Carolina ... Read more
HCPCS Supplies:
Medical Supply Claims Require Proper Modifiers Application
Get acquainted with modifiers NU, KX. When a patient leaves your office with crutches, you... Read more
CCI Edits Update:
Latest CCI Edits 17.3 Target Annual Wellness Visit Codes
New bundles for G0438 and G0439 shouldn't hit your bottom line.The latest updates from the... Read more
ICD-9 2012:
414.4 Lets You Get Specific About Calcified Coronary Lesions
But 425.1 will bring instant denials as of October 1.Don't consider your ICD-9 2012 update... Read more
ICD-10 Watch:
Prepare for ICD-10 Conversion Following Easy Steps
Analyze your practice's mostly used diagnoses to familiarize with It's not too... Read more
ICD-10:
Narrow Choice for Essential Hypertension to I10
ICD-10 streamlines to single diagnosis. Many diagnoses will expand to multiple options... Read more
Reader question:
Avoid Confusion of Block Code With Simple Repair
Question: If a physician performs a digital block on a finger and repairs a 2 cm lacerat... Read more
Reader question:
Choose Between 99213, 99214 for Pre-Op Examination
Question: The local orthopedist requires clearance before scheduling patients for total kn... Read more
Reader question:
99078 vs. 98960-98962
Question: Our physician wants to implement group patient education meetings, when he'll br... Read more
Reader question:
HCPCS code for Lidocaine During Block or Injection Not Separately Billable
Question: Our physicians often use a local anesthetic or a mixture of triamcinolone and li... Read more
Reader question:
Claim Dermabond Supply With 12001-12007
Question: An established patient visited our office because of severe hyperkeratosis affec... Read more
Reader question:
Follow-Up Visit: Fill In Two Of Three E/M Components
Question: I am auditing some of my physician's E/M visits, and discovered that he's not di... Read more
Reader question:
Remove J0570 From Your Superbills
Question: We're receiving denials when we report codes J7610 and J0570. Can you advise reg... Read more
Reader question:
Tinnitus Coding
Question: The internist documented "ringing in head" for a new patient. What diagnosis cod... Read more
You Be the Coder:
Report Arthrocentesis with HCPCS Code For Medicines
Question: The physician used ultrasound guidance when performing arthrocentesis on the p... Read more
Annual Visits:
Be Cautious Reporting EKG With AWV
New Medicare stance steers you away from modifier 25. Medicare now requires a modifier on ... Read more
Modifier Review:
Extremity Fractures: Learn Correct Modifier Usage
Tip: Repeating a procedure or service doesn't always mean extra pay. With football season ... Read more
News You Can Use
786.50 and 786.51 Land on PT 'Paid' ListIf your practice provides prothrombin time (PT) te... Read more
Part B Forms:
New Format ABN Form To Be Used From Nov. 1, CMS Sources Say
Switching to new form is mandatoryIt may seem like just yesterday that you transitioned to... Read more
ICD-9 2012:
Skin Cancer Codes of 173.x Series Are Now More Specific
Physicians need to pinpoint the type of diagnosis. When the updated version of ICD-9-CM go... Read more
ICD-10:
Come 2013, 786.05 Will Have New Code, But Same Descriptor
If your internist notes in a chart today that a patient's presenting complaint is "shortne... Read more
Reader question:
Add Modifier 59 for Repeated Epistaxis treatment
Question: My physician saw a patient in the office for a nosebleed. Later that day, t... Read more
Reader question:
99339-99340 Not Autometic Choice for Assisted Living Facility Coding
Question: One of our physicians evaluated a new patient in an assisted living facility for... Read more
Reader question:
Collect From Secondary Payer Before Approaching A Patient
Question: We have many patients with secondary insurance, some of which have deductibles o... Read more
Reader question:
Coding Negative Strep Test Forces You to Rely on Symptoms
Question: We performed a strep test on a patient who presented with vomiting, rash, and he... Read more
Reader question:
Set Wellness and E/M Visits on Separate Days To Avoid Possible Denial
Question: We often bill well woman and sick visits on the same day if the sick visit warra... Read more
Reader question:
36140-59 Needs Supporting Documentation
Question: Do codes 99144, 36140, 36245, and 75710 require any modifiers to be paid when re... Read more
You Be the Coder:
Patient Wheezing? 519.11 Might Outweigh 786.07
Question: Sometimes our internist suggests diagnosis 519.11 for wheezing, but sometimes he... Read more
Diagnostic Tests:
Colonoscopy Screening: Always Check Frequency Rules and Risk Categories
Watch out: Medicare has specific requirements other payers might not follow.The days have ... Read more
Polypectomy; 45380-45385:
Learn 3 Tips For Proper Polypectomy Coding
If the surgeon spends double time on 45385, bill with modifier 22.If you know how to work ... Read more
ABNs:
Use ABN-Style Waiver for Non-Covered, Non-Medicare Services
Steer clear of angry patients and lost reimbursement by covering your bases up front.When ... Read more
ICD-10:
Separate Fibromyalgia, Myalgia Diagnoses in 2013
ICD-10 also establishes new myositis code. If your internist diagnoses a patient with ... Read more
Reader question:
Count Toes to Choose Between 11720 and 11721
Question: What CPT® code is best for cutting and filing ten toenails?Indiana Subscri... Read more
Reader question:
Code Malignant Facial Lesion With 173.3
Question: The physician removed a lesion from the patient's temple area. The pathology rep... Read more
Reader question:
Coumadin Coding For 99363, 99364
Question: I know Medicare doesn't cover Coumadin clinics, but thought some commercial plan... Read more
Reader question:
Get To Know Modifier 33
Question: We get denials from several insurance companies, stating that modifier 33 is inv... Read more
Reader question:
Incident-To Rules For Follow-Up Visits
Question: One of our non-physician practitioners saw a patient during a follow-up visit. W... Read more
You Be the Coder:
93458's Global Period Offers Coding Clues For Catheterization
Question: The cardiologist was called in to consult for an inpatient presenting with angin... Read more
CCI Edits:
CCI Version 17.2 modifies Annual Wellness Visit With ECG, E/M, and Behavior Assessment Codes
Appending modifier 25 can save AWV with some claims.Until now, you've been able to report ... Read more
Diagnosis Coding:
Take A Look Into New V Codes That Will Affect 'History' Diagnosis
New ICD-9 codes also stress anaphylactic 'reactions' only, not 'shock'.New and revised ICD... Read more
E/M Service:
Double Check Documentation Before Shifting from 99204 to 99203
Do not attract unnecessary audits due to regular downcoding.National insurer data from pre... Read more
ICD-10:
Atrial Fibrillation Directly Maps to a Single Code in ICD-10
Be aware of the code(s) to use when ICD-10 arrives.Reporting an atrial fibrillation diagno... Read more
Reader Question:
Age, Medicare Status Help Decide Pap Test Codes
Question: What CPT® code should we submit for a Pap smear?Rhode Island SubscriberAns... Read more
Reader Question:
Select 079.99 or 079.89 for Diagnosis "Viral Syndrome"
Question: Our internist often uses the phrase "viral syndrome" to describe a patient's sym... Read more
Reader Question:
Skip Reporting Separate E/M With 94760, 94761 for Medicare Patients
Question: Our payers deny a significant number of pulse oximetry codes because they state ... Read more
Reader Question:
Steer Clear of 'Seen and Agreed' Note or Face Claim Rejections
Question: Our physician works with residents each year. It's very time consuming, but he d... Read more
Reader Question:
Don't Avoid 25 Because of the Same Diagnosis
Question: I recently heard that you do not need different diagnosis codes to use modifier ... Read more
Reader Question:
Select 20610 for Trochanteric Bursa Injection Procedure
Question: How should I code injection of trochanteric bursa and sacral crest? My physician... Read more
Reader Question:
Remember Face-to-Face Factor in New vs. Established
Question: We saw a patient for pain injections earlier in the year and he is now coming in... Read more
You Be the Coder:
Understanding Multiple Uses of HCPCS code G8553
Question: We're still working to become compliant with e-prescribing. We don't have a larg... Read more
Case Study:
Affected Systems Tell When to Code Anaphylaxis Vs Allergic Reaction
Tip: Count the number of body systems involved to make the right choice.Summertime is here... Read more
Knee Injections:
When Coding Trigger Points, Count Muscles, Instead of Injections
Here's your guide to success with TPI versus other knee injections.All knee injections&nbs... Read more
E/M:
Refrain Getting Caught in These 3 Common Evaluation& Management Traps
Incident to, critical care must meet certain criteria.As a coder, you're accustomed to rep... Read more
ICD-10:
Make Ready for Extra Code Reporting for Foreign Body Removal
Once ICD-10 goes into effect, check the type of retained body.Choosing your primary diagno... Read more
Reader Question:
See Beyond Obesity for Primary Diagnosis
Question: Some of our insurers refuse to pay for obesity as a primary or secondary diagnos... Read more
Reader Question:
Select Between Codes 782.9 and 705.89 for Body Odor
Question: A mother brought her 6-year-old daughter to our office because she was concerned... Read more
Reader Question:
Maintain Your ABN for U/A Screening Tests
Question: Is a urinalysis (screening) included in or bundled with a patient's initial prev... Read more
Reader Question:
Coding Procedure for Simple Repair with Dermabond
Question: An established patient visited our office because of severe hyperkeratosis affec... Read more
Reader Question:
Disregard Preventive Exam Codes for Skin Cancer Screening
Question: My physician saw a patient for a skin cancer screening. Should I use the prevent... Read more
Reader Question:
Obtain Specific Diagnosis Before Coding Tissue Infection
Question: Our physician treated a soft-tissue infection on a patient's finger. Which diagn... Read more
Reader Question:
Payer Tactics Outweigh Coding Guidelines
Question: Our Medicaid carrier refuses to accept the new vaccination codes, but we know it... Read more
You Be the Coder:
Picking Correct ICD-9 Code for Multiple Burns
Question: An established patient reports to our physician with firstand second-degree burn... Read more
Injection Coding:
Ask Yourself 3 Questions While Coding CTS Injections
Verify evidence of previous treatments for successful claims.If you're coding for a patien... Read more
Pediatrics:
Follow 3 Steps When Coding and Billing Summer Camp Exams
From ICD-9 coding to your forms policy, we've got you covered.Summer camp season is coming... Read more
PEG Tube Coding:
PEG Tube Removal: Avoid Common Errors By Sticking To E/M
Find out why 43247 just won't do you any good.If you've asked yourself frequently what CPT... Read more
Documentation:
MD's Notes is Crucial to Find if E/M Is 'Separate' or 'Inherent'
The answer to your question gives 'yes' or 'no' to modifier 25.If your internist performs ... Read more
ICD-10:
Conjunctivitis Coding Will Bring Direct Cross-Code in 2013
Tip: Check whether more detailed diagnoses are more appropriate.Conjunctivitis (also known... Read more
Reader Questions:
Imaging For Different Purposes? Multiple X-Ray Charges OK
Question: A new patient presented to the office because of an injured left ankle she hurt ... Read more
Reader Questions:
Origins of Blood Indicate Either 569.3 or 578.1
Question: I'm not sure when I should use 569.3 and 578.1 for bloody stool. Are they one an... Read more
Reader Questions:
Review Incident-To Guidelines For Follow-Ups Cases
Question: One of our nonphysician practitioners saw a patient during a follow-up visit. ... Read more
Reader Questions:
V70.0 Counts for Well Woman Urinalysis
Question: One of our providers wants to order urinalysis as a routine part of a well woman... Read more
Reader Questions:
Check All Notes for Chronic Condition Detailed Info
Question: The 1997 audit guidelines state that I can reach an extended history by updating... Read more
Reader Questions:
Difference Between 20610 And 27096
Question: Which CPT® code applies to a sacroiliac joint injection? Would we bill it ... Read more
Reader Questions:
Append Proper Code To Secca Procedure
Question: I've heard about the Secca procedure being utilized as a treatment for fecal inc... Read more
Reader Questions:
Code NERD And Carditis With 530.81
Question: Has anyone come across chronic carditis on a biopsy taken from the gastroesophag... Read more
You Be the Coder:
Use -79 for Repeat Wart Freezing Within Global Period
Question: Eight days after an initial wart freezing, the patient returns, and the physicia... Read more
Nosebleeds:
Instrumentation and Methods Help Avert Nosebleed Or Epistaxis Coding Problems
Warning: Reporting 30901 for ice stoppage might not be proper. A patient comes to your ... Read more
CCI 17.1:
Newest CCI Edits Teach You to Take Note of Involved Joints Before Coding Arthrotomy
Tip: Exploration and drainage codes override some biopsy or synovectomy codes. The late... Read more
ICD-10:
Significant Changes Will Come for ADD/ADHD Coding Under ICD-10-CM
Prepare for 5 --" not 2 --" code choices in 2013. You may know the diagnosis codes for ... Read more
Collections:
Learn Your State's Prompt Pay Laws -- Overcome Regular Payer Headaches
Medicare contractors must pay clean claims within 30 days, but private payers vary.It's a ... Read more
ASC Payments:
5 Tips To Make Your ASC Coding Better
Check out the new 2011 payment rates for dermatology procedures performed in an ambulatory... Read more
Reader Questions:
Choose From 99393-99395 Based on Patient's Age
Question:Our internist saw a patient for a sports physical clearance. During the visit, th... Read more
Reader Questions:
Check Out HCPCS Code G0372 for Power Wheelchair Evaluation
Question:What code applies to a face-to-face evaluation for a power wheelchair? Maryland S... Read more
Reader Questions:
No MPFS RVU Means No Medicare Coverage
Question:Can you explain to me why some codes (such as 99172) do not have an associated re... Read more
Reader Questions:
Denote Abnormal Feces Fluidity With 787.91
Question:A patient says she has had chronic bowel problems for the last 10 years, with dia... Read more
Reader Questions:
Nurse Could Count for 98960 Professional
Question:Is it appropriate to use code 98960 for a nurse who completes extensive asthma ed... Read more
Reader Questions:
Subcutaneous Foot Splinter Removal Could Be 28190
Question:The physician removed a 1.5 cm splinter from beneath the dermis of the patient's ... Read more
You Be the Coder:
Friction Burns Are Still Counted As 'Burns'
Question:A patient presented with multiple friction burns from a treadmill. He had partial... Read more
Osteoporosis:
Check Out 3 Areas to Stay Within New Osteoporosis Screening Regulations
Medical necessity and acceptable timeframes are must-haves before coding.New recommendatio... Read more
Modifier Mythbuster:
Bust 3 Myths to Avert the Trap of 'Increased Procedural Services'
If you decide to append modifier 22 always in certain situations, be prepared to head towa... Read more
Dermatology:
Do Not Forget Office Visits for Initial and Follow-Up Patch Tests
Plus: Count every test to get the money your physician is due.When your internist conducts... Read more
Audits:
Follow This 3-Step Strategy To Get Through Irrational Denials
The contract a patient signs with the insurance company holds true no matter what.Have you... Read more
Reader Questions:
Don't Expect Insurance Company To Pay for Driver's Physicals
Question: What is the best way to code and bill for driver's physicals? I'm thinking the p... Read more
Reader Questions:
692.4 or 995.2x Could Fit Multiple Chemical Sensitivities (MCS)
Question: What diagnosis code applies to multiple chemical sensitivities?Wyoming Subscribe... Read more
Reader Questions:
Removal Technique Helps Guide Lesion Coding
Question: We have an ongoing discussion in our office regarding how to code for excisions ... Read more
Reader Questions:
Choose Either 17110 or 17111 for Removal, Not Both Codes
Question: The physician removed plantar warts from each of a patient's feet. Do I submit t... Read more
Reader Questions:
99211 Vs. 69210 for Ear Wax Removal
Question: Can you explain how we know whether to report a procedure or E/M code for ear wa... Read more
Reader Questions:
Verify Payer Details Before Billing 99307
Question: How do I bill if our physician went to the nursing home to see Medicare patients... Read more
Reader Questions:
45385, 45380: Resolve Colon Polyps With 2 Colonoscopy Methods
Question: How should I report the procedure based on this physician's notes:"Patient with ... Read more
You Be the Coder:
Add A Secondary Dx With 702.11 or 702.19
Question: Our physician excised a 0.4 cm lesion and documented, "She has a bleeding black ... Read more
Closures:
12001 or 13100? Consider More Than Tissue Layers to Code Exact Closure Level
Follow these tips to find the differences between 'simple,' 'intermediate,&#... Read more
CPT 2011:
New Observation Codes 99224, 99225, 99226 Help Answer the 'Middle Day' Code Dilemma
Expanded choices eliminate payer-to-payer coding variation.2011 brings a new coding option... Read more
Rural Care:
Medicare Lagging on Implementing Preventive Service Fee Waivers
PPACA waived fees starting Jan. 1, but CMS won't until April 4.The Centers for Medicare &a... Read more
Reader Questions:
Bilateral X-Ray Doesn't Always Mean -50
Question: Our internist x-rayed a patient's symptomatic knee and ordered an x-ray of the o... Read more
Reader Questions:
Medical Necessity Could Mean Extra Hemoccult Pay
Question: Preventive care guidelines state that hemoccult slides are covered once each yea... Read more
Reader Questions:
Dates and Physician Presence Dictate 99221 Alone or With Office Visit
Question: Our physician saw a patient in the office, and then admitted her to the hospit... Read more
Reader Questions:
Consider Skin Biopsy Timing, Location, Intent
Question: How do I know when to report skin biopsy separately with, or in place of, other ... Read more
Reader Questions:
Don't Mix Family History With Personal History
Question: My understanding has been that I cannot bill for "family history of" a condition... Read more
Reader Questions:
Check Each Component Before Submitting 80053
Question: The physician ordered a basic metabolic panel and hepatic function panel for a p... Read more
You Be the Coder:
Remember Your Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The internist used a scalpel and tweeze... Read more
CCI 17.0:
Newest CCI Edits Include More Procedures Related to "Guidance"
Don't submit 77001 or 77002 with fracture care, TPI, arthrocentesisThe newest edition of C... Read more
CPT 2011:
5 Tips to Sail You through G0438, G0439 Coding Scenarios
Boost your revenue by reporting new annual wellness visits correctlyIf you want your annua... Read more
CPT 2011 Errata:
93268-93272 Require Attended Surveillance -- Mark The Guidelines
Plus: 93923 replaces 93922 in a key parenthetical note, and your index requires updateIf y... Read more
PECOS Dilemma:
CMS Says It May Not Deny PECOS Claims Initiating in January
New CMS DirectiveYou may -- or may not -- face claims denials in January due to ... Read more
Reader Questions:
Start and Stop Times Important to Infusion Coding
Question: We're starting to bill for hydration and therapeutic infusions at our clinic. Do... Read more
Reader Questions:
36416 With 85018: True, But Better To Be Aware of Bundles
Question: Are we allowed to bill 36416 with 85018?Answer: Yes, you can submit 36416 (Colle... Read more
Reader Questions:
414.2 Should Follow Atherosclerosis Code Based On ICD Guidelines
Question: I heard at a conference that you shouldn't use 414.2 as a firstlisted diagnosis.... Read more
Reader Questions:
No CCI Bundle Applicable? Here's Where to Find Modifier Details
Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which c... Read more
Reader Questions:
Look to The Cause Responsible for Coding Bruises
Question: What is the ICD-9 code for "easy bruising"?Answer: Easy bruising is a symptom of... Read more
Reader Questions:
Remember Your Anatomy on Sub-Q FBRs
Question: I have a puzzling denial in front of me. The internist used a scalpel and tweeze... Read more
You Be the Coder:
Coding 96372 With 90471
Question: During an office visit, our nurse administered a B12 injection and a flu shot to... Read more
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