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Neurosurgery Coding Alert

News You Can Use:
Fee Schedule Numbers Have Providers Worried
The 2023 MPFS features a deep CF cut. The Centers for Medicare & Medicaid Services (C... Read more
Surgery:
Use This Guide for Spinal Fusion Claims
Check for instrumentation, graft coding opportunities. When a patient needs a spinal fu... Read more
Clinical Coding Quiz:
Can You Code This Skull Fracture Fix?
Try to code this scenario before checking the answer. Last month, we printed a primer o... Read more
Reader Questions:
There Are 2 Complicated Codes for This Craniofacial Fix
Question: The surgeon performed treatment on a LeFort III craniofacial separation.&nb... Read more
Reader Questions:
Be Confident With This Shy-Drager Dx
Question: During an office evaluation and management (E/M) service for an established... Read more
Reader Questions:
Do This for Bilateral Problems During E/Ms
Question: If a patient has a bilateral problem (for example, the patient has tingling... Read more
Reader Questions:
Counting Referrals in MDM Table
Question: Our providers say that referrals are always considered low risk under the R... Read more
You Be the Coder:
Coding Carotid Artery Stenosis
Question: A patient is diagnosed with carotid artery stenosis in the left and right a... Read more
Condition Spotlight:
Condition Spotlight Take Note of E/M, Treatment Type on Skull Fractures
Do you know the trio of codes for skull fracture repair? It's a safe bet that almost all ... Read more
CPT® 2023:
Imaging Guidance Gets Bundled Into Some Injections
Imaging guidance update could lower pay for these codes. If your surgeon provides somati... Read more
Compliance:
Cut Duplicate Claims With Modifier Smarts
There are basic rules to follow on repeat modifiers. If Medicare starts sending your prac... Read more
Reader Question:
Puncturing Previous Burr Hole Calls for These Codes
Question: Encounter notes indicate that the surgeon created a ventricular puncture th... Read more
Reader Question:
Avoid Coding Headache by Answering Intractable Question
Question: The provider diagnosed post-traumatic headache. Is G44.3 the correct ICD-10... Read more
Reader Question:
Get More Info to Target Crushing Injury Dx
Question: Encounter notes indicate that a patient suffered from a crushing injury to ... Read more
You Be the Coder:
Craniectomy With Electrode Array Implantation
Question: The neurosurgeon performs a craniectomy with electrode array implantation on the... Read more
Surgical Coding:
Less-Invasive Stereotactic Surgery Requires Special Coding Skills
You'll choose 1 of 2 codes when surgeon operates on intracranial lesions. When your neuro... Read more
Clip and Save:
Rely on These Terms for Intracranial Lesion Surgeries
Do you know the 3 meninges? During her recent presentation at HEALTHCON Regional Denver ... Read more
Surgical Coding:
Know Specifics Before Coding These 3 Vertebral Surgeries
Here's why you must be able to ID excision, corpectomy, osteotomy. When a surgeon perfo... Read more
Reader Questions:
Follow Through to Components for Skull Base Lesion Removal
Question: During surgery of the skull base to remove lesions, our surgeon performs a ... Read more
Reader Questions:
Px Status Drives Code Choice on E/M-Myelography Claim
Question: Encounter notes indicate that after an office evaluation and management (E/... Read more
Reader Questions:
Look at RVUs Before Ordering Chemodenervations
Question: Encounter notes indicate that the provider performed chemodenervation of th... Read more
Reader Questions:
Consider Companion Code When Reporting This Syndrome
Question: Notes indicate that the provider performed a level-three office evaluation ... Read more
Reader Questions:
Answer Trauma Question, Then Code Brain Herniation
Question: Encounter notes indicate that the patient suffered a herniated brain stem. ... Read more
Reader Questions:
Use This Code for Nonspecific Lumbago Dx
Question: Encounter notes indicate that the provider treated a patient with “lumbag... Read more
You Be the Coder:
Co-Surgeons and an Accident Victim
Question: A 35-year-old mountain biker lost control of their bike during a competitio... Read more
CPT® 2023:
New Code Set Features Arthroplasty, Implant Changes
Here's what you should report instead of +0163T in 2023. The AMA has set its additions, r... Read more
E/M 2023:
MDM Is at Center of ED Code Refocus
Check out the new rules for 99281-99285. When coding for evaluation and management (E/M)... Read more
ICD-10 2023:
Codes Converted to Parent, Given New Families
See how some existing codes are modified to make way for new codes. In addition to the ... Read more
Reader Questions:
Head to This Code Set for Encephalocele Dx
Question: What is encephalocele, and how do I choose an ICD-10 code for this conditi... Read more
Reader Questions:
Ask More Questions on Sparse Spina Bifida Note
Question: Encounter notes indicate that the provider treated a patient suffering from... Read more
Reader Questions:
No Shared Billing? Incident-to Could Be an Option
Question: One of our physicians and a nurse practitioner (NP) both saw a patient duri... Read more
Reader Questions:
Rein in Behavior That Could Compromise ePHI
Question: A provider in our practice informed us that they have been sending patient ... Read more
You Be the Coder:
Gamma Rays, Headframes, and Stereotactic Radiosurgery
Question: Encounter notes indicate that after a level-five office evaluation and mana... Read more
E/M 2023:
Inpatient, Observation Code Revisions Highlight Changes
Here's what you'll use instead of 99217 next year. The American Medical Association (AMA)... Read more
ICD-10 2023:
New Code Book Expands Several Cranial Injury Sets
Blast-wave injuries get big Dx bump. Last month, we examined a bevy of new diagnosis code... Read more
E/M Coding:
This Advice Can Help Strengthen Shared Billing Skills
Remember that the patient's medical narrative is documentation-driven. If you haven't per... Read more
Reader Questions:
Go With Add-On for Multiple Intercostal Shots
Question: Encounter notes indicate that the provider performed a steroid injection to... Read more
Reader Questions:
Modifier 22 Documentation Keys Successful Claims
Question: I was told documentation for modifier 22 (Increased procedural services) sh... Read more
Reader Questions:
Phlebotomy Does not Equal Blood Draw
Question: I recently used 99195 (Phlebotomy, therapeutic (separate procedure)) for a ... Read more
You Be the Coder:
Consider This Clinical Chemodenervation Example
Question: Encounter notes indicate a patient reports complaining of chronic migraine ... Read more
ICD-10 2023:
Concussion, Other Brain Injuries Get Big Code Bump
Remember, these codes take effect before 2023. The World Health Organization (WHO) has re... Read more
Surgery:
Back Up Corpectomy Coding With Anatomy/Approach Knowledge
Prep with research, as corpectomy comes with slew of codes. When your neurosurgeon perfo... Read more
Injections:
Documentation Can Ease Chemodenervation Code Choice
CPT® has suggested conditions in descriptors, but they're not required. When a patient ... Read more
Reader Questions:
Use This Specific New Code for These Arrays
Question: When our provider implants a neurostimulator electrode array in the hypoglo... Read more
Reader Questions:
Mind (Notes) to Nail Cath Placement
Question: Encounter notes indicate the provider replaced a distal catheter in a cereb... Read more
Reader Questions:
Check Synonyms to Find Migraine With Prodrome
Question: During a level-three office evaluation and management (E/M) service for a n... Read more
You Be the Coder:
Surgery of Skull Base With Approach, Repair
Question: Encounter notes indicate that the surgeon performed the following procedure... Read more
Surgery:
Extract Every Detail from Notes to Code Excision, Osteotomy
Do you know which procedure is for spinal realignment? Two surgical procedures your provi... Read more
Surgery:
Know Region, Complexity on AV Malformation Fixes
Here's how these conditions differ from aneurysms. When a patient presents to your neuro... Read more
E/M Coding:
Follow Incident-to Rules to Garner Full E/M Payment
Remember the established care plan rule. In order to maximize resources, many practices... Read more
Reader Questions:
Be Accurate With EEG Code
Question: Encounter notes indicate that the provider performed an electroencephalogra... Read more
Reader Questions:
Tread Carefully on Pre-Op E/M Coding
Question: One of our providers will decide that a patient has to have surgery, then h... Read more
Reader Questions:
Tough Discitis Dx Requires ICD-10 Smarts
Question: The provider performed a level-four office evaluation and management (E/M) ... Read more
You Be the Coder:
Dyskinetic CP With E/M
Question: Encounter notes indicate that the provider performed an office evaluation a... Read more
Surgery Coding:
Listen to Experts on Stereotactic Cranial Radiosurgery
Alternative to more invasive surgery has trio of key of add-ons. When your surgeon perfo... Read more
Injections:
Get Your Nerve (Knowledge) Up for These Injection Claims
Here's why you need to know the difference between trigeminal and greater occipital nerves... Read more
E/M Coding:
Max Out Claims by Knowing Non-Face-to-Face Time
Know how to capture work that occurs beyond the patient encounter. Every coder knows how ... Read more
Reader Questions:
Parse Spinal Canal MRIs by Anatomy
Question: Encounter notes indicate that the provider performed the following: “MRI... Read more
Reader Questions:
Dive Deep Into Notes for Skull Fracture Fix Code
Question: The surgeon performed elevation of a depressed skull fracture. How should I... Read more
Reader Questions:
Arnold-Chiari = Encephalocele
Question: Encounter notes indicate that a patient suffered from “arnold chiari typ... Read more
You Be the Coder:
Nail Anatomy Question on PET Scan
Question: Notes indicate our provider performed ‘PET scan, whole body.' I reported ... Read more
Surgical Coding:
Keep Your Head When Coding Craniotomy/Craniectomy Claims
Knowing the differences between the procedures is vital. Naturally, neurosurgery coders a... Read more
ICD-10 Coding:
Avoid Shaky Movement Disorder Coding With G20-G26 Smarts
Do you know what secondary parkinsonism is? When most coders think of movement disorders,... Read more
E/M Coding:
VANDALISM Can Aid Your Hospital Coding
Mnemonic device leads to cleaner hospital claims. Getting all the information just right ... Read more
Reader Questions:
Stay Current With #Resequenced Updates
Question: I was coding for a patient who had a spinal puncture, and was perusing this... Read more
Reader Questions:
Use Add-on for Transpedicular Approaches
Question: The day after a level-four office evaluation and management (E/M) service f... Read more
Reader Questions:
Know Differences in After-Hours Codes
Question: When it comes to billing after-hours or evening codes, is it true that ther... Read more
Reader Questions:
Face Time Vital When Reporting This Service
Question: I read that when reporting discharge day management service, we must provi... Read more
You Be the Coder:
Dig Into Alternate Terms on Muscular Dystrophy Dx
Question: What is the diagnosis code for a patient with muscular dystrophy? Louisian... Read more
Cranial Coding:
Pair Codes for Optimal Neurostimulator Placement Coding
This is typically a 2-code service … or possibly more. Patients that report to your neu... Read more
Modifier Madness:
Remember Q6 on Your Locum Tenens/FTC Claims
Also, make sure you know the new verbiage for locum tenens. When one of your physicians ... Read more
ICD-10 Coding:
Know Pain Types, Prevent Dx Coding From Hurting Bottom Line
Do you know how long pain must last before it's chronic? When you have to submit ICD-10 c... Read more
Reader Questions:
Answer Injection Question Before Choosing Puncture Code
Question: What code should I report when my provider performs a cisternal C1-C2 punct... Read more
Reader Questions:
Use G40.5- for These Epileptic Seizure Patients
Question: Encounter notes indicate that a patient suffered from “epileptic seizures... Read more
Reader Questions:
Get This Info to Strengthen Headache Dx
Question: Some of our coders are having trouble getting the ICD-10 codes for our head... Read more
Reader Questions:
Proceed With Caution on MDM Level Decision
Question: If a patient has only one chronic problem that is not worsening but is not ... Read more
You Be the Coder:
Use This Primer to Get Familiar With Q75.-
Question: There are a lot of very specific-sounding conditions under the Q75.-base co... Read more
News You Can Use:
CF (Slightly) Upped Again; Errata Straightens Spinal Issues
In a rare move, CMS increased the CF after the final rule this year. The new year has arr... Read more
Modifier Madness:
Code Partial Services With 26, 54
When you're coding for post-op care only, use this modifier. Whatever the reason, there a... Read more
Imaging:
Get Specific When Choosing MRI Code
Anatomy only the beginning when looking for right MRI code. Patients that report to your... Read more
You Be the Coder:
Deciphering Diagnosis Code Notes
Question: Encounter notes indicate that a patient suffered a fracture Encounter notes indi... Read more
Reader Questions:
CPT® Rolls Out New Telehealth Modifier
Question: I heard there was a new telehealth modifier that we're supposed to be using... Read more
Reader Questions:
Tic Douloureux Tracks to This Dx
Question: Our provider treated a patient with “tic douloureux.” Is there a straig... Read more
Reader Questions:
Make Sure You’re Up on Modifier 25 Rules
Question: Have the modifier 25 rules changed now that the E/M guidelines are differe... Read more
CMS Final Rule:
Conversion Rate Dips for 2022
No increase in pay for providers this year. The final rule has finally been published, a... Read more
Surgery:
I.D. Arthrodesis Types for Coding Success
Do you know which add-ons go with which arthrodesis types? Coding for arthrodesis poses a... Read more
E/M Coding:
Use These Tips to Get Hip to New Prolonged Services Coding Rules
Here's why you should be careful when coding longer MDM-decided E/Ms. Coding for prolonge... Read more
Reader Questions:
Answer Original Surgery Question Before Coding Halo Removal
Question: Encounter notes indicate that the surgeon performed cranial halo removal on a ch... Read more
Reader Questions:
Use T Codes for Additional Interspace Removals
>Question: >Encounter notes indicate that the surgeon removed a total disc arthropla... Read more
Reader Questions:
Note Differentials When Making E/M Level Decision
Question: An established patient came to our office complaining of left-sided facial pain... Read more
You Be the Coder:
7-Character Dx Codes for Skull Fractures
Question: Encounter notes indicate that a patient suffered a fracture of the right medial ... Read more
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