Primary Care Coding Alert
News You Can Use:
Learn These 3 Lessons From the 2019 Final Rule
You'll find documentation relief, but not E/M revision, in the New Year. There were a few... Read more
Learn These 3 Lessons From the 2019 Final Rule
You'll find documentation relief, but not E/M revision, in the New Year. There were a few... Read more
CPT® Updates:
Use These 2019 CPT® Codes for Primary Care Psych Tests
Current codes make way for extensive updates. Last month, we looked at changes in the 201... Read more
Use These 2019 CPT® Codes for Primary Care Psych Tests
Current codes make way for extensive updates. Last month, we looked at changes in the 201... Read more
Case Study Corner:
Follow This Guide for Simple Burn Coding
And don't forget this acronym to assign Dx A male patient spills hot water from a pan on ... Read more
Follow This Guide for Simple Burn Coding
And don't forget this acronym to assign Dx A male patient spills hot water from a pan on ... Read more
Reader Question:
Use These Guidelines for Sample Drug Administration Claims
Question: My provider billed an office call and then gave a patient an injection of the ne... Read more
Use These Guidelines for Sample Drug Administration Claims
Question: My provider billed an office call and then gave a patient an injection of the ne... Read more
Reader Question:
Fold Reading into E/M Level in This X-ray Encounter
Question: We used to do X-rays in our practice, but we now send out for them. If the facil... Read more
Fold Reading into E/M Level in This X-ray Encounter
Question: We used to do X-rays in our practice, but we now send out for them. If the facil... Read more
You Be the Coder:
Apply This Advice to Avoid Seventh Character Confusion
Question: I am confused about the use of seventh characters when our provider removes sutu... Read more
Apply This Advice to Avoid Seventh Character Confusion
Question: I am confused about the use of seventh characters when our provider removes sutu... Read more
News You Can Use:
Catch up on CPT®'s CCM Changes
And look out for new ways to report data collection. Coding for patients with chronic con... Read more
Catch up on CPT®'s CCM Changes
And look out for new ways to report data collection. Coding for patients with chronic con... Read more
CPT® Revisions:
Know Technique, not Depth, to Master New CPT® Biopsy Codes
Trio of new codes, add-ons will give procedure reporting new specificity beginning Jan. 1.... Read more
Know Technique, not Depth, to Master New CPT® Biopsy Codes
Trio of new codes, add-ons will give procedure reporting new specificity beginning Jan. 1.... Read more
ICD-10 Coding:
Grasp Gout Dx Codes With This Guide
All you have to do is take these 4 pain-free steps. An overweight patient with hypertensi... Read more
Grasp Gout Dx Codes With This Guide
All you have to do is take these 4 pain-free steps. An overweight patient with hypertensi... Read more
Reader Question:
Manage Medication for a Higher E/M Level
Question: Our office has a policy that patients should come in every three months when the... Read more
Manage Medication for a Higher E/M Level
Question: Our office has a policy that patients should come in every three months when the... Read more
Reader Question:
Improve Your Coding Health with This New Flu Vaccine
Question: It seems like every year the AMA adds yet another CPT® code for a flu vaccine. ... Read more
Improve Your Coding Health with This New Flu Vaccine
Question: It seems like every year the AMA adds yet another CPT® code for a flu vaccine. ... Read more
You Be the Coder:
Can You Code This Sick Visit Chart?
Question: How would you code the following? Chief complaint: Patient is here for a sick v... Read more
Can You Code This Sick Visit Chart?
Question: How would you code the following? Chief complaint: Patient is here for a sick v... Read more
Preventive Medicine:
Prevent Fall Risk Counseling Coding Errors with This FAQ
IPPE, AWV, and E/M key opportunities for education. The need for fall risk prevention cou... Read more
Prevent Fall Risk Counseling Coding Errors with This FAQ
IPPE, AWV, and E/M key opportunities for education. The need for fall risk prevention cou... Read more
Mythbusters:
Bust These Myths for Accurate 99211 Reporting
Hint: Descriptors and documentation are your best guides. Of all the evaluation and manag... Read more
Bust These Myths for Accurate 99211 Reporting
Hint: Descriptors and documentation are your best guides. Of all the evaluation and manag... Read more
Case Study Corner:
Can You Code This Adolescent Acne Case Study?
Know these three simple concepts to code like an expert. An adolescent patient reports to... Read more
Can You Code This Adolescent Acne Case Study?
Know these three simple concepts to code like an expert. An adolescent patient reports to... Read more
Reader Question:
Take This Counsel When Providing MNT
Question: Our PCP recently gave nutrition counseling to a Medicare patient. We used F50.02... Read more
Take This Counsel When Providing MNT
Question: Our PCP recently gave nutrition counseling to a Medicare patient. We used F50.02... Read more
Reader Question:
Choose Code from Provider Note, not EMR Default
Question: Our providers sometimes enter ICD-10 codes into a patient's electronic medical r... Read more
Choose Code from Provider Note, not EMR Default
Question: Our providers sometimes enter ICD-10 codes into a patient's electronic medical r... Read more
Reader Question:
Specify Jaw Dx in This Accident Scenario
Question: Our FP treated a patient who had been in a minor motorcycle accident (the patien... Read more
Specify Jaw Dx in This Accident Scenario
Question: Our FP treated a patient who had been in a minor motorcycle accident (the patien... Read more
You Be the Coder:
Code Associated Condition in This Fibromyalgia Encounter
Question: Our provider diagnosed a patient with chronic migraines and headaches r/t (relat... Read more
Code Associated Condition in This Fibromyalgia Encounter
Question: Our provider diagnosed a patient with chronic migraines and headaches r/t (relat... Read more
News You Can Use:
Report Vision Screens, Preventive Medicine Separately, Says CCI
Know which edit pairs CMS has deleted effective July 1. The Centers for Medicare and Medi... Read more
Report Vision Screens, Preventive Medicine Separately, Says CCI
Know which edit pairs CMS has deleted effective July 1. The Centers for Medicare and Medi... Read more
Coding Quiz:
Answer These Questions, Advance Your ACP Coding Knowledge
Do you know the key elements to report this service? Few of us want to contemplate the en... Read more
Answer These Questions, Advance Your ACP Coding Knowledge
Do you know the key elements to report this service? Few of us want to contemplate the en... Read more
Procedure Coding:
Take These Steps, Code Cerumen Removal With Ease
Hint: Procedures, providers, and Dx are key. Cerumen, or earwax as it is more commonly kn... Read more
Take These Steps, Code Cerumen Removal With Ease
Hint: Procedures, providers, and Dx are key. Cerumen, or earwax as it is more commonly kn... Read more
Coding Quiz Answers:
Check Your Answers to Our ACP Coding Quiz
Once you've answered the quiz questions on page 67, compare your answers with the ones our... Read more
Check Your Answers to Our ACP Coding Quiz
Once you've answered the quiz questions on page 67, compare your answers with the ones our... Read more
Reader Question:
Use Units or Modifier to Bill for Assessments
Question: Our provider received results of a Drug Abuse Screening Test (DAST-10) and an Al... Read more
Use Units or Modifier to Bill for Assessments
Question: Our provider received results of a Drug Abuse Screening Test (DAST-10) and an Al... Read more
Reader Question:
Establish the Rule for This Taxing Situation
Question: I work for a hospital that owns multiple family practice clinics. If a patient g... Read more
Establish the Rule for This Taxing Situation
Question: I work for a hospital that owns multiple family practice clinics. If a patient g... Read more
You Be the Coder:
Know When to Use This Nosebleed Code
Question: We recently saw a patient who came to the practice with a nosebleed. One of our ... Read more
Know When to Use This Nosebleed Code
Question: We recently saw a patient who came to the practice with a nosebleed. One of our ... Read more
News You Can Use:
Know These New Codes to Document Exploitation, Abuse
Cyberbullying makes its first appearance in ICD-10. With just 320 additions, 172 revised ... Read more
Know These New Codes to Document Exploitation, Abuse
Cyberbullying makes its first appearance in ICD-10. With just 320 additions, 172 revised ... Read more
ICD-10 Update:
Update Your Understanding of the New Screening Codes
Mental health and developmental disorders focus of latest ICD-10 revisions. The passage o... Read more
Update Your Understanding of the New Screening Codes
Mental health and developmental disorders focus of latest ICD-10 revisions. The passage o... Read more
E/M Coding:
Code by the Numbers for MDM
But make sure everything adds up to consistency and medical necessity. Of the three eleme... Read more
Code by the Numbers for MDM
But make sure everything adds up to consistency and medical necessity. Of the three eleme... Read more
Reader Question:
Choose Modifiers Based on Procedure, not Medication Type
Question: We billed a private payer 99213-25; 20610; J7328-RT; J7328-LT for Gelsyn-3 injec... Read more
Choose Modifiers Based on Procedure, not Medication Type
Question: We billed a private payer 99213-25; 20610; J7328-RT; J7328-LT for Gelsyn-3 injec... Read more
Reader Question:
Look to Code First Note in This Type 2 UTI Encounter
Question: What is the correct way to code for type 2 diabetes and a urinary tract infectio... Read more
Look to Code First Note in This Type 2 UTI Encounter
Question: What is the correct way to code for type 2 diabetes and a urinary tract infectio... Read more
You Be the Coder:
Draw on These Codes for Successful Venipuncture Reporting
Question: I know that age is one of the factors that differentiates between the venipunctu... Read more
Draw on These Codes for Successful Venipuncture Reporting
Question: I know that age is one of the factors that differentiates between the venipunctu... Read more
Compliance:
Take this Advice, Avoid the Audit Blues
Voluntary disclosure rules best followed by proactive practices, say experts. Your office... Read more
Take this Advice, Avoid the Audit Blues
Voluntary disclosure rules best followed by proactive practices, say experts. Your office... Read more
Clip & Save:
Use This Chart to Reference Common Respiratory Dx Codes
And use these hints to identify conditions quickly and easily. Sometimes, finding the rig... Read more
Use This Chart to Reference Common Respiratory Dx Codes
And use these hints to identify conditions quickly and easily. Sometimes, finding the rig... Read more
Case Study Corner:
Test Skin Lesion Removal Knowledge with These 3 Scenarios
Hint: Be mindful of malignancy, method, and modifiers to make meticulous code choices. Co... Read more
Test Skin Lesion Removal Knowledge with These 3 Scenarios
Hint: Be mindful of malignancy, method, and modifiers to make meticulous code choices. Co... Read more
Reader Question:
Dial in this New Modifier for Telehealth Services
Question: When telehealth services are provided from our practice office, should our pract... Read more
Dial in this New Modifier for Telehealth Services
Question: When telehealth services are provided from our practice office, should our pract... Read more
Reader Question:
Get the Right Answer to this Extremity Pain Scenario
Question: Our physician saw a new patient with a complaint of right-sided extremity pain e... Read more
Get the Right Answer to this Extremity Pain Scenario
Question: Our physician saw a new patient with a complaint of right-sided extremity pain e... Read more
You Be the Coder:
Start with These Codes for Smoking Cessation
Question: We have a patient who wishes to quit smoking, even though he currently has no ad... Read more
Start with These Codes for Smoking Cessation
Question: We have a patient who wishes to quit smoking, even though he currently has no ad... Read more
Documentation:
Follow These 4 Hints, Produce Clean, Compliant Documentation
NCQA standards, experts shed light on common problem areas. How important is accurate doc... Read more
Follow These 4 Hints, Produce Clean, Compliant Documentation
NCQA standards, experts shed light on common problem areas. How important is accurate doc... Read more
E/M Coding:
Take Care to Code These Complex Subsequent Care Scenarios
And check your responses with those of our experts. The scenario is pretty familiar: an e... Read more
Take Care to Code These Complex Subsequent Care Scenarios
And check your responses with those of our experts. The scenario is pretty familiar: an e... Read more
Procedure Coding:
Know These Guidelines, Enhance Your Pap Smear Coding Knowledge
Risk level key to code choice, test frequency. When both the US Preventive Services Task ... Read more
Know These Guidelines, Enhance Your Pap Smear Coding Knowledge
Risk level key to code choice, test frequency. When both the US Preventive Services Task ... Read more
Reader Question:
Look to the Clock to Calculate Counseling Units
Question: We recently saw a patient for a nutrition therapy counseling session. The sessio... Read more
Look to the Clock to Calculate Counseling Units
Question: We recently saw a patient for a nutrition therapy counseling session. The sessio... Read more
You Be the Coder:
Reach for These Codes in This Emergency Laceration Scenario
Question: A patient came to the office on an emergent basis with several lacerations to th... Read more
Reach for These Codes in This Emergency Laceration Scenario
Question: A patient came to the office on an emergent basis with several lacerations to th... Read more
News You Can Use:
Get Ready for Care Management, Prolonged Services Bundle Changes
Know how these April CCI edits could affect your practice. The Centers for Medicare and M... Read more
Get Ready for Care Management, Prolonged Services Bundle Changes
Know how these April CCI edits could affect your practice. The Centers for Medicare and M... Read more
ICD-10 Coding:
Look to BMI to Understand Weight Dx Coding
Just be sure your provider makes the call. It was discovered by a Belgian statistician al... Read more
Look to BMI to Understand Weight Dx Coding
Just be sure your provider makes the call. It was discovered by a Belgian statistician al... Read more
E/M Coding:
Anticipate These Answers to Report Preventive Medicine Visits Accurately
This FAQ on how to report 99381-99397 is exactly what the doctor ordered. Recently, the C... Read more
Anticipate These Answers to Report Preventive Medicine Visits Accurately
This FAQ on how to report 99381-99397 is exactly what the doctor ordered. Recently, the C... Read more
Reader Question:
Report Units, Supply for Depo Injection
Question: What is the best way to go about reporting and billing Depo Provera administrati... Read more
Report Units, Supply for Depo Injection
Question: What is the best way to go about reporting and billing Depo Provera administrati... Read more
Reader Question:
Factor Age into Principal Dx for This Immunization Encounter
Question: What is the appropriate way to bill for an outpatient visit when the patient com... Read more
Factor Age into Principal Dx for This Immunization Encounter
Question: What is the appropriate way to bill for an outpatient visit when the patient com... Read more
You Be the Coder:
Know the Difference Between These Finger-Stick Tests
Question: Our provider regularly performs finger-stick glucose tests on diabetic and predi... Read more
Know the Difference Between These Finger-Stick Tests
Question: Our provider regularly performs finger-stick glucose tests on diabetic and predi... Read more
Procedure Coding:
Get Physical with These School, Sports, and Occupational Exam Codes
Hint: prove your coding fitness by looking to 99381-99397. Whether they are for school, s... Read more
Get Physical with These School, Sports, and Occupational Exam Codes
Hint: prove your coding fitness by looking to 99381-99397. Whether they are for school, s... Read more
Billing:
Know These Guidelines, Ease Reciprocal Billing Headaches
Substitute services aren't so hard to arrange if you follow these dos and don'ts. Summer ... Read more
Know These Guidelines, Ease Reciprocal Billing Headaches
Substitute services aren't so hard to arrange if you follow these dos and don'ts. Summer ... Read more
ICD-10 Coding:
Code for Pressure Ulcers in 4 Easy Steps
Take this tour through the L89 codes to find bed sore coding relief. Pressure ulcers - or... Read more
Code for Pressure Ulcers in 4 Easy Steps
Take this tour through the L89 codes to find bed sore coding relief. Pressure ulcers - or... Read more
Reader Question:
Record Remission, History in This Sobriety Scenario
Question: Our provider documented in the record that she met with a patient who had a hist... Read more
Record Remission, History in This Sobriety Scenario
Question: Our provider documented in the record that she met with a patient who had a hist... Read more
Reader Question:
New Code, Not Gender, Cause for Denial of Mammogram Service
Question: Our provider ordered a diagnostic, bilateral mammogram with tomosynthesis for a ... Read more
New Code, Not Gender, Cause for Denial of Mammogram Service
Question: Our provider ordered a diagnostic, bilateral mammogram with tomosynthesis for a ... Read more
Reader Question:
Try Your Hand at Solving This Myostitis Mystery
Question: Our provider documented that a patient was suffering from pain, swelling, tender... Read more
Try Your Hand at Solving This Myostitis Mystery
Question: Our provider documented that a patient was suffering from pain, swelling, tender... Read more
You Be the Coder:
Bring Closure to This Multiple Procedure Encounter
Question: An established patient came to our provider with a deep 10 cm cut on his right a... Read more
Bring Closure to This Multiple Procedure Encounter
Question: An established patient came to our provider with a deep 10 cm cut on his right a... Read more
ICD-10 Coding:
Dive Into Diabetes Documentation for Best Dx Possible
Go from general to specific with these 5 simple suggestions. With almost 250 different di... Read more
Dive Into Diabetes Documentation for Best Dx Possible
Go from general to specific with these 5 simple suggestions. With almost 250 different di... Read more
Mythbusters:
Get Time on Your Side with Prolonged E/M Codes
Extend your prolonged service coding knowledge by busting these 4 myths. Sometimes, patie... Read more
Get Time on Your Side with Prolonged E/M Codes
Extend your prolonged service coding knowledge by busting these 4 myths. Sometimes, patie... Read more
Case Study Corner:
Turn to ICD-10 Index, Connect These Soft Tissue Scenarios
Categories key to pain-free coding. Even the most experienced coders can get stumped when... Read more
Turn to ICD-10 Index, Connect These Soft Tissue Scenarios
Categories key to pain-free coding. Even the most experienced coders can get stumped when... Read more
Reader Question:
Code for Counseling When Patient not Present
Question: We have a mom that came in for a consult about her 5-year-old son, but he was no... Read more
Code for Counseling When Patient not Present
Question: We have a mom that came in for a consult about her 5-year-old son, but he was no... Read more
Reader Question:
Use Separate Codes for Separate Encounters in this COPD Scenario
Question: A couple of months ago, our provider saw a patient and provided a diagnosis of a... Read more
Use Separate Codes for Separate Encounters in this COPD Scenario
Question: A couple of months ago, our provider saw a patient and provided a diagnosis of a... Read more
Reader Question:
Factor Patient's Age in This Flu Shot Scenario
Question: A 57-year-old patient came in for a flu shot, but when we billed 90662 we got de... Read more
Factor Patient's Age in This Flu Shot Scenario
Question: A 57-year-old patient came in for a flu shot, but when we billed 90662 we got de... Read more
You Be the Coder:
Time to Brush Up on E/M Guidelines
Question: As a new coder, I am still a little confused by the times listed in the descript... Read more
Time to Brush Up on E/M Guidelines
Question: As a new coder, I am still a little confused by the times listed in the descript... Read more
E/M Coding:
Got ROS Questions? We've Got Answers
This FAQ sheds light on common system review problems. The review of systems (ROS) is a k... Read more
Got ROS Questions? We've Got Answers
This FAQ sheds light on common system review problems. The review of systems (ROS) is a k... Read more
Procedure Coding:
Look Beneath the Surface to Code Removals, Excisions, and Biopsies
Four concepts help simplify reporting these skin procedures. Knowing how to code for an e... Read more
Look Beneath the Surface to Code Removals, Excisions, and Biopsies
Four concepts help simplify reporting these skin procedures. Knowing how to code for an e... Read more
Clip & Save:
Use These Codes for Common GI Conditions
And let these pointers, expert tips guide you to fast, accurate documentation. We all hav... Read more
Use These Codes for Common GI Conditions
And let these pointers, expert tips guide you to fast, accurate documentation. We all hav... Read more
Reader Question:
Report Supervision, Not Interpretation, in This Stress Test Scenario
Question: Our physician has been sending patients to a local hospital for stress echo test... Read more
Report Supervision, Not Interpretation, in This Stress Test Scenario
Question: Our physician has been sending patients to a local hospital for stress echo test... Read more
You Be the Coder:
Code Stimulant Drug Use Differently in Therapeutic Situations
Question: I have two questions about documenting periodic therapeutic drug screens, which ... Read more
Code Stimulant Drug Use Differently in Therapeutic Situations
Question: I have two questions about documenting periodic therapeutic drug screens, which ... Read more
News You Can Use:
Know What Changes Are Heading Your Way in the 2018 PFS
Find out whether code changes, revenue adjustments will impact your practice. On Nov. 15,... Read more
Know What Changes Are Heading Your Way in the 2018 PFS
Find out whether code changes, revenue adjustments will impact your practice. On Nov. 15,... Read more
Coding Quiz:
Identify Status, Stages, Ace This AIDs Quiz
Let these answers guide you to flawless HIV coding. There's good news and bad news regard... Read more
Identify Status, Stages, Ace This AIDs Quiz
Let these answers guide you to flawless HIV coding. There's good news and bad news regard... Read more
ICD-10-CM Coding:
Overwhelmed by UTI Code Choices? Here's How to Narrow Them Down
There's more to coding these infections than you might think. Look up Infection/urinary (... Read more
Overwhelmed by UTI Code Choices? Here's How to Narrow Them Down
There's more to coding these infections than you might think. Look up Infection/urinary (... Read more
Coding Quiz Answers:
Check Your Answers to Our HIV Coding Quiz
See how your answers stack up with our experts'. Answer 1: The answer to this question de... Read more
Check Your Answers to Our HIV Coding Quiz
See how your answers stack up with our experts'. Answer 1: The answer to this question de... Read more
Reader Question:
Pick Group Education Codes by Patient, Provider
Question: To meet the needs of a number of our patients with diabetes, our provider decide... Read more
Pick Group Education Codes by Patient, Provider
Question: To meet the needs of a number of our patients with diabetes, our provider decide... Read more
You Be the Coder:
Run, Don't Walk, to Code This I&D Scenario
Question: One of our diabetic patients recently competed in a marathon. Several days later... Read more
Run, Don't Walk, to Code This I&D Scenario
Question: One of our diabetic patients recently competed in a marathon. Several days later... Read more