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Primary Care Coding Alert

Year in Review:
Let the Answers to These FAQs Ease Your 2021 Worries
This year's biggest stories reveal what might be in store for the New Year. As if dealing... Read more
Condition Spotlight:
Take These 4 Steps to Improve Your Asthma Coding Accuracy
And code this scenario to bring it all home. Though asthma triggers can occur at any time... Read more
Procedure Coding:
Scrutinize These 2 Scenarios for Spirometry Success
Beware of bundling bungles. Now that respiratory illness season is in full swing, your pr... Read more
You Be the Coder:
Make Sure Modifiers Follow MUE, MAI Mandates
Question: We recently submitted a claim of 99214-25, 64400 x2, and 64505 x2, which was den... Read more
Reader Questions:
Know These Issues Before Billing E/M With Alcohol Screens
Question: We are trying to bill 99408 with 99213, but we are having problems with Na... Read more
Reader Questions:
Assemble This Advice for COVID Swab Collection
Question: If a provider has a telehealth visit with a patient, and the patient is the... Read more
Procedure Coding:
Give Your Immunization Coding Skills a Boost With This FAQ
But remember to note our expert advice and two important exceptions. Now that immunizati... Read more
Coding Quiz:
Ace This Quiz, Avoid Contraceptive Service Coding Errors
“Context is key,” say experts. One of the most important services primary care provid... Read more
Coding Quiz Answers:
Check Your Answers to Our Contraceptive Service Coding Quiz
Time to find out the depth of your contraceptive coding knowledge. Once you've answered t... Read more
Condition Spotlight:
Use This Guide to Resolve Back Pain Coding Problems
And check out these three scenarios to help you navigate the M54.- codes and beyond. If y... Read more
You Be the Coder:
Know Incident-To Rules for Correct NPP Cerumen Removal Billing
Question: Can impacted cerumen removal by lavage be performed by a nurse? Pennsylvania Su... Read more
Reader Questions:
Boost Your Bottom Line With This New PHE PPE Code
Question: What do you know about the new CPT® code for reporting additional practice... Read more
Reader Questions:
Take Time to Go Back Over This ACP Bill
Question: Medicare just denied our bill for 99497, 99498, and 99498, saying that the ... Read more
Reader Questions:
Provide Dx for Monitoring Lab Test
Question: If one of our providers saw a patient for problems related to asthma, but went a... Read more
News You Can Use:
Take a Look at CMS’ Good, Bad, and Confusing Proposals for 2021
E/M, immunization fees could be going up, while prolonged service coding could get tricky.... Read more
CPT® 2021 Revisions:
Prepare for These Upcoming CPT® Changes
Don't worry. There are very few surprises coming up in 2021. The 2021 CPT® revisions hav... Read more
ICD-10 Coding:
Get Ready for These New 2021 ICD-10 Codes and Instructions (Part 2)
And say hello to a new chapter you've already seen. In last month's Primary Care Coding ... Read more
Reader Questions:
Check Out Guidelines Before Billing for Psych Evals
Question: How often is it possible to bill 90791 and/or 90792 per Medicare guidelines... Read more
Reader Questions:
Don’t Take a Risk With This Encounter Code
Question: We had an established male patient report today with a cough. One of our pr... Read more
Reader Questions:
Query Payment Guidelines for This Hormone Treatment
Question: How do we bill for chorionic gonadotropin (HCG) when our provider supplies it an... Read more
You Be the Coder:
Stay on the Right Side of This Provider/Consultant Equation
Question: Our provider examined a patient, then provided information about that patient's ... Read more
News You Can Use:
Get Ready for These New 2020 ICD-10 Codes and Instructions (Part 1)
New external cause codes, headache and influenza instructions take center stage. The best... Read more
Guidelines:
Manage the 2021 ICD-10-CM Guideline Revisions With Ease
Temporary guidelines for COVID-19 and vaping are made permanent. Like the 2021 ICD-10-CM ... Read more
Critical Care:
Got Critical Care Questions? We've Got Answers
Hint: Patient status and services, not location, drive 99291-+99292 billing. The adult cr... Read more
Reader Questions:
Wa(i)ve Goodbye to This Modifier for PTH Testing
Question: Medicare has repeatedly denied our claim for 83970 due to modifier QW. Is this t... Read more
Reader Questions:
Locate the Answer to This Benign Lesion Destruction Question
Question: Our provider recently performed cryotherapy on a female patient to remove mollus... Read more
You Be the Coder:
Know How to Apply This Cost-Sharing Modifier
Question: Our payer has a guideline that states: “Modifier CS must be added to each line... Read more
ICD-10 Coding:
Know the What, Why, and When of the External Cause Codes
Use them to paint the patient's complete picture … most of the time. You're probably fa... Read more
Coding Quiz:
Can You Use the 2020 and 2021 E/M Guidelines to Code This Case Study?
One common scenario, two different processes, and a surprising result. Over the course of... Read more
Guidelines:
Improve Your I&D Coding With These 4 Important Insights
Know your procedures to make smart coding choices. For a small group of 10 related codes,... Read more
Coding Quiz Answers:
Check Your Answers to Our 2021 E/M Case Study
Find out if your E/M coding knowledge is up to next years' big challenge. Once you've cod... Read more
Reader Questions:
Document This Tonsil FBR With Precision
Question: A primary care provider in our practice removed a piece of popcorn kernel f... Read more
Reader Questions:
Bill Supplies in This Sedation Scenario
Question: My office is not a surgery center, but we do perform minor surgeries under POS 1... Read more
Reader Questions:
Understand Causality, Document This Hypoglycemic Encounter Correctly
Question: Our provider documented a patient with prediabetes and hypoglycemia. The patient... Read more
You Be the Coder:
Pass by These Codes to Make a Definitive Dermis Debridement Decision
Question: Our provider just saw a patient who had a superficial linear abrasion that exten... Read more
Mythbusters:
Bust These 3 Myths, Become a HIPAA Hotshot
 Let our experts help you understand these complex confidentiality concepts. How wel... Read more
ICD-10 Coding:
Use This Guide to Navigate the Arthritis Codes
These 3 scenarios will help you make the best M15-M19 code choice. Coding arthritis can b... Read more
Procedure Coding:
Get the Answers to All Your Frequently Asked ECG Questions
Know what's at the heart of coding these critical tests. If you have questions about elec... Read more
Reader Questions:
Make This Modifier Choice for Separate EOL Services
Question: Our provider recently counseled an established patient on end-of-life (EOL) dire... Read more
Reader Questions:
Found Nothing New? Use This Code for Routine Physicals
Question: I am confused about when to use Z00.00 or Z00.01. If a patient has a preexisting... Read more
Reader Questions:
Follow This Guideline When Coding Chronic Pain
Question: What is the correct ICD-10 code for chronic back pain? Can I use M54.9? Codify ... Read more
You Be the Coder:
Corral These Codes for Correct Swab Collection
Question: Some local hospitals are referring patients to us for COVID-19 testing prior to ... Read more
E/M Coding:
Get the Answers to These 5 Frequently Asked 2021 Outpatient E/M Time Questions
Note changes in total times, prolonged outpatient services. Last month, we took an in-de... Read more
Care Management:
Know These Best Practices for Managing Your CCM Program
Understand what it takes to implement and maintain this valuable service. How do you sta... Read more
Condition Spotlight:
Take These Steps to Code Diabetic Foot Exams Correctly
Here are all the combo Dx codes and Medicare rules you need to know. With a diagnosis of ... Read more
Reader Question:
Stay on Top of These New COVID-19 Guidelines, Codes
Question: There have been so many coding changes regarding COVID-19 that we are having tr... Read more
You Be the Coder:
Rectify This Denial by Removing This Modifier Mistake
Question: We billed a patient's Wellcare Medicare Advantage Plan 11400-25, 17000, and +170... Read more
News You Can Use:
Hear These Answers to Your Frequently Asked PHE Telehealth Questions
All the guideline changes and additions to the telehealth list you need to know. On Marc... Read more
Coding Quiz:
Do You Have What It Takes to Pass This Hypertension Coding Quiz?
Hint: pay close attention to the Chapter 9 guidelines. Many of us are being asked to st... Read more
Guidelines:
Code These 3 Scenarios, Master Telehealth Coding
Know how to decide which services best fit your practice. The current public health emer... Read more
Coding Quiz Answers:
Check Your Answers to Our Hypertension Coding Quiz
Find out if your coding knowledge needs to get back on schedule. Once you've answered t... Read more
Reader Question:
Follow CDC, AMA Advice, Choose These COVID-19 Codes
Question: Thank you for keeping us up to date with the changes in medical coding due to th... Read more
Reader Question:
Don't Complicate Your Diabetes Dx in This Unstable Scenario
Question: Our provider documented that a type 2 diabetic patient's condition was “unstab... Read more
You Be the Coder:
Rule Out This Z Code When Dx Ruled Out
Question: A patient came into our practice saying he thought he might have a hernia. Our p... Read more
E/M Coding:
Know How 2 of Your Most-Used E/M Codes Will Change in 2021
MDM table revisions, new language, spell changes and challenges. In last month's Primary ... Read more
Mythbusters:
Bust These 4 Myths for Signs and Symptoms Coding Success
Know when, and when not, to use these commonly used codes. You know that Chapter 18 in IC... Read more
Preventive Medicine:
Don't Let Your 99406 and 99407 Claims Go up in Smoke
Here are all the answers to your Medicare smoking cessation counseling guideline question... Read more
Reader Question:
Consider This Coding Counsel to Curtail COVID-19 Confusion
Question: Has the Centers for Disease Control (CDC) issued any guidance regarding coding f... Read more
Reader Question:
Add Times When Billing This Multi-Provider Critical Care Encounter
Question: One of our providers spent 40 minutes treating a critically ill adult patient in... Read more
Reader Question:
Expand Your History Understanding by Solving This Problem
Question: If I have a chief complaint, an extended history of present illness (HPI), a pro... Read more
You Be the Coder:
Stick to This Advice to Report Blood Draw, E/M, on Same Day
Question: Is it possible to bill 99211 with 36415? If so, do I need to append modifier 25 ... Read more
E/M Coding:
Get the Answers to These 3 Frequently Asked 2021 E/M MDM Questions
Know what changes, what stays the same, and what we still have yet to learn. If you read ... Read more
Guidelines:
Don't Get Left in Denial – Make the Right Modifier 50 Choice Every Time
These 3 tips will keep payers on your side. Modifier 50 (Bilateral procedure) is one of t... Read more
ICD-10 Coding:
Confused by Dermatitis Codes? Here Are 3 Things to Remember
Understand contact type and synonyms for success. When it comes to coding dermatitis, the... Read more
Reader Question:
Add U07.0 to Code for Vaping Disorder
Question: Thank you for your recent article on coding for vaping-related conditions [see P... Read more
Reader Question:
Code for Current Condition When Care Continues
Question: A patient of ours was hospitalized for pneumonia. On release, the patient receiv... Read more
Reader Question:
Know Who, What to Bill for Pre-Employment Drug Tests
Question: What is the best way to bill for a pre-employment drug test? We would like to ch... Read more
You Be the Coder:
Understand Options in This Suture Removal Scenario
Question: One of our patients was involved in an accident that required him to go to the e... Read more
News You Can Use:
Get Onboard With These NCCI Edits for Online E/Ms
Billing 98970-98972 and 99421-99423 just got a whole lot trickier this year. As you would... Read more
Coding Quiz:
Fine-Tune Your Bronchitis Coding With This Quiz
And use these 3 pro-coding tips to sharpen your skills. Think you're a bronchitis coding ... Read more
Guidelines:
Take a Closer Look at the NCCI PTP Edit Pair Guidelines
Know how 0, 1, and 9 add up to total coding success. Do you have questions about how to i... Read more
Coding Quiz Answers:
Check Your Answers to Our Bronchitis Coding Quiz
Once you've answered the quiz questions, compare your answers with the ones provided below... Read more
Reader Question:
Administer This Advice to Avoid Injection Confusion
Question: We just got a denial on 20526 with 96372. What are we doing wrong? Missouri Sub... Read more
Reader Question:
Depend on These Code Choices in This Alcohol Withdrawal Encounter
Question: What is the correct ICD-10 coding for a patient diagnosed with alcohol use ... Read more
Reader Question:
Get on the Right Side of This Modifier Misunderstanding
Question: When a provider performs an incision and drainage (I&D) on a right brea... Read more
You Be the Coder:
Don't Experiment With This Steroid Claim
Question: We have been getting denials from one of our payers whenever one of our provider... Read more
Care Management:
Take Care to Manage These Care Management Changes This Year
TCM, CCM, receive rigorous revisions and reevaluation. In addition to the addition of pri... Read more
E/M Coding:
Get Ready for 2021 by Taking These 2 Steps Now
Hint: get your documentation and implementation ducks in a row. You know that a year from... Read more
Condition Spotlight:
Follow This Guide, Code Vaping Problems With Precision
New CDC advice provides clear coding suggestions. If you've been paying attention to rece... Read more
Reader Question:
Use 1 Code for These 2 Bed Sores
Question: How should I code a patient who has two stage-two pressure ulcers on the right b... Read more
Reader Question:
Take a Long-Term View of This Code Use
Question: If a provider writes out a prescription for a drug pending the results of a lab ... Read more
Reader Question:
Understand Global for Correct Modifier Application
Question: If a provider makes a decision to perform cerumen removal using 69209, can I use... Read more
You Be the Coder:
Manage Billing Responsibilities in This CCM Scenario
Question: My company, FirstVitals, is credentialed with Medicare and all commercial insura... Read more
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