Primary Care Coding Alert

News You Can Use:
Use This FAQ to Boost Your Understanding of the New COVID Vaccine Codes
Learn how to document the new vaccine, additional doses, and boosters. If your head is s... Read more
Year in Review:
Refresh Your Memory of These 2021 PCM, Prolonged Services, and Dx Documentation Stories
How much do you remember about these big changes from the last 12 months? Like any year, ... Read more
Condition Spotlight:
Let Level, Duration, Linked Conditions and Remission Determine Depression Dx
But let provider judgement take the wheel. Primary care physicians are on the front line... Read more
Reader Questions:
Be Certain Assigning MDM Levels for Uncertain Dx Encounters
Question: An established patient came to our office complaining of left-sided facial ... Read more
Reader Questions:
Note Provider Taxonomy for New Patient Determination
Question: A family practice provider in our large practice saw a patient, and the pat... Read more
Reader Questions:
Know the Difference Between These Hypertension Diagnoses
Question: If a patient has a diagnosis of pulmonary hypertension, does the patient ha... Read more
You Be the Coder:
Ask These 3 Questions, Use Modifier 24 Correctly
Question: What are the proper situations to use modifier 24? We are having a debate in the... Read more
News You Can Use:
Know These CDC Updates and Recommendations for Flu Vaccinations This Winter
And use this handy clip-and-save chart to code all your quadrivalent flu vaccines. Flu va... Read more
MythBusters:
Bust These 4 Myths for Winter Illness Dx Coding Success
Let ICD-10 guidelines and instructions keep your cold-weather condition coding hot. Winte... Read more
ICD-10 Coding:
Determine 4th Digits for Definitive Diabetes Dx Documentation
These five numbers will help you locate diabetic complications quickly and easily. Nowher... Read more
Reader Questions:
Understand When “With” Doesn’t Mean “Linked”
Question: If a provider documents hypertension with diabetes mellitus, can I assume, and i... Read more
Reader Questions:
Code Kenalog Units by Dose, Not Volume
Question: How many units of J3301 is 4 mL of Kenalog? The descriptor references milligram... Read more
Reader Questions:
List Other Specified Condition to Resolve This Medicare Denial
Question: We have a Medicare patient who has a history of swelling during travel, and whil... Read more
You Be the Coder:
Mix These Modifiers, Make a Medicare Mess
Question: Our physician performed trigger finger injections on the middle fingers of a pat... Read more
CPT® 2022 Update:
Adapt to This 99211 Revision and COVID Additions in Next Year’s CPT®
Heads up: Most of these new codes aren't really new at all. Have you been worried you'll ... Read more
Coding Quiz:
Can You Code These 3 Burn Encounters? Find Out.
Learn the acronym that will direct you to the right codes every time. Coding burns is alw... Read more
Care Management:
Stand By for RTM to Debut in 2022
And understand the similarities, differences between RTM and RPM. Beginning Jan. 1, 2022,... Read more
Coding Quiz Answers:
Check Your Answers to Our Burn Coding Quiz
Here's why you need to remember the acronym S/S.E.E. Once you've answered the quiz questi... Read more
Reader Questions:
Identify Surgery Risk Factors for Higher MDM Level
Question: In the current CPT® Elements of Medical Decision Making (MDM) table, one of the... Read more
Reader Questions:
Back Off Billing for Telephone Triage
Question: We have been getting calls from patients who have tested positive for COVID-19 a... Read more
Reader Questions:
Take Care to Check Symptoms in Chronic Migraine Code Choices
Question: When I look up chronic migraine in the ICD-10 alphabetic index, I am directed to... Read more
You Be the Coder:
Observe the Answer to This Prolonged Service Problem
Question: Our provider performed an evaluation and management (E/M) service on a new patie... Read more
News You Can Use:
Know These 2022 Medicare Proposals for Immunizations, Split/Shared, PCM
And watch out for a possible CF reduction. As always, Medicare's Physician Fee Schedule p... Read more
Guidelines:
Get the Gist of These ICD-10 Laterality, COVID-19 Guideline Revisions for 2022
You'll soon be able to report laterality when clinicians other than your provider note it.... Read more
Preventive Medicine:
Know the Who, What, Why and When Behind BMM Claims
Do you know when you can bend the two-year rule? Bone density screenings, or bone mass me... Read more
Reader Questions:
Can You Comprehend This Cachexia Coding Conundrum?
Question: Our provider documented underweight as a patient's official diagnosis, but unde... Read more
Reader Questions:
Evaluate the Necessity of Adding E/M to This Injection Service
Question: We have been administering Prolia injections to a patient, and I have been bill... Read more
Reader Questions:
Add This 7th Character for Care Plan Review
Question: If a patient comes to us following a visit to the emergency department (ED) for ... Read more
You Be the Coder:
Assign These Codes for Lower Back Pain Severity
Question: How do I code acute or chronic lower back pain? Even with the new ICD-10 codes i... Read more
News You Can Use:
Document Determinants in Definitive Detail With These Brand-New Z Codes
2022 ICD-10 revisions let you document housing, food insecurity and more. You'll find man... Read more
ICD-10 2022 Updates:
Add to Your COVID, Cough Coding Comprehension With These ICD-10 Revisions
More common primary care conditions get an ICD-10 update. In addition to all the encounte... Read more
Mythbusters:
Bust These 4 Myths for Perfect Inpatient Care Coding
Make sure you pay attention to payer guidelines for 96160/96161. Health risk assessments ... Read more
Reader Questions:
Dig Deep, Find the Answer to This Debridement Dilemma
Question: Our provider removed a plantar wart and documented the following: “Skin lesion... Read more
Reader Questions:
Remember to Code Cause First in Vascular Dementia Dx
Question: A payer has denied an F01.50 diagnosis code as an invalid primary diagnosis on a... Read more
Reader Questions:
Time to Understand MI Coding Guidelines
Question: I am confused over when you would use I25.2. When does the code come into effec... Read more
You Be the Coder:
Understand New, Uncertain for Correct MDM Level
Question: Our provider diagnosed an established patient with nasal vestibulitis and prescr... Read more
Telehealth:
Know the Current State of Telehealth for Future Claims Success
Here's what some experts believe will stay and what will go. Now that the COVID-19 public... Read more
ICD-10 Coding:
Follow This Advice, Step Up Your Sequela Coding Game
There's more to coding condition aftereffects that adding a seventh character. Many inju... Read more
Procedure Coding:
Refresh Your Coding Knowledge of These 3 Common Primary Care Procedures
Hint: Know your anatomy and your resources for coding success. In her HealthCon 2021 pres... Read more
Reader Questions:
Combo Codes Key to Classifying Co-Existing Conditions
Question: When can I use a combination code for diabetes and its complication? For example... Read more
Reader Questions:
Use These Time Parameters for Holter Monitor Codes
Question: If a patient on a Holter monitor provides data for 7 days and 8 hours, do I... Read more
Reader Questions:
Understand These Codes, Avoid Injection Confusion
Question: I am getting an error message to remove code 96372 for vaccine administration fo... Read more
You Be the Coder:
Select Dysphagia Codes by Swallowing Phase
Question: If a provider documents different phases of dysphagia, do you code each phase se... Read more
Modifiers:
Understand These 5 Things to Avoid Unwanted Modifier 25 Scrutiny
Hint: understand “above and beyond” to justify E/M-25. “If we're going to talk abo... Read more
Coding Quiz:
Answer These Questions, Document Diabetes Drug Use Definitively
Coding insulin and hypoglycemics together is trickier than you think. All type 1 diabetic... Read more
E/M Coding:
Know How Medical Necessity Impacts Coding
Here's how the term can add to your documentation and E/M understanding. Medical necessit... Read more
Coding Quiz Answers:
Check Your Answers to Our Diabetes Drug Coding Quiz
How well do you know the diabetes drug codes and guidelines? Once you've answered the qui... Read more
Reader Questions:
Don’t Let These Dx and Maneuver Codes Set Your Head Spinning
Question: A patient reported to our provider complaining of brief episodes of vertigo that... Read more
Reader Questions:
Let Provider Documentation Make This Dx Decision
Question: One of our patients is a former opioid addict, and I am not sure what ICD-10 cod... Read more
Reader Questions:
Code Conditions Before They Happen? Think Again
Question: Please settle this debate. One of our providers is saying that we should always ... Read more
You Be the Coder:
Give a Boost to Your Tetanus Vaccine Admin Understanding
Question: Our provider recently moved to a new electronic medical record (EMR), and I am g... Read more
News You Can Use:
Get Greater E/M Clarity With These AMA Rulings
Recent updates shed more light on the 2021 office/outpatient E/M revisions. If you misse... Read more
Condition Spotlight:
Don’t Be Rash Coding These Summer Scenarios
Do you have what it takes to beat the coding heat? Summer's here again, but before you bo... Read more
Mythbusters:
Bust These 4 Myths for Precision RPM Coding
And be aware of the ways the 2021 final rule changed RPM services. Remote physiologic mon... Read more
Reader Questions:
Provide These Modifiers for MNT Counseling
Question: We are getting a denial on 97803 saying that it needs a modifier. What modifier ... Read more
Reader Questions:
Fold E/M Into TCM on First F2F Encounter
Question: One of our patients was discharged from a local hospital and enrolled in transit... Read more
Reader Questions:
Go Outside Viral Infection Codes for Primary Dx
Question: Can ICD-10 codes for bacterial and viral infectious agents ever be used as ... Read more
You Be the Coder:
Don’t Risk Level Calculations by Turning These Tables
Question: Both the Elements of Medical Decision Making (MDM) table in the 2021 CPT® Manua... Read more
Preventive Medicine:
Get the Answers to Your Frequently Asked Preventive Medicine Documentation Questions
Look to medical associations for age- and gender-appropriate recommendations. As importan... Read more
Guidelines:
Follow These Guidelines for Accurate Advance Care Planning
This ACP primer will help you keep your documentation straight. While it's particularly... Read more
ICD-10 Coding:
Know These Terms, Code Cholesterol Conditions Correctly
Time to get hip to the ‘hypers.' You know from your introductory coding classes that th... Read more
You Be the Coder:
Distinguish Between These Modifiers in This Multiple Injection Encounter
Question: What is the correct modifier to use on an injection administration code when a p... Read more
Reader Questions:
Don’t Let These HCPCS S Codes Give You Heartburn
Question: We want to bill Medicare for Protonix and Pepcid given to our patients in the of... Read more
Reader Questions:
Make the Right Decision in This MDM Risk Scenario
Question: Our provider recently spent some time discussing the risk factors for major surg... Read more
Reader Questions:
Use Single Dx in This Colitis Coding Conundrum
Question: Our provider documented a patient as having both diarrhea and colitis. Do I assi... Read more
CPT® 2021 Revisions:
Know How CCM Has, Has Not Changed in 2021
Time changes and care plan tweaks make CCM easier to use, experts say. In Primary Care Co... Read more
Coding Quiz:
Increase Your Hypertension Coding Skills by Taking This Quiz
Hint: Is the hypertension causing another condition, or vice versa? Hypertension coding... Read more
Procedure Coding:
Get the Answers to Your Frequently Asked Retinal Imaging Questions
And remember to save images for documentation purposes. From detecting conditions such as... Read more
Coding Quiz Answers:
Check Your Answers to Our Hypertension Coding Quiz
How well do you know the I10-I16 codes and guidelines? Once you've answered the quiz ques... Read more
You Be the Coder:
Take These 3 Tips for Test Totaling Success
Question: In the article “Start the Year at the Highest Level by Solving These MDM Scena... Read more
Reader Questions:
Heed This Advice in This TCM Scenario
Question: One of our patients had a planned laparoscopic surgery in which they were admitt... Read more
Reader Questions:
Are You Ready for This New COVID-19 Vaccination Code?
Question: I know we now have CPT® vaccine and vaccine administration codes for the curren... Read more
Reader Questions:
Get a Handle on the New ICD-10 CKD Codes
Question: I'm confused by the new ICD-10 codes N18.31 and N18.32. I don't see anything in ... Read more
Guidelines:
Understand the Importance of SDoH Documentation
And learn how to factor it in to your 2021 office/outpatient E/M MDM decisions. While you... Read more
Mythbusters:
Ask These 3 Questions, Bust 3 Common Venipuncture Myths
Here's all you need to know about blood draws. And it won't hurt a bit. There's an awful ... Read more
ICD-10 Coding:
Learn How to Code BMI and Overweight/Obesity Dx With These Scenarios
They may be linked, but they aren't always coded together. The relationship between body ... Read more
You Be the Coder:
Consolidate Your 2021 Bottom Line With the Answer to This Stimulus Bill Question
Question: How will the passage of the COVID-19 spending bill on Dec. 27, 2020 affect prima... Read more
Reader Questions:
Know This Code for Diabetes 1.5
Question: Our provider recently documented a patient as having both type 1 and type 2 diab... Read more
Reader Questions:
Ignore Administration Route for Correct Medicare Vaccine Billing
Question: We billed 90672 with administration code 90473 for administering a dose of FluMi... Read more
Reader Questions:
Test Your Modifier Knowledge in This AWV Scenario
Question: Do I need to use a modifier when billing 87491 with an annual wellness visit? G... Read more
News You Can Use:
Find Out What CMS Has in Store for You This Year
The 2021 final rule is a mixed bag, say experts. In Primary Care Coding Alert v22n10, we... Read more
Guidelines:
Know the Pros and Cons of the New Medicare Prolonged/Complex Service Codes
Will G2211 and G2212 make your life easier or harder? In addition to the telehealth addit... Read more
E/M Coding:
Start the Year at the Highest Level by Solving These MDM Scenarios
The arrival of the New Year means your office/outpatient evaluation and management (E/M) c... Read more
Reader Questions:
Consider This Type 2 Combo Code for Kidney Complications
Question: What is the correct way to document type 2 diabetes with microalbuminuria? Would... Read more
Reader Questions:
Evaluate MDM to Determine E/M Revisit Decision
Question: Our provider saw a patient who was experiencing shoulder pain. The provider deci... Read more
You Be the Coder:
Are You Up to Speed With all the COVID-19-Related Codes?
Question: We're trying to find out if we are up to date with the various codes regarding C... Read more
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