Primary Care Coding Alert

ICD-10 Coding:
View This FAQ, Review What Was New in 2022
Test your memory of some recent major ICD-10 updates. Whether you're a new or seasoned c... Read more
Condition Spotlight:
Advance Your Asthma Coding Abilities Using These Tips
Look for advice on how to handle proper sequencing. Now that winter is officially here, ... Read more
Compliance:
Practice Proper PHI Handling, Remain HIPAA-Compliant
See how many E/M visits you'd need to provide to pay even a minor fine. With the promise ... Read more
Reader Questions:
Beware the 5th Character in This Sixth Disease Scenario
Question: Our provider saw one of our pediatric patients who had a fever and a bad ra... Read more
Reader Questions:
Get Technical in This New vs. Established Patient Scenario
Question: Our clinic had a patient come in for a wellness visit. They had only been t... Read more
You Be the Coder:
Ramp Up Your Record Reading Prowess to Report Rhinitis
Question: The provider diagnosed a patient with persistent allergic rhinitis. She has... Read more
News You Can Use:
Fly Through Flu Vaccine Coding with this Clip-and-Save Chart
Find out which code is making a comeback this season. Whether your clinic administers jus... Read more
Behavioral Health:
Review What’s Required for Coding Behavioral Health Integration
Find whether 2023 consult codes will affect BHI coding. Many communities within the Uni... Read more
E/M Coding:
Curb Your Confusion on How to Count Data Toward MDM
Also learn expert advice on when not to count data. If you consider data counting to be o... Read more
Reader Questions:
Look for Keywords to Properly Report Candidiasis
Question: I've been using B37.3 to report yeast infections, but the last claim I submitted... Read more
Reader Questions:
Gear Up for Solid GERD Coding
Question: Our provider established that one of our patients suffers from gastro-esophageal... Read more
Reader Questions:
Find Out When to Report a Flu Diagnosis
Question: I thought I had to wait for the test result before coding a flu diagnosis, but j... Read more
You Be the Coder:
Do You Know the New COVID-19 Booster Codes?
Question: The newest COVID-19 boosters have come out recently. What the codes are, and whi... Read more
News You Can Use:
Report Monkeypox Testing and Vaccines Using 3 New Codes
Look for updated reporting instructions from CMS. The CPT® Editorial Panel has approved ... Read more
E/M Coding:
Correctly Code for Time to Avoid Auditor Red Flags
Fixing red flag 2 can boost your bottom line. The 2021 updates to the CPT® Office and O... Read more
Medicare Part B:
Check Your Processes to Avoid Medicare Part B Billing Errors
Check out the advice on how to effectively resolve problems. Keeping up with guideline u... Read more
Reader Questions:
Look for This Code to Report Long COVID
Question: We've seen several patients whose records say they have “long COVID” bu... Read more
Reader Questions:
Be Careful Not to Assume Level Based on Condition
Question: Does a patient's status as morbidly obese automatically put a patient encou... Read more
Reader Questions:
Know When to Code to Signs and Symptoms for a UTI
Question: I've been using N39.0 for urinary tract infections (UTIs), but it was recen... Read more
You Be the Coder:
Know How Linked Conditions Affect Mental Health Coding
Question: The physician diagnosed a teen patient with mixed anxiety and depressive di... Read more
News You Can Use:
Get an Inside Look at the 2023 Inpatient/Observation Care Codes’ Revisions
Prepare for a change in MDM elements and new time parameters. CPT® updates are here agai... Read more
ICD-10 Revisions:
Consider How Z79.- Code Expansion Could Affect E/M Visits
Hint: Think MDM leveling. With medical records constantly on the move between offices as... Read more
Condition Spotlight:
Keep an Eye on Documentation for Correct Conjunctivitis Coding
Learn when to use B30.- versus H10.- codes. Some common medical conditions seem to alwa... Read more
Reader Questions:
Secure Your Sequela Savvy Status
Question: How do I determine whether a condition is considered sequela? How do I app... Read more
Reader Questions:
Know When to Code Just the Cold
Question: If a patient has a sore throat and a cold, do I code both conditions? Mass... Read more
Reader Questions:
Using 99211 Is a New-Patient No-No
Question: Should I be reporting all services performed by a nurse, including those pr... Read more
You Be the Coder:
Breathe New Life Into Your Understanding of Asthma Coding
Question: My provider assessed a patient with asthma who was experiencing acute exace... Read more
News You Can Use:
Report Stress, Grief, and Past Substance Use With These New ICD-10 2023 Codes
And learn these 9 new codes to report drug and alcohol remission. Recently, the Centers ... Read more
Coding Quiz:
Can You Ace This Back-to-School Coding Quiz?
Learn the ABCs of coding school and sports physicals. This time of year, it seems like e... Read more
Condition Spotlight:
See What’s on the Horizon for Dementia Coding in ICD-10 2023
Hint: Check for upward of 70 new codes. ICD-10 2023 will make significant changes to ICD-... Read more
Coding Quiz Answers:
Check Your Answers to Our Physicals Quiz
See how well you can identify the correct CPT® codes. Once you've answered the quiz ques... Read more
Reader Questions:
Get the Skinny on These Hyperlipidemia Codes
Question: What is the difference between E78.5 (Hyperlipidemia, unspecified) and E78... Read more
Reader Questions:
Puncture Misconceptions About Venipuncture Coding
Question: I recently used 99195 (Phlebotomy, therapeutic (separate procedure)) for a ... Read more
Reader Questions:
Monitor This Commonly Misunderstood RPM Rule
Question: Our provider thinks one of our patients is eligible for the remote physiol... Read more
You Be the Coder:
Get to the Heart of When to Use Modifier 25 With EKG
Question: Do the CMS 2022 guidelines require modifier 25 for an evaluation and manage... Read more
Condition Spotlight:
Don’t Let Heat-Related Encounters Leave You Hot Under the Collar
Look for comorbidities to accurately assess MDM. Feeling warm in the summer months is one... Read more
Modifiers:
Learn When and How to Use Modifier 25 (Part 2)
Hint: Established patient with a new problem doesn't guarantee a billable E/M service. La... Read more
Procedure Coding:
Increase Your Comfort Level Coding Common Skin Lesion Procedures
Procedure details are not just nice to have, they're essential for coding accurately. Pr... Read more
Reader Questions:
Remember the Reason for the Visit With This Rx Refill Encounter
Question: How do you bill for an established adult patient coming in for a medicatio... Read more
Reader Questions:
Know the Score in This Split/Shared Situation
Question: The primary care practitioner (PCP) and the nurse practitioner (NP) both sa... Read more
Reader Questions:
Identify When Unspecified Is as Specific as You Can Get
Question: A colleague said to try not to use unspecified ICD-10 codes. However, numer... Read more
You Be the Coder:
Can You Reckon the Referral’s Role in Determining MDM?
Question: Our providers say that referrals are always considered low risk under the R... Read more
ICD-10 Coding:
Do You Understand the Newest Low Back Pain Codes?
Find out when it's appropriate to use codes from the G89.- category. Low back pain codes ... Read more
Modifiers:
Learn When and How to Use Modifier 25 (Part 1)
And identify the correct documentation necessary to support it. One of the most commonly ... Read more
Case Study Corner:
Can You Code These Constipation Encounters?
Practice identifying the nuances of coding this common yet complex condition Frequent c... Read more
Reader Questions:
Understand When and How to Add After-Hours and Weekend Codes
Question: I work at a family practice and the doctor has come across CPT® codes 990... Read more
Reader Questions:
Know When Not to Count Data Review Toward MDM
Question: A patient with sleep apnea was fitted for a continuous positive airway pres... Read more
Reader Questions:
Avoid Double Billing for Image Interpretation
Question: In the Amount and/or Complexity of Data to be Reviewed and Analyzed element... Read more
You Be the Coder:
Don’t Let the Index Distract You While Looking for ADHD Codes
Question: The doctor's notes say this patient has attention deficit hyperactivity dis... Read more
Condition Spotlight:
Avoid Rash Decisions When Coding Lyme This Season
Know when unspecified code A69.20 is your best option. As temperatures start to rise, so ... Read more
ICD-10 Coding:
Study These Scenarios to Become a Sequencing Scholar
Check out scenario three to understand underlying conditions. Proper sequencing of ICD-... Read more
Mythbusters:
Bust These Myths to Banish Bad Coding Habits for Good
Improving your first-pass acceptance ratio might be easier than you think. The phrase, ... Read more
Reader Questions:
Don’t Assume Low Risk in This OTC Scenario
Question: We have a patient who frequently takes Flonase who comes to see us for epis... Read more
Reader Questions:
Take Note When Chapters Include Excludes Notes
Question: Can I bill R53.83 and F33.1 together if they are unrelated? AAPC Forum Pa... Read more
Reader Questions:
Let the Symptoms Speak for This Dermatitis Dx
Question: The provider determined an acute rash was an allergic reaction to nickel ex... Read more
You Be the Coder:
Can You Clarify This Z Code Colonoscopy Conundrum?
Question: A patient came in for follow-up on a chronic condition, and the provider noticed... Read more
ICD-10 Coding:
Clear Away Confusion Around COVID Coding
And stay ahead of the curve with these new treatment codes. The pandemic rolls on, new tr... Read more
Guidelines:
Understand How to Code Developmental/Behavioral Screens and Tests
Do you know which instruments match the codes? The four codes that comprise the Developm... Read more
Condition Spotlight:
Locate the Answers to Your Frequently Asked Stomach Pain Questions
Here's all the clinical knowledge you need before applying an R10.- code. With 27 differ... Read more
Reader Questions:
Confirm Before Coding Causality
Question: Am I able to code M06.9 with D89.89 if the patient suffers immunosuppressio... Read more
Reader Questions:
Avoid Getting Burned When Coding Sequela
Question: Is the condition of an injury in its healed state ever considered a sequela... Read more
Reader Questions:
Can You Distinguish Between Anorexia Codes?
Question: I'm confused about how to code for anorexia. ICD-10 has two coding options:... Read more
You Be the Coder:
Stay on the Level With This New Chronic Condition E/M
Question: A patient had labs drawn and came back in to review the results. Upon revie... Read more
Care Management:
Worried About PCM Denials? Here’s What to Do
Billing with other care management E/M services is probably to blame. Maybe you implement... Read more
Condition Spotlight:
Step Up Your UTI Coding With This Handy Guide
Know how and when to bypass N39.0. Coding for urinary tract infections (UTIs) seems very ... Read more
Mythbusters:
Bust These Myths, Distinguish New vs. Established Patients Correctly
There's more to determining patient status than the 3-year rule. With all the changes to... Read more
Reader Questions:
Hear This Advice for Using New Audio-Only E/M Modifier
Question: I know that, at the beginning of this year, the American Medical Associatio... Read more
Reader Questions:
Boost Your Understanding of These Pfizer COVID Vaccine Administration Codes
Question: Which administration code should I be using for the third/booster dose of t... Read more
Reader Questions:
Revisit This Unique Lab Reorder
Question: Two weeks ago, a patient saw one of our providers who orders labs. The pati... Read more
You Be the Coder:
Lower Your Expectations for This COVID E/M Encounter
Question: A patient with COVID symptoms visited our primary care provider (PCP). The... Read more
Condition Spotlight:
Understand These 3 Scenarios, Get Your Epistaxis Coding Under Control
And remember these 3 proven tips for billing success. If a patient presents to your provi... Read more
Coding Quiz:
Take This Quiz to Fine Tune Your Eating Disorder Dx Understanding
Learn how to choose between codes for different manifestations and unusual conditions. C... Read more
Behavioral Health:
Get the Answers to Your Frequently Asked BHI Code Questions
Here's what you need to know about providing, keeping track of, and billing for the servic... Read more
Coding Quiz Answers:
Check Your Answers to Our Eating Disorders Quiz
See how well you can match these clinical conditions to their ICD-10 codes. Once you've ... Read more
Reader Questions:
Capture All Conditions Affecting Patient Care and Treatment
Question: When preparing a claim, should you enter the diagnosis code only for the conditi... Read more
Reader Questions:
Don’t Sweat This Hyperhidrosis Chemodenervation Code Choice
Question: Our internist performed intradermal injections of botulinum toxin on a patient s... Read more
Reader Questions:
Use These Encounter Codes in Suspected STD Situations
Question: If a provider tests a patient for a sexually transmitted disease (STD), but the ... Read more
You Be the Coder:
Mend This Medicare AWV Muddle
Question: I am new to Medicare billing, so I need some help. At a patient's annual wellnes... Read more
News You Can Use:
Be Positive With CMS’ Final Rule Despite CF Decrease
Vaccination, CCM pricing increase should offset, experts feel. First, here is the bad new... Read more
Documentation:
Find Out if Your Practice Is Triggering OIG Work Plan Audits
Make sure you avoid these 5 primary care pitfalls. No one wants to attract unwanted att... Read more
Case Study Corner:
Can You Code This Pilonidal Cyst Case Study Correctly? Find Out.
Hint: Pay attention to condition synonyms and procedure complexity. If you revert to au... Read more
Reader Questions:
Follow This Guidance to Code Adverse COVID Vaccine Reaction
Question: We administered a COVID-19 vaccine to a patient and, as we usually do, we ... Read more
Reader Questions:
Don’t Code for Irrigation and Instrumentation
Question: If a provider performs an ear lavage and uses instrumentation on both ears,... Read more
Reader Questions:
Know Which of These Codes to Use for MVA Neck Pain
Question: Our provider treated a patient for a sore neck after the patient was involv... Read more
You Be the Coder:
Proceed With Caution on This SK Claim
Question: One of our providers removed a 1.5 cm inflamed seborrheic keratosis from a patie... Read more
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