Primary Care Coding Alert
Year in Review:
Refresh Your Memory by Revisiting 2023’s ICD-10 Updates
Also: check out the new guidance for reporting COPD. Last month, we covered the office/ou... Read more
Refresh Your Memory by Revisiting 2023’s ICD-10 Updates
Also: check out the new guidance for reporting COPD. Last month, we covered the office/ou... Read more
FAQ:
Answer These Few FAQs to Heighten Your Hypertension Coding
Check out the brief refresher on combination codes. As a primary care coder, you've proba... Read more
Answer These Few FAQs to Heighten Your Hypertension Coding
Check out the brief refresher on combination codes. As a primary care coder, you've proba... Read more
Practice Management:
Use These 4 Tips to Dial in a Stronger Telehealth Program
Select the correct codes by using the clip-and-save chart. Based on how prominently it ap... Read more
Use These 4 Tips to Dial in a Stronger Telehealth Program
Select the correct codes by using the clip-and-save chart. Based on how prominently it ap... Read more
You Be The Coder:
Verify the Correct Coding on This Virtual Visit
Question: My provider wants to bill 99350 when performing a home visit via telehealth... Read more
Verify the Correct Coding on This Virtual Visit
Question: My provider wants to bill 99350 when performing a home visit via telehealth... Read more
Reader Question:
Review Your Options for Coding Routine ECGs
Question: A patient with a history of heart disease presented to the practitioner for... Read more
Review Your Options for Coding Routine ECGs
Question: A patient with a history of heart disease presented to the practitioner for... Read more
Reader Question:
Understand Usage for New RSV Vaccine Product Codes
Question: What is the difference between all the new respiratory syncytial virus (RSV... Read more
Understand Usage for New RSV Vaccine Product Codes
Question: What is the difference between all the new respiratory syncytial virus (RSV... Read more
News You Can Use:
Look Toward Office/Outpatient Time Changes in 2024
Also: review how to count total time. Next year's office/outpatient E/M changes are minim... Read more
Look Toward Office/Outpatient Time Changes in 2024
Also: review how to count total time. Next year's office/outpatient E/M changes are minim... Read more
Vaccine Flu:
Master Flu Vaccine Coding with These Latest Updates
Check out the clip-and-save chart to take back to your practice. The onset of flu season ... Read more
Master Flu Vaccine Coding with These Latest Updates
Check out the clip-and-save chart to take back to your practice. The onset of flu season ... Read more
Practice Management:
Study These Strategies to Set Up a Solid CDI Process
Also: get an expert's take on how to identify the need for a query. Effective clinical d... Read more
Study These Strategies to Set Up a Solid CDI Process
Also: get an expert's take on how to identify the need for a query. Effective clinical d... Read more
You Be the Coder:
Connect With This Contraceptive Coding Concept
Question: Can I bill injectable contraceptives separately from counseling services? Calif... Read more
Connect With This Contraceptive Coding Concept
Question: Can I bill injectable contraceptives separately from counseling services? Calif... Read more
Reader Questions:
Remember to Account for Wastage
Question: We are unable to purchase the small kid dosage of liquid albuterol (1.25 mg/.25m... Read more
Remember to Account for Wastage
Question: We are unable to purchase the small kid dosage of liquid albuterol (1.25 mg/.25m... Read more
Reader Questions:
Consider Method Before Coding This Biopsy
Question: A patient presented with what they thought was just an annoying wart, but the pr... Read more
Consider Method Before Coding This Biopsy
Question: A patient presented with what they thought was just an annoying wart, but the pr... Read more
Reader Questions:
Review This Repeat Pulmonary Function Test Scenario
Question: Can I report a pulmonary function test (PFT) CPT® code twice if my provider rep... Read more
Review This Repeat Pulmonary Function Test Scenario
Question: Can I report a pulmonary function test (PFT) CPT® code twice if my provider rep... Read more
News You Can Use:
Get Ready for Easier COVID-19 Vax Coding
Also: check out new guidance on Appendix Q. CPT® has created new codes for reporting CO... Read more
Get Ready for Easier COVID-19 Vax Coding
Also: check out new guidance on Appendix Q. CPT® has created new codes for reporting CO... Read more
E/M Coding:
Dissect the Difficult Concepts in the MDM Table
Gain perspective on words like “acute” and “risk.” The levels of medical decisio... Read more
Dissect the Difficult Concepts in the MDM Table
Gain perspective on words like “acute” and “risk.” The levels of medical decisio... Read more
CPT® Coding:
Clear Away Confusion Over Smoking Cessation Coding
See how reporting cessation phone calls differs from in-person. According to the AMA, a... Read more
Clear Away Confusion Over Smoking Cessation Coding
See how reporting cessation phone calls differs from in-person. According to the AMA, a... Read more
Reader Questions:
Activate Your Understanding of Overactive Bladder
Question: My provider documented that a patient has an overactive bladder. Does this ... Read more
Activate Your Understanding of Overactive Bladder
Question: My provider documented that a patient has an overactive bladder. Does this ... Read more
Reader Questions:
Quell Confusion Around Combining E/M Codes
Question: Can I report the preventive medicine counseling codes with problem-oriented... Read more
Quell Confusion Around Combining E/M Codes
Question: Can I report the preventive medicine counseling codes with problem-oriented... Read more
Reader Questions:
Recall Whether Incident - to Applies to AWVs
Question: I know that a physician is not required to perform a patient's Annual Welln... Read more
Recall Whether Incident - to Applies to AWVs
Question: I know that a physician is not required to perform a patient's Annual Welln... Read more
You Be the Coder:
Get an Inside Look at This X-ray Scenario
Question: An established patient presents to the office complaining of pain in their ... Read more
Get an Inside Look at This X-ray Scenario
Question: An established patient presents to the office complaining of pain in their ... Read more
Condition Spotlight:
Follow These Steps For Smooth Osteoarthritis Coding
And get clarification on the different terms associated with the condition. According to... Read more
Follow These Steps For Smooth Osteoarthritis Coding
And get clarification on the different terms associated with the condition. According to... Read more
Pediatric Coding:
Familiarize Yourself With These Frequently Used Codes for Kids
Also: get clarification on the differences between screens and tests. As primary care cod... Read more
Familiarize Yourself With These Frequently Used Codes for Kids
Also: get clarification on the differences between screens and tests. As primary care cod... Read more
ICD-10 Coding:
Unlock SDoH Coding Success with These Tips
Plus: get a sneak peek at the updated SDoH guidelines. Last month, in issue 25, number ... Read more
Unlock SDoH Coding Success with These Tips
Plus: get a sneak peek at the updated SDoH guidelines. Last month, in issue 25, number ... Read more
Reader Questions:
Look to 2024 For ICD-10’s Newest Military History Code
Question: One of our new patients is retired from the military, which came up during a rec... Read more
Look to 2024 For ICD-10’s Newest Military History Code
Question: One of our new patients is retired from the military, which came up during a rec... Read more
Reader Questions:
Get an Advanced Look at Three New COPD Codes
Question: We see a lot of elderly patients in our practice, and many of them have chronic ... Read more
Get an Advanced Look at Three New COPD Codes
Question: We see a lot of elderly patients in our practice, and many of them have chronic ... Read more
You Be the Coder:
Determine Whether to Code Dementia With Alzheimer’s Diagnosis
Question: Dementia is a symptom of Alzheimer's, so does that mean I can't code them togeth... Read more
Determine Whether to Code Dementia With Alzheimer’s Diagnosis
Question: Dementia is a symptom of Alzheimer's, so does that mean I can't code them togeth... Read more
News You Can Use:
Catch a Glimpse of the New ICD-10 Z Codes
Also: review the benefits of documenting noncompliance. As you know, Z codes capture info... Read more
Catch a Glimpse of the New ICD-10 Z Codes
Also: review the benefits of documenting noncompliance. As you know, Z codes capture info... Read more
Mythbusters:
Bust These Myths to Strengthen Your R-Code Understanding
Also: look for tips on when to query the provider. Understanding the distinction between... Read more
Bust These Myths to Strengthen Your R-Code Understanding
Also: look for tips on when to query the provider. Understanding the distinction between... Read more
Compliance:
Get Serious About Accessibility for Deaf Patients
Check out our list of easy-to-implement changes your practice can make. Primary care pr... Read more
Get Serious About Accessibility for Deaf Patients
Check out our list of easy-to-implement changes your practice can make. Primary care pr... Read more
Reader Questions:
Stay Up to Date on Cigna’s Modifier 25 Policy
Question: I'm seeing a lot of conflicting information. Did Cigna update their modifier 25 ... Read more
Stay Up to Date on Cigna’s Modifier 25 Policy
Question: I'm seeing a lot of conflicting information. Did Cigna update their modifier 25 ... Read more
Reader Questions:
Understand the Physician’s Role in CCM Services
Question: In order to bill chronic care management (CCM) services 99490 and 99439, how inv... Read more
Understand the Physician’s Role in CCM Services
Question: In order to bill chronic care management (CCM) services 99490 and 99439, how inv... Read more
Reader Questions:
Know How to Report the New RSV Vaccine
Question: There's buzz around the office of a respiratory syncytial virus (RSV) vaccine. ... Read more
Know How to Report the New RSV Vaccine
Question: There's buzz around the office of a respiratory syncytial virus (RSV) vaccine. ... Read more
You Be the Coder:
Solidify Your Understanding of Separate E/M Services
Question: If a patient presents for a Medicare Wellness Visit (MWV) and the provider notic... Read more
Solidify Your Understanding of Separate E/M Services
Question: If a patient presents for a Medicare Wellness Visit (MWV) and the provider notic... Read more
Medicare:
Revisit ‘MWV’ Coding With Help From These FAQs
Also, gain insight on using modifier 52. As primary care coders, you see patient records... Read more
Revisit ‘MWV’ Coding With Help From These FAQs
Also, gain insight on using modifier 52. As primary care coders, you see patient records... Read more
Documentation:
Keep Lines of Communication Open to Improve Documentation
Hint: Take this helpful acronym back to your provider. There are several reasons why do... Read more
Keep Lines of Communication Open to Improve Documentation
Hint: Take this helpful acronym back to your provider. There are several reasons why do... Read more
Condition Spotlight:
Get The Skinny on Obesity Intervention Encounters
Recognize the role of counseling and the criteria required to report it. Identifying op... Read more
Get The Skinny on Obesity Intervention Encounters
Recognize the role of counseling and the criteria required to report it. Identifying op... Read more
Reader Questions:
Know When Procedures Don’t Get Procedure Codes
Question: One of my providers recently removed an ear piercing, and he documented tha... Read more
Know When Procedures Don’t Get Procedure Codes
Question: One of my providers recently removed an ear piercing, and he documented tha... Read more
Reader Questions:
See How Stability Suits This Celiac Case
Question: Our provider saw a patient with diagnosed celiac disease. I'm trying to lev... Read more
See How Stability Suits This Celiac Case
Question: Our provider saw a patient with diagnosed celiac disease. I'm trying to lev... Read more
You Be the Coder:
Address Abnormal Findings in This Well Check/Recheck Scenario
Question: The provider ordered a urinalysis as part of a child wellness check. The te... Read more
Address Abnormal Findings in This Well Check/Recheck Scenario
Question: The provider ordered a urinalysis as part of a child wellness check. The te... Read more
Documentation:
Know What’s Necessary to Prove Necessity
Critical: Find out what documentation is required. Medical necessity is a term that gets ... Read more
Know What’s Necessary to Prove Necessity
Critical: Find out what documentation is required. Medical necessity is a term that gets ... Read more
Condition Spotlight:
Sweeten Your Understanding of Diabetes Coding with This FAQ
Also, gain insight into provider education. As primary care coders, you've likely seen yo... Read more
Sweeten Your Understanding of Diabetes Coding with This FAQ
Also, gain insight into provider education. As primary care coders, you've likely seen yo... Read more
Testing:
Clear Up Coding Confusion With This Comprehensive Urinalysis Review
Plus: Review important details on the QW modifier. Urinalysis tests are frequently perfo... Read more
Clear Up Coding Confusion With This Comprehensive Urinalysis Review
Plus: Review important details on the QW modifier. Urinalysis tests are frequently perfo... Read more
Reader Questions:
Learn Why Payers Deny F98.8 for ADHD Diagnoses
Question: A payer denied a claim for an adult patient with attention deficit hyperact... Read more
Learn Why Payers Deny F98.8 for ADHD Diagnoses
Question: A payer denied a claim for an adult patient with attention deficit hyperact... Read more
Reader Questions:
See How Asymptomatic Patients are Still Eligible for This Screening
Question: My provider performed a bone density screening on a post-menopausal woman ... Read more
See How Asymptomatic Patients are Still Eligible for This Screening
Question: My provider performed a bone density screening on a post-menopausal woman ... Read more
You Be the Coder:
Review This Oximetry Scenario for Separate Billing Insight
Question: A patient with chronic obstructive pulmonary disease (COPD), who also suffe... Read more
Review This Oximetry Scenario for Separate Billing Insight
Question: A patient with chronic obstructive pulmonary disease (COPD), who also suffe... Read more
Condition Spotlight:
Focus on These Codes for Adult ADHD Encounters
Learn how to overcome potential reimbursement challenges. Though attention deficit hypera... Read more
Focus on These Codes for Adult ADHD Encounters
Learn how to overcome potential reimbursement challenges. Though attention deficit hypera... Read more
Case Study Corner:
Shore Up Your Skills with These 3 Springtime Situations
Plus: Learn the subtle difference between J30.1 and J30.2. With winter weather behind us,... Read more
Shore Up Your Skills with These 3 Springtime Situations
Plus: Learn the subtle difference between J30.1 and J30.2. With winter weather behind us,... Read more
ICD-10 Coding:
Don’t Let Pain Codes Leave You Sore
Check out the helpful sequencing advice. Pain management can be tough for primary care co... Read more
Don’t Let Pain Codes Leave You Sore
Check out the helpful sequencing advice. Pain management can be tough for primary care co... Read more
Reader Questions:
Avoid Relying on Positive Test Results to Confirm Diagnosis
Question: I have a patient with a cough, and the record shows that the respiratory s... Read more
Avoid Relying on Positive Test Results to Confirm Diagnosis
Question: I have a patient with a cough, and the record shows that the respiratory s... Read more
Reader Questions:
Proof of a Prescription is Not Proof of an E/M Service
Question: An established patient came in for a routine immunization. The physician's ... Read more
Proof of a Prescription is Not Proof of an E/M Service
Question: An established patient came in for a routine immunization. The physician's ... Read more
Reader Questions:
Modify Your Thinking of Modifier 51
Question: There has recently been an argument in our department regarding modifier 5... Read more
Modify Your Thinking of Modifier 51
Question: There has recently been an argument in our department regarding modifier 5... Read more
You Be the Coder:
Account for Age in This Newborn Nursing Scenario
Question: An 8-day-old presents with trouble nursing. The mother explains the baby ea... Read more
Account for Age in This Newborn Nursing Scenario
Question: An 8-day-old presents with trouble nursing. The mother explains the baby ea... Read more
News You Can Use:
Look to New ICD-10 Codes to Report Abuse, Neglect, and SDoH
Plus: See how financial difficulty is incorporated into several new codes. Starting April... Read more
Look to New ICD-10 Codes to Report Abuse, Neglect, and SDoH
Plus: See how financial difficulty is incorporated into several new codes. Starting April... Read more
Mythbusters:
Bust These Myths to Avoid Injection Rejection
Hint: Gain some insight on medical necessity, too. Injection encounters are easy to mi... Read more
Bust These Myths to Avoid Injection Rejection
Hint: Gain some insight on medical necessity, too. Injection encounters are easy to mi... Read more
Practice Management:
Turn Your Basic Audit Program into a Strong One With These Tips
Discover how audit type can influence the kind of sample you use. With the COVID-19 pub... Read more
Turn Your Basic Audit Program into a Strong One With These Tips
Discover how audit type can influence the kind of sample you use. With the COVID-19 pub... Read more
You Be the Coder:
No Cauterization? No Problem for This Nose-Bleed Scenario
Question: How can I report epistaxis treatment when the provider didn't perform caute... Read more
No Cauterization? No Problem for This Nose-Bleed Scenario
Question: How can I report epistaxis treatment when the provider didn't perform caute... Read more
Reader Questions:
Watch for EHR Quirks When Reporting Dx Codes
Question: It looks like my providers recently started selecting their own ICD-10 cod... Read more
Watch for EHR Quirks When Reporting Dx Codes
Question: It looks like my providers recently started selecting their own ICD-10 cod... Read more
Reader Questions:
Clear Up Confusion About Leveling Using Time
Question: One of our providers wants to bill an evaluation and management (E/M) visit... Read more
Clear Up Confusion About Leveling Using Time
Question: One of our providers wants to bill an evaluation and management (E/M) visit... Read more
Procedure Coding:
Learn to I.D. the Correct IUD Codes
And find out how to code an unsuccessful procedure. While many women prefer to see a gyne... Read more
Learn to I.D. the Correct IUD Codes
And find out how to code an unsuccessful procedure. While many women prefer to see a gyne... Read more
Quiz:
3 FAQs Guide You Toward No-Problem Payment
Submit thorough documentation to prevent payer pushback. Primary care practitioners (PCPs... Read more
3 FAQs Guide You Toward No-Problem Payment
Submit thorough documentation to prevent payer pushback. Primary care practitioners (PCPs... Read more
Documentation:
Question Incomplete Notes and Confidently Query
Remember M.E.A.T to determine documentation deficiencies. Complete, accurate documentat... Read more
Question Incomplete Notes and Confidently Query
Remember M.E.A.T to determine documentation deficiencies. Complete, accurate documentat... Read more
Reader Questions:
Separate AWV from Chronic Condition E/M
Question: Does the Medicare annual wellness visit (AWV) include the provider discussi... Read more
Separate AWV from Chronic Condition E/M
Question: Does the Medicare annual wellness visit (AWV) include the provider discussi... Read more
Reader Questions:
Consult State Regs to Confirm BHI Provider Eligibility
Question: Our primary care practice has a behavioral health integration (BHI) compon... Read more
Consult State Regs to Confirm BHI Provider Eligibility
Question: Our primary care practice has a behavioral health integration (BHI) compon... Read more
Reader Questions:
Remember Excludes1 and 2 Notes in This Common Cold Scenario
Question: We're seeing a ton of patients with colds who have a sore throat as a promi... Read more
Remember Excludes1 and 2 Notes in This Common Cold Scenario
Question: We're seeing a ton of patients with colds who have a sore throat as a promi... Read more
You Be the Coder:
Cling to Clinical Significance for Alcohol Use Reporting
Question: The provider recently documented occasional alcohol use in the social histo... Read more
Cling to Clinical Significance for Alcohol Use Reporting
Question: The provider recently documented occasional alcohol use in the social histo... Read more
Condition Spotlight:
Tune Into These Tried-and-True Tonsillitis Coding Tips
Plus: Learn how to code the difference between inflamed and enlarged. Tonsillitis seems t... Read more
Tune Into These Tried-and-True Tonsillitis Coding Tips
Plus: Learn how to code the difference between inflamed and enlarged. Tonsillitis seems t... Read more
Guidelines:
Keep This Guideline Handy When Considering Abuse Dx
Figure out how to decipher contradictory ICD-10 instructions. One of the first things you... Read more
Keep This Guideline Handy When Considering Abuse Dx
Figure out how to decipher contradictory ICD-10 instructions. One of the first things you... Read more
Modifiers:
Review These Rules to Avoid Modifier Mix-ups
Hint: Understand when not to append for repeat procedures and tests. Modifiers can make o... Read more
Review These Rules to Avoid Modifier Mix-ups
Hint: Understand when not to append for repeat procedures and tests. Modifiers can make o... Read more
Reader Question:
Keep Definitions in Mind When Leveling This Encounter
Question: We have a patient with one chronic problem. It is not worsening, but it is ... Read more
Keep Definitions in Mind When Leveling This Encounter
Question: We have a patient with one chronic problem. It is not worsening, but it is ... Read more
Reader Question:
Determine Drug Code Usage When Reporting Diabetes
Question: I thought all diabetes cases required the use of an additional code to iden... Read more
Determine Drug Code Usage When Reporting Diabetes
Question: I thought all diabetes cases required the use of an additional code to iden... Read more
Reader Question:
Choose Symptoms Over “Suspected” in This Injury Encounter
Question: The primary care practitioner recently wrote “probably Achilles tendoniti... Read more
Choose Symptoms Over “Suspected” in This Injury Encounter
Question: The primary care practitioner recently wrote “probably Achilles tendoniti... Read more
You Be the Coder:
Consider Context in this Drug Toxicity Scenario
Question: A patient came in complaining of vomiting following chemotherapy. The chemothera... Read more
Consider Context in this Drug Toxicity Scenario
Question: A patient came in complaining of vomiting following chemotherapy. The chemothera... Read more
News You Can Use:
Turn Your Attention to These 2023 Final Rule Highlights
Gain insight into why CMS changed its mind on split/shared visits. Calendar year (CY) 202... Read more
Turn Your Attention to These 2023 Final Rule Highlights
Gain insight into why CMS changed its mind on split/shared visits. Calendar year (CY) 202... Read more
Coding Quiz:
Test Your RSV Readiness: Can You Answer These Questions?
Learn the ins and outs of treating patients of all ages. Normally, respiratory syncytial ... Read more
Test Your RSV Readiness: Can You Answer These Questions?
Learn the ins and outs of treating patients of all ages. Normally, respiratory syncytial ... Read more
Final Rule:
Know What’s What for PHE Telehealth in 2023
Learn how to remain HIPAA compliant. If you're like most coders, you've probably had a ne... Read more
Know What’s What for PHE Telehealth in 2023
Learn how to remain HIPAA compliant. If you're like most coders, you've probably had a ne... Read more
Coding Quiz Answers:
Check Your Answers to Our RSV Coding Quiz
See how well you can navigate these diagnosis codes. Once you've answered the quiz questi... Read more
Check Your Answers to Our RSV Coding Quiz
See how well you can navigate these diagnosis codes. Once you've answered the quiz questi... Read more
Reader Question:
Remember to Code the Reason for the Encounter First
Question: A patient with a history of asthma (controlled by medication) came in compl... Read more
Remember to Code the Reason for the Encounter First
Question: A patient with a history of asthma (controlled by medication) came in compl... Read more
Reader Question:
Consider Cessation Counseling in This Vaping Versus Smoking Scenario
Question: During a routine wellness exam, the primary care practitioner (PCP) asked a... Read more
Consider Cessation Counseling in This Vaping Versus Smoking Scenario
Question: During a routine wellness exam, the primary care practitioner (PCP) asked a... Read more
You Be the Coder:
Catch the Cell Block Restriction
Question: A patient came in with severe windburn on her face and lips, and the provider pr... Read more
Catch the Cell Block Restriction
Question: A patient came in with severe windburn on her face and lips, and the provider pr... Read more