Primary Care Coding Alert

Avoiding this Pap smear pitfall will prevent -outdated- code denials. If you-re linking 17110 to a nonspecific code or reporting MRSA with 041.11, V09.0, your superbill needs a compliance check-up. Verify your diagnosis charge sheet is compliant by answering these questions. Switch Plantar Wart Final Digit Question 1: Fill in the blank. Your physician evaluates a painful sore on a patient's foot, diagnoses a plantar wart, and removes it. The most specific ICD-9 code for this patient's condition is 078.____. Answer 1: You should now code a diagnosis of plantar wart as 078.12 (Plantar wart). Prior to 078.12, providers and coders had to put plantar warts in with the other specified viral warts, 078.19 (Other specified viral warts), recalls Kris Cuddy, CPC, billing education and coding specialist at Mid-Michigan Physicians, PC. Benefit: "With 078.12, coders and physicians get a boost of appropriate, specific, and much needed coding ease," Cuddy says. Plantar warts are one of the most common viral warts destroyed in an office setting. If you spot verruca plantaris in chart notes, equate this with plantar warts. The formal Latin term "verruca plantaris," which is an infection caused by human papilloma virus (HPV), has been moved from under 078.19 to under 078.12. For destruction of plantar warts, which are benign tumors that occur on the sole, heel, or ball of the foot and most often in children and young adults between the ages of 12 and 16, you-ll use 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) or 17111 .. 15 or more lesions) with 078.12. Add Pap Smear Digit Question 2: Your physician performed a vaginal Pap smear that showed atypical squamous cells of undetermined significance. True or False? You should report 795.1 (Abnormal Papanicolaou smear of vagina and vaginal HPV) for this patient's condition. Answer 2: False. If you report 795.1 (Abnormal Papanicolaou smear of vagina and vaginal HPV), your carrier will deny the claim. A fifth digit is needed, Cuddy says. "Look to 795.11 (Papanicolaou smear of vagina with atypical squamous cells of undetermined significance [ASC-US])." "In 2009, gynecological Pap smear coding gained ground with ten new, and two revised, Pap smear codes." Kuddy says. Plus, an entire new category (796.7, Abnormal cytologic smear of anus and anal HPV) for male or female Papanicolaou smears of the anus. Action plan: For accurate coding and specificity, if your FP office performs vaginal or anal Pap smears you should add all the new and revised codes, Cuddy recommends. These additions, which you can download from www.cms.hhs.gov/ICD9ProviderDiagnoticCodes/07_summarytables.asp, span three categories. Here are some tips to get you started: In category 795.0, [...]