View the ICD-9 code's corresponding Diagnosis Related Groups (DRGs). In a click, verify the DRG, its IPPS allowable, length of stay, and more. Protect your facility's payments by subscribing to DRG Coder.
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If I am reading your question correctly, I would have 1 question and 1 recommendation.
1. Is the postoperative chest x-ray being performed only to "confirm placement" of the pacemaker ... [ Read More ]
If you are the gyn performing this visit with a decision for sterilization, I don't believe any of these codes should be submitted on your claim.
The ORDER for PST covid swab should have Z01.812 prima... [ Read More ]
Patient is seen for counseling discussion, desires permanent sterilization. After the counseling patient chose surgical permanent contraception; laparoscopic salpingectomy. Procedure/surgical plannin... [ Read More ]
Medical necessity edits are based on payer reimbursement policies (usually Medicare LCDs) so you would need to take a look at your particular payer’s published policies to see whether or not the edi... [ Read More ]
Lab order diagnoses codes are Z01.818 and M16.11 - only labs were charged and our guidelines are to change the Z01.818 to Z01.812 in this situation; however, when I do that, the Hgb fails medical nece... [ Read More ]
[QUOTE="DGgirll20, post: 501039, member: 693252"]
For CPT codes 64492 and 64495, the need for a three-level procedure may be considered under unique circumstances and with sufficient documentation of ... [ Read More ]
MCR does not reimburse for A4550, for us here in NY they do not even pass through EDI. Also your DX codes are incorrect. DX M54.2 should be M54.12 for Cervical Radiculopathy and DX code M47.812 will n... [ Read More ]
My Ophthalmologists use diagnosis codes: H25.811 and H25.812 instead of the bilateral code. I have not been able to find guidelines that state they have to use the bilateral diagnosis code instead of... [ Read More ]
Is there a specific guideline that instructs us to use a bilateral diagnosis code of H25.813 instead of using the diagnosis codes H25.811 and H25.812? I know there is a guideline for glaucoma coding ... [ Read More ]
"Per LCD or NCD guidelines, procedure code 64490 has not met the associated Code-to-Code relationship criteria for CMS ID(s) L34892"
This is the denial received for an AARP Medicare Complete plan wher... [ Read More ]
2023 ICD10CM update expands F01F03 code categories to allow providers to indicate disease stage and symptoms. The 2023 update to ICD10CM finally provided an expansion of the dementia codes which has b... [ Read More ]
Build your dream team and avoid low productivity low morale and high turnover. Recruiting and hiring new employees can be expensive and will eat up your production time quickly if you dont manage the ... [ Read More ]
EM gastro and lab coders take note. The American Medical Association AMA announced some lastminute corrections to the CPT code set effective Jan. 1 2023. Add these to your code book along with the pre... [ Read More ]
Did you know that tetanus vaccines are only covered under Medicare Part B when given for treatment Preventative tetanus vaccinations are noncovered. I found this hard to believe so I looked it up. Sur... [ Read More ]
The government is taking care of business and AAPC membership is taking care of their own. The federal government has declared public health emergencies PHEs in Puerto Rico in response to Hurricane Fi... [ Read More ]