Recent content by DeeCPC

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    Atypical lymphoid infiltrate, code needed

    I agree with 238.2 - this a an appropriate example of uncertain behavior.
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    Excision Size vs Lesion size vs path report

    Do not use the size of the elliptical excision You would code this as 1.8 cm - You do not code this as the 3 cm elliptical. The codes are for the lesion plus margins. An elliptical excision is not about margins but about appropriate closure technics. Please see the pictures associated with...
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    Need help with lesions excision guidelinse

    Anyway this CPT assistant could be provided? This contradicts what I have read about coding this scenario. Please note this article by Dr. Janevicius an ASPS representative to the AMA CPT Advisory Committee. This is his comment under the header 'Coding excisions of neoplasms': Many of these...
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    skin lesion removal coding

    lesion plus margins = excision code When a doctor removes a "BCC 9mm lesion on the trunk."however with margins it is 1.5cm. How would that be coded. According to the CPT book, it states "lesion including margins" so would it be 11601 (0.6 to 1.0cm) lesion size only or (11602 1.1 to...
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    Neoplasm table

    FYI A neoplasm of the skin of the breast is not the same as a neoplasm of the structures of the breast.
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    Clarification 111xx vs. 113xx

    The difference between these two code sets is whether the lesion was removed. If a complete removal then it is not a biopsy. When a lesion is removed by shave technique it is coded with 113xx. 'Does anyone know why some MDs state "Shave Removal" "Shave Biopsy" and always bill same code...
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    Biopsy vs excision

    I agree with Tonya. Follow the original intent which was a biopsy. I discourage providers from changing anything already documented just for better reimbursement.
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    Help with Self Auditing?

    I agree with Cheryl. There is a lot of incorrect cross usage of PFSH into the ROS. CMS specifically states that past medical history can not be used as ROS.
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    colonoscopy diagnosis coding

    I agree that this would not be a screening. The screening benefit is for colorectal cancer so the doctor must be clear that s/he is performing a screening to evaluate for colorectal cancer on an asymptomatic patient. Keep in mind that there is no cure for Crohn's so there is no 'history'...
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    digital block-If anesthesiologist

    I agree with aaron that the block is normally bundled with the closure. This could be seen as unbundling. I coded for ER for 4+ years and have never heard of anesthesiology involved in a laceration repair.
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    EMR & Documentation

    I think we agree. Doctors should not be coders-they do not want to code. My point is if the provider is putting a code anywhere in the medical record then they need to agree to changing those codes. Many EMRs record the provider's assignment of CPT and ICD-9 codes directly into the notes...
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    How do I know when I NEED a modifer?

    You do not need a -59 modifier here. The -59 is a misunderstood and overused modifier. This should only be used when you bill two codes that are bundled and there is reason to unbundle the codes. Here are the reasons per CMS: 1) Different sites 2) Different incisions 3) Different encounters...
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    EMR & Documentation

    The medical record is a legal document. You must be the author of the record in order to change the record. You must have permission to change the codes.
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    Full Thickness Skin Graft Closure

    What modifiers were used?
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    Mohs done in global period of ED&C

    No, the global period is on the other provider's procedure and is not a repeat of the same procedure.