Neck Pain Will Have an Easy Code Switch in ICD-10

Posted on 09. May, 2013 by rpandit.

Descriptor won’t even change from 723.1 to M54.2.

Chronic neck pain is one of the most common complaints among patients who see a pain management specialist, and a simple one to code from a diagnosis standpoint. You report 723.1 (Cervicalgia).

Your choice will remain simple in ICD-10, when you’ll make an easy switch to M54.2 (Cervicalgia). Diagnosis M54.2 falls under the category “Other Dorsopathies; Dorsalgia.” Note that M54.2 does not apply to cervicalgia due to intervertebral cervical disc disorder. For those situations, ICD-10 directs you to the M50 (Cervical disc disorders) code family.

Coding tip:

Continue Reading

Choose 20552 or 20553 — Not 20605 — for Trigger Points

Posted on 08. May, 2013 by rpandit.

Question: The physician administered trigger point injections to fingers 2-5 on both the patient’s hands. He coded the procedure as 20605 x 8, but I don’t think that’s correct. What should we report?
Massachusetts Subscriber

Continue Reading

Appeals: CMS Just Updated Medically Unlikely Edits–Do You Know How to Appeal Them?

Posted on 08. May, 2013 by rpandit.

Many MUEs make sense, but for those that don’t, you can fight back.
By now, most practices are familiar with Medicare’s medically unlikely edits (MUEs), which CMS instituted to prevent overpayments caused by gross billing errors. On April 1, CMS updated the MUE listing, and some of your favorite codes may now be limited by the bundles. When you scour your unpaid claims, make sure you are watching for MUE denials to ensure that you’re getting paid when appropriate but that you fight back when your claims are inappropriately denied.”

Continue Reading

News You Can Use: State Medicaid Programs Offer E/M, Vaccine Reimbursement Boosts

Posted on 08. May, 2013 by rpandit.

Watch for retroactive pay raises, if you self-attest.
Getting a payment increase from Medicaid sounds quite appealing to most practices, and it can be a reality for some primary care providers — but don’t forget to do your part to ensure that you’ll see a rise in Medicaid payments for E/M and vaccine services this year. Follow a few quick steps to confirm that you’ll get the raise.

Continue Reading

Research How to Report Radiation Oncology Procedures in ICD-10-PCS

Posted on 25. Apr, 2013 by rpandit.

Highlight this character for the radioactive isotope.

When you prepare to report a radiology oncology procedure, you need to pay particular attention to characters 3-6, as these specify the radiation, treatment type, modality, and radioactive isotope.

Review Your Seven Digit PCS Structure

When reporting any ICD-10-PCS code, you have seven characters. You can break them down as follows:

Character 1 Section
Character 2 Body System
Character 3 Root Type
Character 4 Treatment Site
Character 5 Modality Qualifier
Character 6 Isotope
Character 7 Qualifier

For radiation oncology services, you can focus on the first character of “D,” because “D” stands for “radiation oncology.”

Specifically, the main focus of your character selection should be the following:

Continue Reading

Reader Question: Watch Details When Deciding Between Levels 4 and 5 E/M

Posted on 24. Apr, 2013 by rpandit.

Question: We have enough details for an encounter to reach these levels: 

·         HPI – detailed

·         ROS – complete

·         PFSH – complete

·         EXAM – 10 systems

·         MDM – moderate.

Is this documentation sufficient to support a Level 5 E/M code for an established patient?

Continue Reading

Practice Management: Time to Re-Enroll Your Gynecologist? You’ll Have an Easier Job, CMS Says

Posted on 24. Apr, 2013 by rpandit.

You can fax or email the revalidation documents this time around.

If your gynecologist sees Medicare patients, re-enrolling your provider every few years is on your to-do list. The good news is that CMS has made improvements to the re-enrollment process, according to an Oct. 10 CMS National Provider Call with the agency’s Provider Enrollment Operations Group.”

Continue Reading

News You Can Use: Stop Wondering: Congress Freezes Medicare Pay at 2012 Rates

Posted on 24. Apr, 2013 by rpandit.

However, don’t assume your HPSA bonus will continue.

As many practices are aware, medical offices nationwide were waiting to find out whether legislators halted a 26.5 percent pay cut that the 2013 Fee Schedule predicted, which would have brought the 2013 conversion factor down to $25.0008. In addition, practices were facing

Continue Reading

News: Code Search Result’s Color Identifies Keyword-Code Mapping Source

Posted on 10. Apr, 2013 by rpandit.

News: Code Search Result’s Color Identifies Keyword-Code Mapping Source

If you’ve ever wondered where a code suggestion for a keyword came from, SuperCoder’s new color-coded search results reveal the definitive source. In SuperCoder’s Code Search box [Keyword tab], when you enter a keyword that exists in a codeset’s index, the index’s suggested codes appear in purple and red. Additional codes suggested by SuperCoder’s extensive Keyword to Code Correspondence Helper (KECH) appear in blue and green. Often, the first code entry suggestion will be in purple and red meaning the result from the code book index and KECH match.

The color coding’s pinpointing of the definitive source helps you:

Continue Reading

ICD-10: I82.4 — Names Vessels for Lower Extremity Embolism/Thrombosis

Posted on 10. Apr, 2013 by rpandit.

ICD-10:

I82.4 — Names Vessels for Lower Extremity Embolism/Thrombosis

That’s a change from 453.4x ICD-9 terminology.

 Right now, knowing whether a lower extremity deep vein embolism or thrombosis is proximal or distal is all the information you need to fill out your claim forms. But that won’t be the case once you begin using ICD-10 in October 2014. To get ready for the change, you’ll need to train your surgeons to identify the specific vessel, if possible.

ICD-9 provides the following diagnosis codes for the condition:

Continue Reading