Archive for 'Hot Coding Topics'

TAP Into Latest CPT® Assistant’s Advice on Reporting Anesthesia Blocks

Posted on 13. Aug, 2015 by .

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The June 2015 CPT® Assistant is chock full of advice for reporting the year’s new codes for transversus abdominis plane (TAP) local anesthesia blocks. Before these codes arrived, you didn’t have any specific codes that accurately reflected these peripheral nerve blocks applied to anesthetize the anterior abdominal wall nerves inabdominal or pelvic surgery patients. But the 2015 CPT® code set features specific codes to report TAP block procedures. The issue spells out the guidelines and provides real-world clinical examples that assist you to appropriately report the codes for TAP block.

Other areas featured in the latest CPT® Assistant include cystourethroscopy with transprostatic implants as well as stereotactic body radiation therapy (SBRT). You will also benefit from a radiostereometricanalysis exam clinical scenario and an ICD-10 case scenario featured custom essays in this issue. Take advantage of SuperCoder.com’s Code Connect code and keyword search to keep your skills up to date on these topics:

  • CystourethroscopyWith Transprostatic Implants: 52282, 52310, 52441-52601, 52648-52649, 53850-53852, 53855, 53899
  • ICD-10-CM Case Scenario: Hypertensive Heart Disease
  • Radiostereometric Analysis: 0348T-0350T
  • Thoracic Stereotactic Body Radiation Therapy:31626, 32553, 32701, 32999, 61796-61800, 63620-63621, 77295, 77331, 77370, 77373, 77435, 77427-77499
  • Transversus Abdominis Plane Block: 64420-64425, 64450, 64486-64489.

 

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Coding Strategies: Mark These Changes To Refine Your Arthrocentesis Reporting

Posted on 08. Jul, 2015 by .

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Confirm if any ultrasound guidance was used.

Remember how three new codes joined revised codes in the family of ultrasound guided arthrocentesis of small, intermediate, and large joints in January? The previously existing codes, 20600, 20605 and 20610, now include the phrase “without ultrasound guidance” and each is partnered with a new code (20604, 20606, and 20611) with the descriptor, “with ultrasound guidance, with permanent recording and reporting.” The changes are as follows:

  • 20600 – Revised (Arthrocentesis, aspiration and/or injection, small joint or bursa [e.g., fingers, toes]; without ultrasound guidance)
  • 20604 – Code added (with ultrasound guidance, with permanent recording and reporting)

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Confused by Leadless and Pocketless Pacemaker Codes? Latest CPT® Assistant Guides the Way

Posted on 08. Jul, 2015 by .

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The May 2015 CPT® Assistant features the newly established Category III leadless cardiac pacemaker codes. The issue elucidates guidelines and provides real-world clinical examples that assist you to appropriately report the codes for leadless cardiac pacemaker services.

Another topic in the May 2015 CPT® Assistant will help a wide range of providers as it covers proper application of the code changes in 2015 for the vaccines and toxoids section. Plus, reviewing the latest issue will boost your coding skills for reporting carotid artery and innominate artery stent placement as well as bilateral image-guided breast biopsy and marker placement. Take advantage of SuperCoder.com’sCode Connect code and keyword search to keep your skills up to date on these topics:

  • Bilateral Image-Guided Breast Biopsy and Marker Placement: 19081-19086, 19281-19286
  • Pacemaker, Leadless and Pocketless System: 33202, 33203, 33206-33222, 33224-33226, 75820, 76000, 93566, 0378T-0391T
  • Stent Placement in Carotid Artery and Innominate Artery: 37217-37218, 36221-36222, 37236
  • Vaccines and Toxoids Code Changes in 2015: 90460-90474, 90476-90749, 90630, 90651, 90654, 90721-90723, 90734.

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News You Can Use: Rejoice in SGR Elimination

Posted on 24. Jun, 2015 by .

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Decision also means ICD-10 will move forward this year.

Unfortunately, it was no April Fool’s joke that April 1 came and went with no final Congressional action to override the 21 percent Medicare pay cut.

Although the House passed the Medicare Access and CHIP Reauthorization Act (MACRA), the Senate failed to vote on the bill before departing for a two-week recess on March 27.

“Their failure to act leaves physicians facing a devastating 21 percent cut in Medicare reimbursements when the current Sustainable Growth Rate (SGR) payment patch expires on March 31,” said Robert M. Wah, MD, president of the AMA, in a March 27 statement.

Good news: (more…)

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Zip Through the New Definitive vs. Presumptive Designation for Drug Testing With the Latest CPT® Assistant

Posted on 12. Jun, 2015 by .

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The April 2015 CPT® Assistant ends your confusion about new drug identification and testing codes updated in the 2015 CPT® code set. Find out how the new reporting mechanism distinguishes testing procedures based on presumptive, definitive, and therapeutic drug assay categories instead of the old qualitative or quantitative methodology.

Reviewing the latest issue will also improve your understanding of how to report optical coherence tomography of the breast and total disc arthroplasty. Plus, solve an ICD-10-CM coding dilemma with an immunization coding scenario. To get spot-on guidance, simply type a code or keyword into SuperCoder.com’sCode Connect to see the April article that suits your needs.

  • Drug Identification and Testing: 80100-80104, 80150-80299, 80320-80377, 82491-82492, 82541-82544, 83992
  • ICD-10-CM Case Scenario: 90460-90461, 90471-90474, 90654, G0008
  • Optical Coherence Tomography During Breast Surgery: 0351T-0354T
  • Sacroplasty: 22511, 0200T, 0201T
  • Total Disc Arthroplasty: 22554, 22845, 22851, 22856, 22858, 63075, 0375T, 0092T.

The latest selection of CPT® Assistant FAQs also provides guidance for a variety of areas. Find authoritative answers in a snap by looking for these codes and topics on Code Connect: (more…)

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Physician Fee Schedule: Follow Changing Payment Trail for Your Lab

Posted on 12. Jun, 2015 by .

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The RVUs aren’t all you need to observe.

As it turns out, things weren’t settled when CMS published the Medicare Physician Fee Schedule Final Rule in November last year.

Now you’ll need to pay attention to changes in payment and claims processing if you don’t want to face confusion as you bill for your lab services in 2015.

Do this: Just read the following updates, and you’ll have everything you need to understand your Medicare pay — for now.

Your Claims Should Be Moving Again (more…)

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Compliance: Do You Know How to Avoid These 5 Types of Medicaid Fraud?

Posted on 27. May, 2015 by .

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Medicaid auditors could be reviewing your files—make sure you aren’t violating any of these common issues.

If you’re worrying about whether your state Medicaid provider might head your way for an audit, keep in mind that you only have to stress if you’re doing something you shouldn’t be—and one way to find out if that’s the case is to check in on the most common types of Medicaid fraud.

Fortunately, the Arkansas Medicaid Fraud Control Unit recently published five examples of common Medicaid fraud types essayswriters.biz. Read on for the list, as well as examples to help you steer clear of these issues.

1. Billing for Services Not Rendered: This type of fraud occurs when “a provider bills for treatments or procedures which are not actually performed,” the Arkansas Medicaid Fraud Control Unit says on its website. (more…)

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Reimbursement: Final Fee Schedule Confirms Phasing Out of Global Periods

Posted on 14. May, 2015 by .

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Ophthalmology practices, prepare for a 2 percent cut to Medicare payments.

When CMS announced on Halloween that it had published the 2015 Physician Fee Schedule Final rule, many practices were a bit spooked to review it — but fortunately, the finalized version of the document doesn’t differ too wildly from the proposal that the agency published earlier this year. Read on to discover several of the most impactful items from the 1,185-page document.

No Negative Conversion Factor — Yet

When it comes to the conversion factor, the fee schedule had some good news buyessaysonlinecheap.net. Because the Protecting Access to Medicare Act won’t allow any cuts in the conversion factor through March 31, 2015, CMS has finalized the conversion factor of $35.8013 through that date. Starting April 1, (more…)

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Skin Case: Solve this Porokeratotic Lesion Excision Puzzle

Posted on 23. Apr, 2015 by .

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Don’t fall for DSAP diagnosis trap.

Your surgeon treats a patient with a fairly large, circular keratotic lesion on a patient’s right ankle. That sounds like a simple enough case, but read on to see what trials await you as you zero in on the proper diagnosis and procedure codes.

Focus on Diagnosis

The patient presents with a 0.9 cm lesion on the right ankle that appears hyperkeratotic. Suspecting a wart (078.1, Viral warts) or actinic keratosis (702.0, Actinic keratosis), the surgeon treats the lesion.

The patient returns three months later because the lesion has returned. It is now 1.3 cm in diameter and consists of a “plaque” surrounded by a ridge-like border. The surgeon removes the lesion and sends the specimen to pathology. The pathology report reveals a classic cornoid lamella, which is a thin vertical column of parakeratosis in the epidermal stratum corneum that makes up the outer “ring” of the lesion. (more…)

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Don’t Let Modifier Glitches Sideline Your Capsule Endoscopy Claims

Posted on 08. Apr, 2015 by .

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Ask for pre-authorization from the carrier to repeat a capsule study due to previous technical problems.

Reporting capsule endoscopy is not just about knowing the procedure codes and when to use them. It is also about being proficient enough to report interrupted procedures, delayed procedures, or other such contingencies. Remain on top of these situations armed with the knowledge of the correct modifiers.

If you are reporting only the professional component for your capsule endoscopy services ((i.e., interpretation and report of the results), you should append professional component modifier 26 (Professional component) to the appropriate code. For example, if your physician is part of a facility, and the facility owns the equipment used for the endoscopy, the gastroenterologist will only report the professional component. (more…)

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