Archive for 'Hot Coding Topics'

Capture 2015 Medicare Physician Payment Changes With the Latest CPT® Assistant

Posted on 05. Apr, 2015 by .

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The February 2015 CPT® Assistant highlights the changes made in the Medicare physician payment schedule in 2015. You will see how the final conversion factor takes into account the adjustment the Protecting Access to Medicare Act of 2014 (PAMA) brought about for the sustainable growth rate (SGR). Also, check out the Relative Value Scale Update Committee (RUC) recommendations of fee schedule changes for 2015.

You can also sharpen your skills for appropriately reporting arthrocentesis codes with the latest CPT® Assistant. Plus, nail down correct codes for reporting paravertebral facet joint nerve destruction. You can use SuperCoder.com’sCode Connect search to update your skills on all of these topics:

  • Arthrocentesis: 20600-20611, 27370, 76942, 77002, 77012, 77021
  • Medicare Physician Payment Changes in 2015: 92961, 92986-92990, 92997-92998, 99490
  • Paravertebral Facet Joint Nerve Destruction: 64633-64636, 64999.

The customary FAQ section is also available in the latest CPT® Assistant to help you resolve your toughest coding cases. For the assistance you need, search for these codes and keywords on Code Connect:

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Final Rule: Beware Potential ‘Ides of March’ Pay Cut

Posted on 30. Mar, 2015 by .

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Only an act of Congress can save the day.

You might have experienced little change in Medicare pay in January, thanks to a stipulation in the Protecting Access to Medicare Act of 2014 (PAMA) that halts sustainable growth rate (SGR) cuts until April 1, 2015.

But the ticking SGR time bomb, along with aggregate RVU changes that bode well or ill for service providers depending on their specialty, could mean that your lab or pathology practice’s financial outlook is not that stable after all.

Read on to see what Medicare pay changes you might expect this year — now and possibly later, too. (more…)

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Take Advantage of Molecular Pathology Tables and Tips in the Latest CPT® Assistant

Posted on 19. Mar, 2015 by .

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The January 2015 CPT® Assistant is jam-packed with advice on 2015′s molecular pathology code updates. Get the inside scoop on revisions made to the gene table to include claim designators for Tier 2 Molecular pathology codes. Find out how the new section in CPT® 2015 for genomic sequencing procedures (GSPs) and other molecular multi analyte assays impacts reporting of 21 new codes to describe gene panel analysis.

Reviewing the latest issue will also improve your understanding of how to appropriately report percutaneous vertebroplasty and vertebral augmentation codes as well as aqueous shunt procedures and visual field assessment. Make the most of SuperCoder.com’sCode Connect code and keyword search to keep your skills up to date on these topics:

  • Aqueous Shunt Procedures and Visual Field Assessment: 66180, 67255, 66185, 0378T-0379T
  • Maternity Care and Delivery: 99201-99205, 99211-99215, 99241-99245, 99281-99285, 99384-99386, 99394-99396
  • Molecular Pathology Update: 81246, 81288, 81292, 81313, 81400-81408, 81410-81471, 81445-81455, 81479, 81500-81599, 0006M-0008M
  • Percutaneous Vertebroplasty and Vertebral Augmentation: 20225, 22310-22315, 22325, 22327, 22510-22515, 22520-22525, 22526-22527, 22899, 72291-72292, 0200T-0201T.

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CPT® 2015: Get to Know 2 New 2015 Advanced Planning Codes

Posted on 18. Mar, 2015 by .

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Pay attention to time documentation for correct use. 

If your urologist does advance care planning for patients, you will likely make use of two new codes that CPT® added for 2015. Read on to learn about the new additions and the lingering questions experts have about how you’ll use these codes.

Add 99497-99498 to Your Coding Arsenal

CPT® 2015 adds two new advance care planning codes: 99497 (Advance care planning including the explanation and discussion of advance directives such as standard forms [with completion of such forms, when performed], by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member[s], and/or surrogate) and add-on code +99498 (... each additional 30 minutes .…).

According to CPT® 2015, (more…)

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Practice Management: Avoid Brutal HIPAA Fines with These 3 Steps

Posted on 25. Feb, 2015 by .

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Take HITECH lessons to heart, and protect your bottom line.

They might look like a barrage of random numbers, but two recent reports about HIPAA breaches actually contain nuggets of wisdom that you can use to protect your patients’ private health information.

Make sure you apply the following important lessons from the Health Information Technology for Economic and Clinical Health (HITECH)-mandated reports to keep your general surgery practice out of the penalty zone.

Source: (more…)

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News Flash: Look Ahead to New Global Periods Coming Your Way in 2017

Posted on 12. Feb, 2015 by .

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Plus: If CMS prevails, you may get paid less for surgical procedures.

Global periods affect every provider’s coding, billing, and reimbursement, whatever the specialty and place of service might be. Figuring out when you can and can’t bill office visits for patients who have recently had a procedure performed may get easier, thanks to a proposed rule from CMS for the Medicare Physician Fee Schedule (PFS).

Read on for the scoop about CMS’s plan to eliminate global periods for surgical procedures and how the changes could affect your practice’s bottom line. (more…)

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Latest CPT® Assistant Reveals Sigmoidoscopy and Colonoscopy Changes for 2015

Posted on 11. Feb, 2015 by .

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The December 2014 CPT® Assistant is chock-full updates for the lower gastrointestinal (GI) endoscopy code set. Find out how the revisions made to terminology, definitions, and guidelines will impact the reporting of codes for ileoscopy, flexible sigmoidoscopy, colonoscopy through stoma, and colonoscopy in CPT®2015. The issue also briefs you on how to appropriately report percutaneous coronary intervention (PCI) procedures.

Reviewing the latest issue will also improve your understanding about a new sub-section CPT® added to the E/M section titled advance care planning. You’ll also benefit from a comparison between ICD-9-CM and ICD-10-CM structure and format. To get spot-on guidance, simply type a code or keyword into SuperCoder.com’sCode Connect to see the December article that suits your needs:

  • Advance Care Planning: 99497-99498
  • Coronary Therapeutic Services and Procedures:  92920-92944, 92973-92974, 92978-92979, 93454-93461, 93563-93564, 93463, 93571-93572
  • ICD-10-CM Seventh (7th) Character
  • Sigmoidoscopy and Colonoscopy Changes: 44380-44408, 45330-45347, 45339, 45345, 45346, 45347, 45349, 45350, 45378-45384, 45387, 45388, 45389, 45390- 45393, 45398, 45399, 46221.

     

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Industry Notes: CMS Reveals ICD-10 Testing Dates

Posted on 28. Jan, 2015 by .

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Self-disclosure clause built in to nip fraud in the bud.

As promised, the Centers for Medicare & Medicaid Services (CMS) has finally revealed the dates of its latest ICD-10 testing opportunities. MLN Matters article MM8858, issued on Aug. 22, outlines the following date ranges when you can test out your ICD-10 claims:

  • Nov. 17 to 21, 2014
  • March 2 to 6, 2015
  • June 1 to 5, 2015

During these periods, trading partners will have access to MACs and CEDI for testing “with real-time help desk support,” the article says. (more…)

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Simplify Your Stomal Endoscopy Reporting With New 2015 CPT® Changes

Posted on 28. Jan, 2015 by .

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The November 2014 CPT® Assistant is brimming with updates made in CPT® 2015 for reporting stomal endoscopy codes. Find out how the introduction of several new codes for colonoscopy through a stoma affects the reporting of various services. Evaluate the new guidelines, which instruct you on how to report colonoscopy codes during specific scenarios.

Other areas featured in the November 2014 CPT® Assistant address the changes and additions made in 2015 to the cardiovascular system subsection, including pacemaker and implantable defibrillator codes. Sharpen your skills for negative pressure therapy services, coding neoplasms in ICD-10-CM, and much more. Put SuperCoder.com’s Code Connect code and keyword search to good use to deepen your understanding of these topics:

  • Coding Clarification: Special Ophthalmological Services: 92133, 92134, 92135, 92250
  • ICD-10-CM: Neoplasm Coding and the Neoplasm Table
  • Negative Pressure Therapy Services: 97605-97608
  • Pacemaker or Implantable Defibrillator Systems: 10140, 10180, 11042, 11043, 11045, 11046, 11047, 33202-33249, 33262-33264, 33270-33273, 76000, 93260, 93261, 93279-93299, 0319T-0328T
  • Stomal Endoscopy: 44360-44376, 44380-44408.

     

(more…)

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Milia Treatments: Pop These Milia Myths Before They Blemish Your Reimbursement

Posted on 14. Jan, 2015 by .

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Know the difference between 10040 and 17110.

Milia treatments can be notoriously challenging to report, in part because it can be difficult to discern between acne surgery codes and destruction codes. Is one of these four myths causing reimbursement hassles in your dermatology practice?

Myth: 10040 and 17110 Are Interchangeable

Reality: The main difference between 10040 (Acne surgery — e.g., marsupialization, opening or removal of multiple milia, comedones, cysts, pustules) and 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) is that the 17110 code is a destruction while the 10040 code is a removal. (more…)

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