Archive for 'Hot Coding Topics'

Fight Back Against Lost Pay on High-Cost Procedures

Posted on 30. Dec, 2008 by .

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How to lower A/R with RTCA.

Rising costs and increased patient payment responsibility is hitting some practices where it hurts — their incomes. But some payers, such as Highmark in Pennsylvania, are offering you a tool to help you bring in every dollar.

Lower Your A/R: Highmark has introduced a real-time tool that will allow billing and collections departments to estimate the cost of services for specific patients. In turn, the hope is that patients will gain a better understanding of their individual payment responsibility and that the tool will allow the practice to set up financial arrangements when necessary. The cost estimate takes into account the individual patient … More…

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Which Ultrasound Code Is Best for Bladder Volume?

Posted on 26. Dec, 2008 by .

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Question: A urologist wants to bill for an ultrasound on the bladder to check volume, done in a clinical setting. Which ultrasound code is best?

Answer: You should report 51798 (Measurement of postvoiding residual urine and/or bladder capacity by ultrasound, non-imaging) for this service. If your urologist does the bladder sonogram primarily to determine the postvoid residual urine (PVR), use 51798 no matter what equipment the urologist uses and whether or not he derives an image from the equipment.

Pitfall: If the urologist uses the sonogram primarily to view the anatomy or architecture of the bladder, and the PVR is only part of–but not the main reason for–the study, bill 76857 (Ultrasound, pelvic [nonobstetric], real time with image documentation; limited or follow-up [e.g., for follicles]).

This is the only circumstance in which you should bill 76857. Most urologists, however, do a bladder sonogram primarily for PVR determination and should be billing with 51798.

Got more questions on urology coding? Dr. Michael Ferragamo has your 2009 urology coding update.

 

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Undercoding Costs Practices $236 Million

Posted on 26. Dec, 2008 by .

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Yes. $236 million. That’s how much medical practices in all specialties lost due to undercoding in Medicare’s latest Comprehensive Error Rate Testing (CERT) period.

Example: One medical oncology practice billed Medicare for 5 mg of dexamethasone sodium phosphate (J1100), but the documentation revealed that the practice actually dosed 20 mg. This means the practice shorted itself for 15 mg worth of reimbursement.

Are you selling yourself short by undercoding prolonged services? Barbara Cobuzzi’s seminar explains the latest changes to those codes, and how to optimize your reimbursement.

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RAC Fact

Posted on 24. Dec, 2008 by .

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Did you know that those new RAC auditors out there get their paychecks ONLY if they find coding and billing mistakes that mean your practice owes Medicare money?

Deb Grider tells you what mistakes the RAC contractors are looking for.

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Doppler Echo Coding Gets a Facelift for 2009

Posted on 24. Dec, 2008 by .

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The $88 fee cut makes coding right the first time more crucial than ever.

Cardiology coders have been buzzing about a new instruction in CPT 2009′s “Echocardiography” section — you may no longer report your trusty echo code 93307 with spectral (+93320, +93321) and color flow (+93325) Doppler. What does this change mean for you in 2009? Here’s what you need to know… More …

Extra: A stent in the LAD, an atherectomy on the LAD, and a balloon angioplasty of the circumflex marginal. Would you code the atherectomy? 2009 Cardiology Surival Guide reveals the answer.

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What Are the Codes for Vasectomy in an ASC?

Posted on 24. Dec, 2008 by .

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Question: A physician plans to offer vasectomy in an ambulatory surgical center (ASC). How should you report this?

Answer: You should report a vasectomy using 55250 (Vasectomy, unilateral or bilateral [separate procedure], including postoperative semen examination[s]: APC 0183, ASC Payment Indicator A2). The code includes the local or regional anesthesia necessary for the procedure.

The physician normally performs the procedure, which involves cutting the vas deferens and suturing the ends, on both the left and right sides. Because the code descriptor specifies unilateral or bilateral, you should not apply modifiers or report multiple units for a bilateral procedure.

Got more questions on ASC coding? Join us in Las Vegas in February.

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A $20 Million Payback for 99211

Posted on 23. Dec, 2008 by .

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Is 99211 your favorite code? Watch out. According to Medicare, a full 15 percent of 99211 claims submitted to Part B for this code in 2007 were missing critical documentation, causing Medicare to request more than $20 million back from providers.

Will CMS be looking for a part of that money back from your practice next year? Susan Berman-Hvizdash teaches you to avoid 5 E/M documentation gaffes, and get the payment you deserve.

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New ABN Implementation: Are You Ready for Supply or Test Changes?

Posted on 23. Dec, 2008 by .

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What coders and billers must know before March 1, 2009.

Almost a year ago — March 3, 2008 — CMS implemented its revised Advance Beneficiary Notice of Noncoverage (ABN) (CMS-R-131). Providers and suppliers could choose whether to use the new form or continue filing the familiar ABN-G, ABN-L, or NEMB forms, but those days are numbered. Although your office should have made the change during the six-month transition period, the ABN-G and ABN-L forms will no longer be valid beginning … More …

Deb Grider Gets You Up to Speed on the New ABN & Medical Necessity Rules.

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Welcome!

Posted on 23. Nov, 2008 by .

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Welcome to the best online treasure trove of free, specialty-specific how-to medical coding articles from The Coding Institute. Browse and learn, or search our archives by code or keyword. 

We add new articles every work day, so keep us bookmarked for hot coding topics, tools you can use, coding & billing news, coding challenges, and more.

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