CPT 99406, 99407 Coverage Extended to All Smokers

Posted on 31. Aug, 2010 by jennifer.godreau.

CMS announcement is triumph for physicians who haven’t collected in the past.

If you’ve been writing off tobacco cessation counseling as non-payable, it’s time to change your tune.

In the past, CMS only covered 99406-99407 (Smoking and tobacco use cessation counseling visit…) for a beneficiary with a tobacco-related disease or with signs or symptoms of one. But on Aug. 25, CMS announced that “under new coverage, (more…)

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92541 + 92544 Will Soon Be OK

Posted on 25. Aug, 2010 by jennifer.godreau.

AMA corrects vestibular test codes to allow partial reporting.

The Correct Coding Initiative (CCI) came down hard on practitioners who perform vestibular testing earlier this year, but a new correction, effective Oct. 1, should ease the restrictions and help the otolaryngology, neurology, and audiology practices that report these services.

The problem: CCI edits currently restrict practices from reporting 92541, 92542, 92544, and 92545 individually if three or less of the tests are performed, notes Debbie Abel, Au.D., director of reimbursement and practice compliance with the American Academy of Audiology.

The solution: Starting October 1, 2010, “if two or three of these codes are reported for the same date of service by the same provider for the same beneficiary, (more…)

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Medical Record Retention: How Long Should You Keep Patient Charts?

Posted on 25. Aug, 2010 by jennifer.godreau.

CMS says keep patient medical records for 6 years.

Medical practices often hear conflicting advice regarding how long they must hang on to a patient’s medical records, but CMS intends to clear up any misinformation with new MLN Matters article SE1022, issued this month.

Although many physicians follow state laws when determining whether they can discontinue retaining a patient’s records, it’s important to keep in mind that you must hang into the patient’s records for at least six years, according to HIPAA laws. If your state requires (more…)

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CCI 16.2 Bundles Paravertebral Facets With Anesthesia Procedures

Posted on 12. Aug, 2010 by jennifer.godreau.

Don’t assume separate coding for J0670, anymore.

The latest Correct Coding Initiative (CCI) edits contain plenty of anesthesia and pain management pairs you should check — and straight away. They went into effect July 1. CCI 16.2 encompasses 16,843 new edit pairs, according to analyst Frank Cohen, MPA, of MIT Solutions, Inc., in Clearwater, Fla. With 11 percent of all active edits affecting anesthesia procedures, you can’t afford to miss any of the changes.

Other Work Includes Paravertebral Facet Injection

Although the current CPT book doesn’t include them, you could begin using several new codes for paravertebral facet joint injections in January 2010. Now CCI edits bundle two of the new codes with every anesthesia code (00100-01999) and many nerve destruction procedures. The paravertebral injection codes affected are: (more…)

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CMS Clarifies How to Report Audiology Services

Posted on 12. Aug, 2010 by jennifer.godreau.

Look for a physician order for diagnostic audiology tests.

If you thought CMS’s May transmittal on coding for audiology services was the last word on the subject, think again. On July 23, the agency rescinded the May directive and issued new guidance that should help clarify any audiology billing issues you may have.

Transmittal 129 not only breaks down how you’ll report audiology services, but also (more…)

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Proposed 2011 Fee Schedule Offers Vast Benefits for Primary Care Practices

Posted on 10. Aug, 2010 by jennifer.godreau.

CMS adds Obama recs into next year’s fee schedule.

The President signed the Patient Protection and Affordable Care Act (PPACA) into law on March 23, but many practices haven’t yet noticed significant impacts from the legislation. In 2011, however, you could see huge boosts from it, because CMS has proposed incorporating many of the law’s features into next year’s Physician Fee Schedule.

On June 25, CMS released its proposed Physician Fee Schedule for 2011. The 1,250-page document, which will be published in the July 13 Federal Register, offers several advantages to medical practices, including (more…)

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Part B Payment: Expect Claims To Be Released Today

Posted on 18. Jun, 2010 by Editor.

MACs won’t process June claims until today, in hopes that Congress will act.

The Senate’s delays could mean serious payment crunches for your practice.

Last month, the freeze that has been keeping the Medicare conversion factor at 2009 levels expired, meaning that Part B practices were due to face a 21-percent cut effective for dates of service June 1 and thereafter. Because Congress had not yet intervened to stop those cuts, CMS initially instructed MACs to hold claims for the first 10 business days of June while lawmakers could deliberate whether to eliminate the looming cuts.

When the Senate reconvened on June 7, many analysts expected (more…)

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Diagnosis Coding: Here’s How To Decode Your Physician’s Notes

Posted on 16. Jun, 2010 by Editor.

If the doctor does not circle a diagnosis, it may be up to you to find one.

Don’t let an incomplete superbill damage your chances of submitting an accurate claim. If the doctor in your office fails to indicate the ICD-9 code for the condition that he treated, you should read through his documentation to find which diagnoses you should report.

Open the Notes When You Have to — and Even When You Don’t

Suppose your physician hands you a superbill with the procedures circled and the diagnosis left blank.

You could ask the physician which diagnosis to report, or you could examine the documentation yourself. If your office has a policy that includes “coding by abstraction” by certified/qualified coders, then (more…)

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Emergency Coders: Check for Critical Care & You Could Gain $50

Posted on 14. Jun, 2010 by Editor.

If patient’s critical care and visit satisfies time regs, 99291 is the better bet.

When scouring the notes for evidence of an emergency department caveat scenario, coders can easily forget to ask themselves one simple question: Can I report a critical care code for this scenario?

The answer’s yes more often than you might think, says Caral Edelberg, CPC, CPMA, CCS-P, CHC, president of Edelberg Compliance Associates in Baton Rouge, La.

“Many patients who qualify for the caveat may also be candidates for critical care. If the condition is severe enough that the patient’s ability to provide this information is impaired, then the condition may be critical,” she explains.

Critical Care Omits Specific History Component

Considering critical care and the caveat simultaneously can make your head spin, as the ED caveat (more…)

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Radiology Coding: Watch for 4 Key ICD-9 Additions

Posted on 10. Jun, 2010 by Editor.

From head to toe, the new diagnosis codes hold something for everyone.

Whether your patients present with cardiologic, orthopedic, or gynecologic complaints, the next round of ICD-9 codes could hold important changes for you. Here’s the rundown on the new codes most relevant to radiologists — including a new option for retained magnetic metal fragments.

Remember: ICD-9 2011 will go into effect Oct. 1, 2010. The official version will be released in the fall, so the codes below are not yet final.

1. Look Forward to More Specific Ectasia Codes

The proposed changes to ICD-9 2011 add four codes specific to aortic ectasia. These codes are among the most significant changes for radiology coders because you may see that term in (more…)

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