Question: An established patient complains of pain in her left index finger. A nonphysician practitioner (NPP) examines the affected digit, diagnoses a mild sprain, and tapes it to the patient’s left middle finger. Can you report 29280 for this encounter?
Answer: The NPP’s actions do not constitute strapping in most payer’s eyes, so leave 29280 (Strapping; hand or finger) off the claim. When a provider “buddy tapes” one finger to another, you should consider this an E/M service, most of the time. If you have any doubt about the payer’s strapping procedures, check with the carrier before filing the claim.
Do this: When choosing an E/M code, consider all the NPP’s actions during the encounter, including the buddy taping. So if the notes for the entire visit indicate a level-two service, report 99212 (Office or other outpatient visit for the evaluation and management of an established…
Posted on 06. Jan, 2009 by in Hot Coding Topics.
Did you know that certified coders earn an average of 15% more than their non-certified counterparts? The average annual wage for a credentialed coder is $43,100, compared to $36,500 for a non-credentialed coder, according to the AAPC.
Posted on 06. Jan, 2009 by in Provider News.
New study indicates that bariatric surgery reverses Type 2 diabetes in adolescents.
If part of your coding or billing job is to score pre-authorizations for obesity surgeries, keep your eyes on research that may one day support medical necessity for teenaged patients.
Ten out of 11 diabetic teens saw their Type 2 diabetes disappear within a year after weight-loss surgery, according to a small study published in Pediatrics.
SLPs: Watch out for this MBS reimbursement cut.
Happy New Year, rehab coders! Time for hats n’ horns, Auld Lang Syne, and the very latest on therapy caps and Physician Fee Schedule for 2009.
Therapy Cap Lowdown: The new therapy cap will be $1,840 for occupational therapy and $1,840 for physical therapy and speech-language pathology combined. And thanks to the Medicare Improvements for Patients and Providers Act of 2008, you’re still able to use the exceptions process until Jan. 1, 2010.
Reimbursement Upside: “Occupational therapy [and physical therapy] codes will see a 3 percent aggregate increase for 2009,” says Sharmila Sandhu, Esq., regulatory counsel for the American Occupational Therapy Association. “But keep in mind that this is an average — some code values have increased, while others may have decreased, so be sure to check the values of each individual code that you bill.”…
Posted on 05. Jan, 2009 by in Provider News.
Despite economic downturn, demand for health care workers stays strong.
This New Year doesn’t look very Happy for most job seekers, but experts agree that the demand for health care workers remains strong, the Wall Street Journal reports.
And it’s not just MDs, LPNs, & lab techs who are getting health care jobs. Health care employeres are looking for “professionals in an array of business areas, including management, finance, communications, information technology and administrative services,” the paper says. More …
Question: A pediatrician uses Dermabond to close a patient’s 1.0-cm cheek laceration. Should you assign a laceration procedure code and a Dermabond code?
Answer: You should use the same CPT codes for closing a laceration with Dermabond as you do for suture repair. Report the appropriate simple repair code and open wound diagnosis. The repair codes’ practice expense relative value units include the Dermabond supply, which you should not bill separately.
Using the CMS-1500 form, you should code your case as follows:
• in box 21, enter 873.41 (Other open wound of head; face, without mention of complication; cheek)
• in box 24-D, report 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less).
For repair of nonfacial wounds involving Dermabond, you should instead use 12001 (Simple repair of superficial wounds of scalp, neck,…
Posted on 05. Jan, 2009 by in Toolkit.
Fingertip guide to 5 Place-of-Service codes puts you on Easy Street.
Choosing the correct place-of-service (POS) code for your claims is essential to avoiding denials and even investigation for fraud. Keep on your auditor’s good side by choosing your code based on these descriptions, straight from CMS.
• 11 (Office)–Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, state or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis. Fair market value for the office must be paid for this office in order to qualify for an office and POS 11.
• 22 (Outpatient hospital)–A portion of a hospital that provides … More …
If you miss this CPT 2009 change, you’ll lose $21 per claim.
Step 1: Replace 90772 With 96372
The next time staff administers a Decadron shot to a patient, double-check that you’re submitting 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular).
Reporting the injection administration with the 2008 version 90772 will trigger an invalid code rejection delaying approximately $21 in pay. (Figure based on the 2009 Medicare Physician Fee Schedule assigning 0.58 transitional non-facility total relative value units [RVUs] to 96372 and using a conversion factor of 36.0666.)
Error averted: Do not separately bill pre-administration work with a patient visit code.
The AMA considers the pre-administration work (whether it is IVIG, chemotherapy, or other drug administrations) part of the drug administration service, explains Cindy C. Parman, CPC, CPC-H, RCC, principal at Coding Strategies, Inc. in Atlanta.
For payers that adopt Medicare edits, 99211 always…
Posted on 02. Jan, 2009 by in Hot Coding Topics.
Did you know that more employers are requiring coders to have their CPCs? Fifty percent of respondents report that certification was a job requirement in 2008 (up from 42% in 2007), according to the AAPC.
Posted on 02. Jan, 2009 by in Provider News.
In the rush toward EMRs, we may be losing sight of the cardinal rule of the medical profession: First, do no harm. more…