Question: How do we code for CO2 laser ablation of carcinoma in situ of the face? Would it be appropriate to use a dermabrasion code such as 15781 if the operative note is dictated as “C02 laser ablation of carcinoma in situ of the face (not full face-segmental)?”
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The government’s CERT report not only identifies the types of errors that practices make—it also profiles which specialties had the highest Part B error rates, as follows:
Specialty Error Rate
Private practice occupational therapist 21.0%
Radiation Oncology 19.4%
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Follow these 4 tips, and your claim will pass with flying colors
If your ob-gyn performs extensive lysis of adhesions, you can get paid separately for it — but you better make sure the documentation is iron clad.
What they are: Pelvic adhesions are bands of fibrous scar tissue that can form in the abdomen and pelvis after surgery or due to infection. Because adhesions connect organs and tissue that are normally separated, they can lead to a variety of complications, including pelvic pain, infertility and bowel obstruction. Adhesions commonly form on the ovaries, pelvic sidewalls and fallopian tubes, but can also involve the bowel and omentum.
Capture Adhesiolysis With These CPT® Codes
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Lumbar arthrodesis code 22633 includes a combination of services, but you still need to watch out for separately reportable procedures and add-on options. The July CPT® Assistant lays out which spine codes you may report together so reimbursement doesn’t slip through your fingers. As a handy bonus, check out the illustrations for segmental and non-segmental instrumentation, too.
Whether you want to learn more about coding for the spine, the knee, or the heart, just enter your code or keyword into SuperCoder.com’s Code Connect to bring up the July articles and more:
- Arthrodesis, spinal: 20930, 20931, 20936, 20937, 20938, 22633, 22634, 22840-22848, 22851
- Arthroplasty, knee: 27487, 27488
- Electrophysiology services: 93609, 93613, 93621-93623, 93653-93657
- X-ray, cervical spine: 72020, 72040.
Plus, July’s CPT® Assistant FAQs provide targeted answers for specific scenarios. Key the codes below into Code Connect to learn more about these topics:
- Molecular pathology test: 81400-81402
- Sleep study: 95806
- Transitional care management: 99374, 99375, 99377-99380, 99495, 99496.
The psychotherapy codes added in 2013 came with a variety of hurdles for coders, but June’s CPT® Assistant takes them on one by one. Coding with E/M? Find out which codes are appropriate. Less than 16 minutes of psychotherapy? See what the time rule has to say. Plus you’ll get clues about interactive complexity and coding for time spent with the patient’s family.
Check out all the psychotherapy code details and authoritative advice on other coding topics covered in the June issue by searching the codes below on Code Connect:
- Cervicocerebral angiography: 36221-36228, 75650, 75660, 75662, 75665, 75671, 75676, 75680, 75685, 75774, 76376, 76377
- Intracardiac electrophysiology studies and ablation: 93279-93284, 93286-93289, 93462, 93600, 93602, 93603, 93609, 93610, 93612, 93613, 93618-93622, 93642, 93651-93657
- Nuclear imaging, thyroid: 78000, 78001, 78003, 78006, 78007, 78010-78014, 96374
- Psychotherapy: 90785, 90791, 90792, 90801, 90802, 90823-90829, 90832-90834, 90836-90840, 90846, 90847, 90857, 90862, 90863.
You also can search Code Connect for June’s CPT® Assistant FAQs, featuring the AMA’s answers to questions from coders just like you:
- Allogeneic lymphocyte services: 38242, 38243
- Bariatric surgery: 43659
- Bilateral procedure: Modifier 50
- Nervous system surgery: 61682, 61686, 61692, 64506, 64999
- Noninvasive vascular diagnostic test: 93922
- Path/lab, multiple tests or specimens: 87491, 87591, 87801, 88321, 88323, 88325
- Sinus surgery, endoscopic: 31256, 31299
- Upper extremity surgery: 26170, 29820, 29821
- Videonystagmography: 92546.
ICD-10 keeps 3 code choices for you.
When your anesthesiologist is involved with a case to correct an umbilical hernia, you start your diagnosis selection by verifying the presence or absence of obstruction or gangrene.
ICD-9: You currently have three code choices for umbilical hernia:
- 551.1 (Umbilical hernia with gangrene)
- 552.1 (Umbilical hernia with obstruction)
- 553.1 (Umbilical hernia without obstruction or gangrene).
ICD-10: When you begin using ICD-10 codes on Oct.1, 2014, the base code for a diagnosis of umbilical hernia will change to K42 (Umbilical hernia).
Question: Our pediatrician sometimes administers an oral dose of an antibiotic or prednisone. Is there a CPT code to charge if we do give oral medication? We buy the medication to have in office for emergency purposes. For instance, a patient comes in with hives and after the doctor’s evaluation, orders a dose of the Orapred to be given by mouth. How can we report this?
Plus: ICD-10 claims will allow you to submit the letters as either upper or lowercase, CMS confirms.
Still waiting for an announcement that perhaps ICD-10’s start date will be pushed back another year? Stop wishing and start preparing, because the ICD-10 implementation date of Oct. 1, 2014 “is firm,” said CMS’s Denesecia Green during an Aug. 27 CMS Open Door Forum.
To make the transition easier, CMS has started offering free training sessions to practices via phone and the web, and plans to offer an online ICD-10 tool within the next few weeks, Green said. In addition, CMS representatives aimed to dispel several common misconceptions about the new diagnosis coding program.
CMS Likens New System to Cell Phone Transition
Can’t evaluate all required anatomy? Complete exam code may still be an option.
You may see a boost in echocardiography pay from Medicare in 2014. To be sure your practice gets every dollar earned — now and in the future — follow these 3 tips to cleaner 93306 claims.
Fee news: Medicare’s proposed 2014 fee schedule shows an increase in rates for several echocardiography codes. One of note is 93306 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography). The 2013 national rate is roughly $189, but the code may see a payment increase of more than 20 percent in 2014, according to the American Society of Echocardiography (ASE) (www.asecho.org/2013/07/cms-releases-proposes-increased-medicare-payment-for-echocardiography-in-2014/; also see www.cardiosource.org/en/News-Media/Publications/Cardiology-Magazine/2013/07/2014-Medicare-Proposed-Rule-Analysis.aspx).
For 93306, confidently capturing the proper reimbursement depends on watching for documentation of spectral and color Doppler, ensuring the exam is complete, and understanding when congenital echo codes come into play.
1. 93306 vs. 93307: Seek Spectral and Color Doppler Documentation
Question: Can I please get other opinions on the correct ICD-9 code for an infected embedded earring in the ear? The earrings are stuck inside in the pinna, with small open wounds that appear infected. The physician does an incision to remove the impacted earring backs.