Not all patients who present to the office with colon polyps will be diagnosed with colon cancer. This second-leading cause of cancer-related deaths in the US usually begins as small, benign adenomatous lump, and becomes cancerous overtime.
Colon cancer, or colorectal cancer as it’s regularly known, is a cancer which starts in the large bowel portion of the gastrointestinal (GI) system. Because it comes in many forms and symptoms, coding the definitive diagnosis might be risky. Guard your practice’s deserved dollars with these 3 tips.
Your practice is going to have more patients coming in for bone density screenings, thanks to new recommendations from the U.S. Preventive Services Task Force (USPSTF) that might lower the age at which family physicians could begin screening some women for osteoporosis. Act now to ensure you’re assigning the correct diagnosis codes and verifying medical necessity.
1. Know Osteoporosis, Osteopenia Differences
Many people think of osteoporosis when they hear the term “bone density screening.” Osteoporosis — which literally means “porous bone” — is a disease characterized by low bone mass and structural deterioration of bone tissue. The changes lead to bone fragility and an increased risk of hip, spine, and wrist fractures. The condition is essentially a bone disease caused by dropping estrogen levels in postmenopausal women.
When your physician diagnoses osteoporosis, you’ll select from code family
Even if you don’t have prescribing privileges, you can rest assured now as CMS will not cut your pay as a penalty for failing to comply with the new e-prescribing incentive program.
As you are probably aware, starting in 2012, you may be subject to a one percent payment adjustment on your Part B pay if you don’t successfully participate in e-prescribing this year. In 2013, that payment adjustment will go up to 1.5 percent, and in 2014 it will rise to two percent, CMS’s Daniel Green, MD noted on a Feb. 15 CMS-sponsored call.
“To earn an incentive in 2011, an eligible professional must e-prescribe 25 times during the year, ten of which must be in the first six months,” Green said. “If they are a successful e-prescriber during the calendar year, they not only would avoid the 2012 payment adjustment, they would get a
When ICD-10 goes into effect in 2013, high cholesterol will still be a challenge for your patients. Here’s a look at how coding for this, and similar diagnoses, compares between ICD-9 and ICD-10.
- 272.0, Pure hypercholesterolemia
- 272.1, Pure hyperglyceridemia
- 272.2, Mixed hyperlipidemia
- 272.4, Other and unspecified hyperlipidemia
Coding your anesthesia provider’s service is never cut and dried, especially with intricate procedures such as retrobulbar block placement. Answer these three questions regarding your anesthesiologist’s involvement in the case to know how to correctly code her services every time.
Does The Anesthesiologist Handle Everything?
Because administering anesthesia for retrobulbar blocks is riskier than other ocular injections, some surgeons (or facilities) prefer to have the anesthesia team handle everything. If your anesthesiologist is involved throughout the case, she administers the initial block and then administers monitored anesthesia care (MAC) during the case.
Code it: Your anesthesiologist places the block in preparation for the procedure, not as a separate pain management service. Therefore, you only code for the
Stick to these 3 tips for your E/M and lesion removal procedures.
You can report both the E/M and lesion removal if the E/M service was a significant and separately identifiable service for an E/M service with actinic keratoses (AK) removal procedure.
Always verify with your carrier before appending modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the E/M code.
You can only consider reporting modifier 25 when coding an E/M service, says Janet Palazzo, CPC, coder for a practice in Cherry Hill, N.J. If the procedures you are reporting don’t fall under E/M services, it is possible the encounter qualifies for another modifier instead.
Have a look at the following three tips to help you report these services accurately so your practice
When reporting inhaler service, you should remember the type of device the provider is using, but shouldn’t stop with just that. Documentation requirements and qualifying modifiers are just as important when coding for inhaler services.
When you’re confused why some payers would deny reimbursement for certain inhaler claims, the following ideas could guide you to a better understanding of how inhaler service codes work out.
94664 Is Your Ticket to Diskus Demo Pay
The Advair Diskus is an “aerosol generator.” If the nurse/medical assistant taught someone to use an Advair Diskus — or any other diskus — you should report
Nasal cavity polyp also goes by the term “choanal” and “nasopharyngeal.”
If the otolaryngologist performed a removal of a middle turbinate endoscopically, you would report it with CPT 31240 — subsequently linking this procedure to a diagnosis code. One possibility is 471.0 (Polyp of nasal cavity).
When ICD-9 becomes ICD-10 in 2013, you will have to shift to coding type of polyp using
This chart breaks down who is responsible for the charges:
|Modifier||Did the patient sign the ABN?||What does using this modifier mean?|
|GA||Yes||The service is covered by Medicare only under certain circumstances. When you use this modifier, the patient is held financially responsible for the service if it is denied by Medicare.|
|GY||No||The service is never covered by Medicare and the patient is always responsible for the service. You are adding this modifier to get a denial from Medicare so the patient’s secondary insurance will pay.|
|GX||Yes||The service is never covered by Medicare, but you got the patient to sign an ABN anyway. You will get an|
Keeping track of all the different potential allergens that may be causing a patient’s skin rash is challenging enough. But when you add the complexity of different kinds of dermatitis tests that a dermatologist can perform, it’s enough to cause a coder to break out in a rash herself. The variety and complexity of allergy tests can certainly lead to coding mishaps — but understanding the codes and having clear documentation can help clear things up.
The tests that dermatologists commonly perform to learn the source of a patient’s allergic dermatitis include