Reader’s Question: Swine Flu Out of Pandemic Vaccine List

Posted on 28. Jan, 2015 by in Coding Challenge.

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Question: Our practice has been receiving queries for H1N1 vaccinations. What are our coding options and restrictions?

New Jersey Subscriber

Answer:

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Physician Notes: ‘No Show’ Physician Faces 5 Years in Prison Over $13 Million Scheme

Posted on 28. Jan, 2015 by in Provider News.

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A Brooklyn, NY healthcare clinic was raking in cash over the past several years, despite the fact that investigators say its medical director wasn’t even on site to perform the services being billed to Medicare and Medicaid.

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Industry Notes: CMS Reveals ICD-10 Testing Dates

Posted on 28. Jan, 2015 by in Hot Coding Topics.

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Self-disclosure clause built in to nip fraud in the bud.

As promised, the Centers for Medicare & Medicaid Services (CMS) has finally revealed the dates of its latest ICD-10 testing opportunities. MLN Matters article MM8858, issued on Aug. 22, outlines the following date ranges when you can test out your ICD-10 claims:

  • Nov. 17 to 21, 2014
  • March 2 to 6, 2015
  • June 1 to 5, 2015

During these periods, trading partners will have access to MACs and CEDI for testing “with real-time help desk support,” the article says.

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Simplify Your Stomal Endoscopy Reporting With New 2015 CPT® Changes

Posted on 28. Jan, 2015 by in Hot Coding Topics.

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The November 2014 CPT® Assistant is brimming with updates made in CPT® 2015 for reporting stomal endoscopy codes. Find out how the introduction of several new codes for colonoscopy through a stoma affects the reporting of various services. Evaluate the new guidelines, which instruct you on how to report colonoscopy codes during specific scenarios.

Other areas featured in the November 2014 CPT® Assistant address the changes and additions made in 2015 to the cardiovascular system subsection, including pacemaker and implantable defibrillator codes. Sharpen your skills for negative pressure therapy services, coding neoplasms in ICD-10-CM, and much more. Put SuperCoder.com’s Code Connect code and keyword search to good use to deepen your understanding of these topics:

  • Coding Clarification: Special Ophthalmological Services: 92133, 92134, 92135, 92250
  • ICD-10-CM: Neoplasm Coding and the Neoplasm Table
  • Negative Pressure Therapy Services: 97605-97608
  • Pacemaker or Implantable Defibrillator Systems: 10140, 10180, 11042, 11043, 11045, 11046, 11047,

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Dermatology: Don’t Get Zapped When Radiation-Related Disorders Codes Change

Posted on 14. Jan, 2015 by in ICD-10.

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In 2015, look for debut of the L57.- codes.

In the Dermatology Coding Alert volume 10 number 10, we looked at how ICD-10 would change diagnosis coding for sunburn and other solar radiation-related skin conditions. This time, we’ll examine how your coding will change effective Oct. 1, 2015, for skin disorders caused by other sources of radiation.

ICD-10 contains a category of diagnoses relating to “Skin changes due to chronic exposure to nonionizing radiation,” which will map to ICD-9 codes that are now scattered among different sections. The new ICD-10 category, L57.-, consists of:

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Reader Question: Get Clarification on “Dilation” and 58100

Posted on 14. Jan, 2015 by in Coding Challenge.

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Question: The Feb. 2012 issue of the Ob-gyn Coding Alert has an example of CPT® 58100-endometrial sampling (biopsy) as: “…plastic catheter into the uterus and suctions out a small amount of the endometrial lining.” Dilation is bundled with 58100. If a provider does some cervical dilation along with an endometrial sampling, at what point do we change from coding a 58100, 58120-52 or 58120? I spoke with a provider who uses the plastic catheter suction device and states he does a 360 degree endometrial curettage, after dilating the cervix slightly and sounding the uterus. Another provider uses the same tool and states he does a 360 degree endometrial biopsy, after sounding the uterus and dilating the cervix as needed. Is there a clear CPT® guideline on what is considered a sampling/biopsy and what is considered a curettage? Both of these providers do this procedure with out anesthesia for menorrhagia. 

Iowa Subscriber…

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Physician Notes: CMS Clears up the Most Common ICD-10 Myths

Posted on 14. Jan, 2015 by in Provider News.

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Plus: MACs to increase minimum dollar amounts for appeals in 2015

You’ve heard there won’t be an ICD-10 book that you can keep on your desk because the abundance of codes would make a book too thick—but is that tale true? Actually, no—it’s one of many ICD-10 myths that CMS hopes to dispel with its latest publication, called ICD-10-CM/PCS Myths and Facts.

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Milia Treatments: Pop These Milia Myths Before They Blemish Your Reimbursement

Posted on 14. Jan, 2015 by in Hot Coding Topics.

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Know the difference between 10040 and 17110.

Milia treatments can be notoriously challenging to report, in part because it can be difficult to discern between acne surgery codes and destruction codes. Is one of these four myths causing reimbursement hassles in your dermatology practice?

Myth: 10040 and 17110 Are Interchangeable

Reality: The main difference between 10040 (Acne surgery — e.g., marsupialization, opening or removal of multiple milia, comedones, cysts, pustules) and 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) is that the 17110 code is a destruction while the 10040 code is a removal.

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ICD-10: Can You Code This Pediatric Note Using Only ICD-10 Codes?

Posted on 18. Dec, 2014 by in ICD-10.

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Determine whether you’ll be ready for the new coding system with this sample note.

Although you’re probably a professional at coding your pediatric documentation at this point using ICD-9 codes, chances are high that you haven’t yet coded a note using only ICD-10 codes. Test yourself using this documentation example to determine whether you can select the right diagnosis codes, which will be required as of Oct. 1. Determine which ICD-10 codes you would report, then read on for the answers.

Scenario: An eight-year-old established patient presents for a well child visit. While there, the patient’s mother says that the child has recently needed to use his asthma inhaler twice a week, which has limited his activities of daily living to a slight extent, including his need to sit on the bleachers during his physical education class. Although the patient has had mild persistent asthma for a while, this is…

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Reader Question: Bill for X-rays and Contrast in Prostate Cystogram

Posted on 18. Dec, 2014 by in Coding Challenge.

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Question: How should I report prostate cyst aspiration and prostate cystogram? How do we report for the injection of contrast into the prostatic cyst?

Virginia Subscriber

Answer:

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