Descriptor won’t even change from 723.1 to M54.2.
Chronic neck pain is one of the most common complaints among patients who see a pain management specialist, and a simple one to code from a diagnosis standpoint. You report 723.1 (Cervicalgia).
Your choice will remain simple in ICD-10, when you’ll make an easy switch to M54.2 (Cervicalgia). Diagnosis M54.2 falls under the category “Other Dorsopathies; Dorsalgia.” Note that M54.2 does not apply to cervicalgia due to intervertebral cervical disc disorder. For those situations, ICD-10 directs you to the M50 (Cervical disc disorders) code family.
Question: The physician administered trigger point injections to fingers 2-5 on both the patient’s hands. He coded the procedure as 20605 x 8, but I don’t think that’s correct. What should we report?
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Many MUEs make sense, but for those that don’t, you can fight back.
By now, most practices are familiar with Medicare’s medically unlikely edits (MUEs), which CMS instituted to prevent overpayments caused by gross billing errors. On April 1, CMS updated the MUE listing, and some of your favorite codes may now be limited by the bundles. When you scour your unpaid claims, make sure you are watching for MUE denials to ensure that you’re getting paid when appropriate but that you fight back when your claims are inappropriately denied.”
Watch for retroactive pay raises, if you self-attest.
Getting a payment increase from Medicaid sounds quite appealing to most practices, and it can be a reality for some primary care providers — but don’t forget to do your part to ensure that you’ll see a rise in Medicaid payments for E/M and vaccine services this year. Follow a few quick steps to confirm that you’ll get the raise.
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Nerve conduction study (NCS) coding saw a major overhaul for 2013, requiring you to swap counting nerves for counting tests. To ensure your choice of units doesn’t run afoul of the new rules, check out the just released March 2013 CPT® Assistant. You’ll get the nuts and bolts of the procedures 95907-95913 describe, as well as clarification of what counts as a single study. And don’t miss the six different coding scenarios that help you see the rules in action.
Highlight this character for the radioactive isotope.
When you prepare to report a radiology oncology procedure, you need to pay particular attention to characters 3-6, as these specify the radiation, treatment type, modality, and radioactive isotope.
Review Your Seven Digit PCS Structure
When reporting any ICD-10-PCS code, you have seven characters. You can break them down as follows:
Character 1 Section
Character 2 Body System
Character 3 Root Type
Character 4 Treatment Site
Character 5 Modality Qualifier
Character 6 Isotope
Character 7 Qualifier
For radiation oncology services, you can focus on the first character of “D,” because “D” stands for “radiation oncology.”
Specifically, the main focus of your character selection should be the following:
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Question: We have enough details for an encounter to reach these levels:
· HPI – detailed
· ROS – complete
· PFSH – complete
· EXAM – 10 systems
· MDM – moderate.
Is this documentation sufficient to support a Level 5 E/M code for an established patient?
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You can fax or email the revalidation documents this time around.
If your gynecologist sees Medicare patients, re-enrolling your provider every few years is on your to-do list. The good news is that CMS has made improvements to the re-enrollment process, according to an Oct. 10 CMS National Provider Call with the agency’s Provider Enrollment Operations Group.”
However, don’t assume your HPSA bonus will continue.
As many practices are aware, medical offices nationwide were waiting to find out whether legislators halted a 26.5 percent pay cut that the 2013 Fee Schedule predicted, which would have brought the 2013 conversion factor down to $25.0008. In addition, practices were facing
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The CPT® trend of lumping multiple services into a single code has left many questioning whether transcatheter service claims contain too many or too few codes. Help is at hand in the just-released February 2013 CPT® Assistant. You’ll get authoritative guidance on coding catheterization in addition to thrombolysis, feel more secure choosing between primary and secondary mechanical thrombectomy codes, and benefit from coding tips for vena cava filter services, intravascular foreign body retrieval, and carotid stent placement, too.