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New Code Woes, Old Code Deaths, and Payment Celebrations

Posted on 20. Nov, 2012 by .

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 Day 2 of the AMA Symposium gave rundowns of 2013 changes for neurology, cardiothoracic surgery, and pathology. Read on for some top predictions and black-and-white facts.

 “There’s going to be gnashing of teeth over the new chemodenervation codes,” Gregory L. Barkley, M.D., predicted when referring to new code 64615. “Providers have been used to reporting multiple codes when they treat different nerves during an encounter, but the new code changes that. Providers will take a big hit for that.”

Code Search  2013 code overhauls giving you jitters? Stay up to date on the latest code changes for neurology, cardiothoracic surgery, and pathology with SuperCoder’s Code Search. Get it Now.

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AMA 2013 CPT® and RBRVS Symposium: 5 Need-to-Know Points for MPPS Changes in 2013 and Beyond

Posted on 19. Nov, 2012 by .

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 If you’re wondering what the most important changes are for the 2013 Medicare Physician Payment Schedule (MPPS), look no further. Kathy Bryant, deputy director of the department of physician services at CMS, gave a rundown of salient points at the AMA’s annual CPT® and RBRVS Symposium in Chicago. Here are five that apply to the majority of providers:

 Payment rates: Medicare rates are scheduled to take a 26.5 percent hit in 2013 unless Congress takes action to avert the cut. “The President’s budget calls for an aversion of the cut and a permanent fix,” Bryant told attendees. “They seem to be working on it, but we haven’t heard yet where it’s going.”

rel=”nofollow”>Part B Coder Need to stay up-to-date on the MPPS changes for 2013? Let Part B Coder keep you focused on MPPS changes and

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AMA 2013 Annual Symposium: Attendees Ask for CMS Answers to EHR Upcoding Glitches

Posted on 19. Nov, 2012 by .

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The AMA’s 2013 CPT® and RBRVS Symposium kicked off on November 14, with attendees demanding answers to widespread problems with electronic health records (EHR) systems.

“I’m bringing back an issue that was asked about during this meeting last year and we were told that some things would be put in place to correct problems,” one attendee said during an open Q&A time. “And that issue is: CMS is giving a two-sided message regarding electronic records. You offer incentives for physicians to purchase electronic systems for meaningful use, yet those systems are promoting inaccurate E/M levels that lead to inaccurate billing.”

TCI’s Chart Auditing Service Electronic systems can overcode E/M visits, leading to problems internally and beyond. But you can stay away from EHR glitches with TCI’s Chart

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Compliance: 88305: Is 4 the New Prostate Biopsy Maximum for Medicare?

Posted on 12. Nov, 2012 by .

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Palmetto GBA policy sets the tone.

“I’m concerned that payers may interpret the NCCI Policy Manual to be distinguishing 88305 vs. G0416-G0419 on sample number alone,” states William Dettwyler, MTAMT, president of Codus Medicus, a laboratory coding consulting firm in Salem, Ore.

That’s what we published earlier this year in “Mark 5 Prostate Biopsies as the Magic Cutoff for 88305″ (Pathology/Lab Coding Alert Volume 13, Number 5). Now it seems that the concern is becoming reality.

That was Then – 88305 x 10

In 2009, CMS implemented HCPCS Level II codes for pathology exam of specimens from a prostate saturation biopsy (55706 – Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance), which often yields 20 or more specimens, as follows:

  • G0416 – Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling; 1-20 specimens
  • G0417 – … 21-40 specimens
  • G0418 – … 41-60 specimens
  • G0419 –

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CPT® 2013: 32555 and 32557 Promise a Simpler Path to Pleural Aspiration and Drainage Coding

Posted on 12. Nov, 2012 by .

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Catheter aspiration will have an obvious code choice.

The preliminary list of CPT® 2013 code changes is out, and you may be glad to have some extra time to prepare. There are numerous changes affecting radiology, starting with new ways to report thoracentesis and pleural drainage.

Keep in mind, these changes aren’t yet final, so they may change before the codes become official this fall.

rel=”nofollow”>Code Search Next year you’ll have new ways to report thoracentesis and pleural drainage. Be the first to get code updates as 2013 CPT Code Changes are now live on SuperCoder’s Code Search. rel=”nofollow”>Click here to buy.

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Power Up for Prolonged Service Claims Using Latest AMA Guidance

Posted on 22. Oct, 2012 by .

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If you’ve got prolonged service E/M questions, you certainly aren’t alone. Luckily, authoritative answers are now available in the just released August 2012 rel=”nofollow”>CPT® Assistant. Once you understand why the AMA deleted “face-to-face” from 99358-99359, you can be confident your claims will stand up to payer scrutiny.

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CMS Coverage: 0256T-0259T Decision Memo Is a Must-Read for TAVR Practices

Posted on 10. Oct, 2012 by .

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These services may get their own set of Category I codes in 2013.

Practices performing transthoracic aortic valve replacement (TAVR) have some work to do to see if they meet Medicare’s strict requirements for coverage with evidence development (CED).

rel=”nofollow”>Cardiology Coding Alert TAVR is not covered for patients in whom existing co-morbidities would preclude the expected benefit from correction of the aortic stenosis. Gear up for new codes to code correctly for TAVR procedures and stay compliant with this monthly newsletter. rel=”nofollow”>Click here to buy.

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CPT® 2013: CCI Past Is Seen in 64561’s Future

Posted on 01. Oct, 2012 by .

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 Avoid separately reporting 76000 or 77002.

Not all of the coding changes for next year involve new codes. You should pay close attention to code descriptor revisions as well. Of note, CPT® 2013 alters the wording for 64561. Take a look at the change to ensure you don’t inaccurately report this neurostimulator code.

rel=”nofollow”>SuperCoder’s CCI Edits Checker 233241 new edit pairs were added effective October 1, 2012, marking this as one of the biggest CCI changes ever! But you can prepare for this massive overhaul with SuperCoder’s CCI Edit Checker. rel=”nofollow”>Click here to buy.

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Coding Case: Dig Deep To Nail The Right Code For Subacromial Calcific Tendinitis

Posted on 26. Sep, 2012 by .

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Curettage and tendon repair are inclusive to 23000.

When your surgeon removes calcific deposits in the shoulder, you’ll stand a better chance of capturing full reimbursement if you’re well versed in the procedure’s complexities, which typically include cutting the muscle, incising the bursa, and curettage of the cavity to remove the damaged tissue. “It is one of the most painful conditions in the shoulder that can come on acutely without an injury,” offers Bill Mallon, MD, medical director, Triangle Orthopedic Associates, Durham, N.C.

rel=”nofollow”>SuperCoder’s CCI Edits Checker233241 new edit pairs were added effective October 1, 2012. News is your orthopedic practice will one of the hardest hit. So Get ready today with SuperCoder’s CCI Edit Checker. rel=”nofollow”>Click here to buy.

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Coding Strategies: Nail Your Proctosigmoidoscopy Coding With These 5 Easy-to-Use Tips

Posted on 14. Sep, 2012 by .

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Use appropriate modifiers to unbundle codes, when necessary.

To assess a patient with rectal hemorrhage or pain, your gastroenterologist might opt for a proctosigmoidoscopy. Since this procedure is significantly similar to a more extensive sigmoidoscopy, you will have to know how to differentiate these two procedures for accurate coding or face denials to your claims.

1. Ascertain Insertion Approach

Since proctosigmoidoscopy involves examination of the most distal portions of the sigmoid colon and the rectum, your gastroenterologist has to perform this procedure by inserting the scope through the anus. This approach differs from upper endoscopy procedures where the scope is inserted through the mouth.

For example, if the documentation reads, “Scope inserted anally,” you can be rest assured that your gastroenterologist performed a lower gastrointestinal (GI) endoscopy and not an endoscopy of the upper GI tract.

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