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Fee Schedule Update Offers Bilateral Pay Boost for 10 Procedures

Posted on 11. Mar, 2013 by .

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In the Q2 updates to the Medicare Physician Fee Schedule, CMS offers payment boosts for several procedures, including catheter placement and cardiac Doppler monitoring. Although the Q2 updates have an official implementation date of April 1, many of the changes are effective retroactive to Jan. 1, 2013.

 Bilateral Boosts

 You’ll now be able to collect more when you perform selective catheter placement (36222-36228) bilaterally. Previously, the bilateral procedure indicator on these codes was “0,” which meant that no additional payment was assigned when surgeons performed the procedure on both sides. However, effective Jan. 1, 2013, the bilateral indicator is “1,” so you can append modifier 50 (Bilateral procedure) and the payment amount will be 150 percent of the fee schedule RVUs.

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Part B Payment: CMS Offers Bilateral Pay Boost for 10 Procedures

Posted on 11. Mar, 2013 by .

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 Plus: G9157 is now payable under the Fee Schedule.

Not all fee schedule changes are bad news.

In the case of the Q2 updates to the Medicare Physician Fee Schedule, CMS offers payment boosts for several procedures, including catheter placement and cardiac Doppler monitoring. Although the Q2 updates have an official implementation date of April 1, many of the changes are effective retroactive to Jan. 1, 2013.

Bilateral Boosts

You’ll now be able to collect more when you perform selective catheter placement (36222-36228) bilaterally. Previously, the bilateral procedure indicator on these codes was “0,” which meant that no additional payment was assigned when surgeons performed the procedure on both sides. However, effective Jan. 1, 2013, the bilateral indicator is “1,” so you can append modifier 50 (Bilateral procedure) and the payment amount will be 150 percent of the fee schedule RVUs.

The same good news awaits for codes 23000 (Removal

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Reader Question: Provider-Neutral Language Shouldn’t Impact Too Harshly

Posted on 11. Mar, 2013 by .

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Question: Does our practice need to make any changes to our systems to accommodate the fact that CPT® 2013 changed so many descriptors from “physician” to “other qualified health care provider?”

Answer: The most widespread changes throughout CPT® 2013 — the switch to more inclusive or provider-neutral language — shouldn’t be difficult for physician practices to put into place.

“The concepts are pretty straightforward,” said Richard Duszak, Jr., MD, an AMA CPT ® Editorial Panel member and practicing radiologist, during his presentation at the American Medical Association’s (AMA) annual CPT® and RBRVS Symposium, held Nov. 14-16 in Chicago. “There’s been an evolution in CPT® for how codes report services by non-physicians.”

Result: Hundreds of codes were revised for 2013 to include “provider neutral language.” Codes throughout the book have replaced designations of “physician” with “individual” or “qualified health care provider.”

 Exception: A few codes retained the “physician” language, such as those related to skilled nursing facility admissions, because regulations require…

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Visual Fields: Don’t Pick Intermediate VF Code When Extended Code Is Justified

Posted on 11. Mar, 2013 by .

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Choosing between 92082 or 92083 can be tricky – let our expert advice guide you.

Even small practices are likely to have a Humphrey visual field analyzer, yet many ophthalmologists don’t know the secrets for securing adequate reimbursement for these services — and they even go so far as to put themselves at risk for costly audits due to lack of documentation.

Stop Shortchanging Yourself With Intermediate Codes

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Diagnostic Tests: Hone How You Report Hemoccult Tests With This Expert Advice

Posted on 26. Feb, 2013 by .

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Why, who, and where work hand-in-hand to point you to the right code.

If you want to keep the dollars flowing for in-office examination of fecal occult blood test (FOBT), you should focus on the difference between three hemoccult codes and their purpose.

Consider the following scenario:

A patient presented in the ob-gyn office complaining of diarrhea preceded by intestinal cramping, which lasted a couple of weeks. The patient is 60 years old and has no history of cancer in the family. She also didn’t feel nauseous at all. The physician took a stool sample to test for both parasites and blood. How should you tackle this?

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Take Advantage of This CPT Assistant Thyroidectomy Crash Course

Posted on 25. Feb, 2013 by .

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ENT coders will approach tough thyroidectomy coding challenges with confidence after reading the feature article in the December 2012 CPT® Assistant. This just-published issue is chock-full of anatomy insights, key term definitions, and modifier tips to take your thyroidectomy and parathyroidectomy coding to the next level. You’ll even get a better understanding of when +60512 is separately reportable so you can capture every dollar without worrying about refund requests.

Easily find the definitive guidance you need to combat denials and ensure correct coding with a quick search of AMA’s CPT® Assistant on SuperCoder.com. You can locate the articles on correct CPT® code usage in the December issue by searching for the indicated codes:

  • Abdominal paracentesis and peritoneal lavage: 49082-49084, 76705, 76942, 77002, 77012, 77021
  • Island pedicle flaps: 13101, 13102, 14000-14302, 15002, 15570-15650, 15731-15740
  • Temporalis fascial graft: 69631
  • Thyroidectomy and parathyroidectomy: 38724, 60210-60271, 60500-60512.

You also don’t want to…

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Dodge Denials with CPT↔ICD-9 CrossRef – Now Part of Coding Solutions!

Posted on 13. Feb, 2013 by .

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Many SuperCoder.com subscribers asked for an ICD-9 to CPT® crosswalk and SuperCoder’s new CPT↔ICD-9 CrossRef fulfills that need with a standalone dual-entry tool plus CPT code suggestions on ICD-9 code details pages. Coders and billers can avoid the top denial reason by checking if an ICD-9 code matches the reported CPT® code and vise versa.

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CCI Edits: Say Good-Bye to Reporting Anesthesia With Needle EMGs

Posted on 13. Feb, 2013 by .

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Plus: Pay close attention to modifier indicators in CCI 19.0.

The first round of Correct Coding Initiative (CCI) edits for each year is usually the most extensive, and CCI 19.0 effective January 1, 2013, is no exception. We’re here to highlight a few things from the more than 2,050 edits that involve anesthesia codes so you can continue submitting accurate claims for your provider’s services.

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Discover Documentation Hot Spots for Updated Chest Tube Codes

Posted on 22. Jan, 2013 by .

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 Technique, technique, technique! The just-published November 2012 CPT® Assistant highlights procedural technique as your key to interpreting 2013’s thoracentesis and tube thoracostomy codes. This issue’s collection of clinical examples will help you cut through the confusion so you can capture the correct code for your chest case.

 You can pinpoint the official guidance you need from AMA’s rel=”nofollow”>CPT® Assistant with a quick search on SuperCoder’s rel=”nofollow”>Code Connect.  Find the articles in the most recent issue by keying in the codes below into the code search box on Code Connect or any code search box and looking under the Code Connect tab:

   Bronchospasm provocation and spirometry: 94010, 94070, 95070, 95071, 99070

  • Eye paracentesis, anterior chamber: 65800-65815, 66020, 66030, 67500, 67515, 68200
  • Nervous system testing, autonomic: 93660, 95921-95924, 95943
  • Pleural drainage, thoracentesis, and thoracostomy: 32551, 32554-32557, 75989, 76604, 76942, 77002, 77012, 77021, 99143-99145

For answers to even more coding puzzles,…

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V84 to Z15: Don’t Expect Big Changes for Genetic Test Results

Posted on 10. Jan, 2013 by .

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Follow one-to-one crosswalk.

Despite a major CPT® revamping of genetic test codes (see “81200-81479: Get Ready for Molecular Pathology Overhaul” in this issue), you won’t see a similar change for reporting those test results when you change to ICD-10 on Oct. 1, 2014.

In fact, you can expect a direct crosswalk of a few ICD-9 codes to ICD-10 for reporting a limited number of molecular pathology test results.

 Don’t Identify Gene

ICD-9 provides the following limited codes to report some genetic test results:

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