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February 2013 CPT® Assistant Reveals Missed Catheterization Coding Opportunities

Posted on 23. Apr, 2013 by .

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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.

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News: Code Search Result’s Color Identifies Keyword-Code Mapping Source

Posted on 10. Apr, 2013 by .

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News: Code Search Result’s Color Identifies Keyword-Code Mapping Source

If you’ve ever wondered where a code suggestion for a keyword came from, SuperCoder’s new color-coded search results reveal the definitive source. In SuperCoder’s Code Search box [Keyword tab], when you enter a keyword that exists in a codeset’s index, the index’s suggested codes appear in purple and red. Additional codes suggested by SuperCoder’s extensive Keyword to Code Correspondence Helper (KECH) appear in blue and green. Often, the first code entry suggestion will be in purple and red meaning the result from the code book index and KECH match.

The color coding’s pinpointing of the definitive source helps you:

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Latest CPT® Assistant Dishes Up Details on 2013 MPFS

Posted on 08. Apr, 2013 by .

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Whether you’re concerned about Multiple Procedure Payment Reduction changes or want to dig in to group practice electronic prescribing rules, the first 2013 issue of CPT® Assistant has what you need. This issue takes on the 2013 Medicare Physician Fee Schedule (MPFS) presenting the must-know highlights from the massive final rule. Molecular pathology and percutaneous coronary intervention coding updates, Physician Quality Reporting System (PQRS) payments, value-based modifier news, and fee calculation insights are just some of the hot topics featured in this MPFS roundup.
 
A quick search on…

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Medicare: Add to Your Add-On Code Savvy Using 3 CMS Tables

Posted on 08. Apr, 2013 by .

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CCI takes note of these tables. Shouldn’t you?

CPT® doesn’t designate primary codes for every add-on code, but CMS offers a few clues in Transmittal 2636, Change Request 7501, effective April 1, 2013.

Background: An add-on code reports a service that is “always performed in conjunction with another primary service. An add-on code is eligible for payment only if it is reported with an appropriate primary procedure performed by the same practitioner. An add-on code is never eligible for payment if it is the only procedure reported by a practitioner,” states the Transmittal. “Rarely contractors may allow with appropriate submitted documentation, either pre-pay or on appeal, payment for a primary code and add-on code on two consecutive dates of service if the services are appropriately related.”

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You’re Saved From 26.5 Percent Physician Pay Cut

Posted on 08. Apr, 2013 by .

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But RVU changes still in effect.

Optometrists can expect a reprieve from the dreaded 2013 pay cut to the Medicare Physician Fee Schedule (PFS). Congress voted to halt the 26.5 percent rate cut that was tied to the sustainable growth rate (SGR) formula.

rel=”nofollow”>Physician Coder Though pay cut have been halted for now, getting the deserved reimbursement has become all the more important. Enhance your coding proficiency with Physician Coder- get latest coding changes, fee schedules, earn CEU’s and more! rel=”nofollow”>Click here to buy.

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Beware: Don’t Automatically Use 44705 for Fecal Bacteriotherapy

Posted on 25. Mar, 2013 by .

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Hint: Use additional code for instillation when reporting 44705

If your gastroenterologist performs fecal bacteriotherapy as a treatment for Clostridium difficile infections, don’t forget to look at payer policies before you report the assessment and preparation of the fecal microbiota sample with the newly introduced CPT®code 44705.

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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

rel=”nofollow”>Ophthalmology Coder 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. Now there’s an easy way out with Ophthalmology Coder – at just 49.95 a month! rel=”nofollow”>Click here to buy.

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