Use 3 CPT, Modifier, and ICD-9 Code Pairs to Ace This X-Ray Claim

Posted on 24. May, 2010 by Editor.

Decipher why you should include a seconding diagnosis.

Question: A 38-year-old patient presents to the emergency room with complaints of wheezing, coughing, and trouble catching her breath. After the nonphysician practitioner (NPP) performs a problem-focused history, the physician performs a detailed history and exam and discovers focal ronchi. The physician orders a two-view chest x-ray to check for upper respiratory infection (URI) The chest x-ray results reveal acute URI, and the ronchi clears up upon reevaluation. The patient is treated with antibiotics. How should I code this scenario?

Answer:

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Use Shared Visit to Capitalize on NPP/Physician Teamwork

Posted on 25. Mar, 2010 by Editor.

Forget about incident-to in the facility, but consider this similar billing technique.

ED coders that have never heard of “incident-to” billing have nothing to worry about, as you cannot code for “incident-to” services in the hospital. Coders that don’t understand shared visit billing, however, could be costing their ED practices.

Follow this advice on the “what’s” of shared visit billing.

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Migraine ICD-9 Codes: How Do I Get My 5th Digits Right?

Posted on 18. Feb, 2010 by Editor.

Discover what the 5th digit represents and why you need it on your claim.

Question: A presents to the ED with complaints of a headache that’s worsening daily. He is experiencing visual blurring and nausea but no vomiting. This is the third headache of this nature in three weeks, and it has lasted “four or five days.” Documentation indicates a detailed examination and history; after performing the assessment and speaking to the patient, the physician documents migraine with typical aura and status migrainosus Treatment options include acute intervention with prescription, but the physician feels the patient needs to add prophylactic medicine treatments, since the headaches appear to be reoccurring. What migraine ICD-9 code represents this patient’s headache?

Tennessee Subscriber

Answer: This sounds like a migraine with status migrainosus. On the claim, report the following:

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How Do I Code a 2-Sided Nosebleed?

Posted on 19. Jan, 2010 by sanjay.aikat.

Heads up: 2 nosebleed codes are not the answer.

Question: A patient reports to the ED after sustaining injuries during a soccer match; she was hit in the face with a ball, her nose is bleeding, and her right eye is blackened. The physician is not able to stop the bleeding with ice or pressure, so she performs repeated and extensive cautery using a silver nitrate stick on both nostrils. The bleeding relents, and the physician orders an x-ray to ensure that the patient’s nose is not broken.

Results are negative. Notes indicate a level-four E/M. Can I report 30903 x 2, since the physician stopped bleeding in both nostrils? No, you’ll report this under bilateral procedure guidelines. On the claim, report the following:

Answer: No, you’ll report this under bilateral procedure guidelines. On the claim, report the following:

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PQRI 2010: Tips That Boost Your Practice’s Revenue

Posted on 10. Jan, 2010 by .

Follow our links and advice to put more plusses in your claims column

Back again for 2010 is Medicare’s incentive-driven physician quality reporting initiative (PQRI), aimed at tracking quality metric or patient care services that physicians provide. When the practice treats enough patients in the same category, some PQRI dollars might be only a few codes away.

If you know the basics and focus your efforts, PQRI reporting can be a breeze and a boon to your bottom line. Check out this rundown on “The Whats?” of PQRI.

What’s In it for Me?

Coders can garner an extra payout for PQRI-eligible patients that your group treats and you code correctly; for 2010, Medicare will fork over a 2 percent bonus if you meet certain criteria.

Lowdown: In order to qualify for the PRQI bonus, you have to report on at least three of 179 PQRI measures in 80 percent of the eligible cases, explains Alice Marie Reybitz, RN, BA, CPC, CPC-H, CHI, a healthcare coding and billing consultant based in Belleair, Fla.

What Extra Coding Work Is Involved?

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