Modifiers, not Math, Make Multi-Excision Claims Go

Posted on 15. Mar, 2010 by Editor.

Measuring total removal lengths is a no-no … here’s why.

Your ED physician removes a pair of benign lesions from the patient’s left thigh; you add the repair lengths and code based on those numbers. You’ve coded correctly … right?

Wrong: Many coders get tripped up by lesion removal codes, which are governed by different rules than lesion excision codes. Get the real lowdown on coding multiple lesion excisions right here, and you’ll get it right every time.

CPT, Experts Agree: Don’t Add Lengths

When your physician removes multiple lesions, “code for each individual lesion; this is not like laceration repairs, where you combine the length of all of the same body area/complexity wounds,” explains Sharon Richardson, RN, compliance officer at Emergency Groups’ Office in Arcadia, Calif.

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2010 CPT General Surgery Coding Update: Changes for Lap, Abdominal Repair & Hemorrhoidectomy

Posted on 30. Dec, 2009 by Editor.

Can you find codes in 2010’s resequencing mess? We show you how.

Reporting your general surgeon’s service with an unlisted code means more documentation work and a payment guessing game — that’s why you’ll welcome CPT 2010’s more specific codes.

General surgery can get all the details at this on-demand, specialty-specific audio update. But we won’t keep you in complete suspense. Here’s a peek at what you’ll learn in the audio.

Capture Large Abdominal Repairs With New Code

When your general surgeon repairs a large abdominal wall defect, you didn’t have a way to report the work — until now.

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The ASC Coder’s Resource Guide for 2010

Posted on 12. Dec, 2009 by Editor.

Here’s a quick, handy way to get to all of Medicare’s new rules and reimbursement rates

Ambulatory surgery center coders have a lot to learn for 2010, stressed Joanne Schade-Boyce at the ASC 2010 Coding & Reimbursement Update in Orlando.

It’s absolutely essential that ASC coders study the AMA’s CPT Changes this year, Schade-Boyce recommended. Why? Because CPT 2010’s wacky resequencing affects codes many ASC coders use a lot. Checking out Appendix M and Appendix N of your CPT book will also help you get a handle on the resequenced codes.

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CPT 2010 Code Selection Chart for Paravertebral Facet Joint Injections

Posted on 10. Dec, 2009 by Editor.

CPT 2010 introduces a slew of new codes for paravertebral facet injections, so why not consult our handy flow chart to help you select the correct code?

© Neurology Coding Alert. To read the full article on the new facet joint injection codes for 2010, download your 2 FREE sample issues here.

Was it painful for you to miss the 2010 Pain Management Coding & Reimbursement Conference? Get CDs or MP3s of sessions from Joanne Mehmert, Marvel Hammer & more!

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Facet Joint Injection Coding for 2010

Posted on 08. Dec, 2009 by Editor.

Marvel Hammer’s Quick Start Guide to changes you’ll face in 2010.

Tons of pain management coders gathered at the Orlando conference this week, and everyone was abuzz about the coding changes the painful reimbursement cuts their practices are going to get next year.

Some big news: Effective January 1, 2010 radiological imaging will be required and bundled for facet joint injections, confirmed instructor Marvel Hammer.

Old way: CPT 2009 used to ask us to separately report radiological imaging for needle placement (1 unit per spinal region for these codes):

77003: Fluoroscopic guidance for needle placement

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CPT 2010 Update: Tally Up Common Audiology Code Groups Into Single Codes

Posted on 06. Dec, 2009 by Editor.

Plus, add this new tympanometry code to your cache next year.

One of CPT 2010’s initiatives is to move several codes typically performed together into one code. Check out these new audiology testing codes and understand the rationale before Jan. 1 hits.

For instance, if your physician performs a vestibular evaluation in 2010, you will report new global code 92540 (Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of four positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording,and oscillating tracking test, with recording).

Note the code descriptor describes “four different things are being done, with recording,” says Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC, president of CRN Healthcare Solutions.

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Celebrate CT Colonography’s 2010 Move to Category I

Posted on 01. Dec, 2009 by sanjay.aikat.

But don’t assume the new codes will yield improved fees.

Virtual colonoscopy coverage may be a mixed bag, but the AMA showed some confidence in the service by moving its codes from temporary Category III status to full-fledged Category I in 2010.

The switch from Category III to Category I does offer some hope of better reimbursement in the future, says Rhonda Townley, CPC, with University Radiology in Knoxville, Tenn. But don’t make assumptions.

For example, you should continue to check and follow coverage policies for Medicare beneficiaries, she warns. Medicare’s current policy is noncoverage, as announced in its “Decision Memo for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer” (CAG-00396N).

Watch Contrast Use for Diagnostic Test

The details: CPT 2010 deletes 0066T (Computed tomographic [CT] colonography [i.e., virtual colonoscopy]; screening) and 0067T (… diagnostic). But in their place, you’ll have the following 3 codes:

• 74261 — Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material

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Urology CPT 2010: 3 New Codes, 2 Deletions Change Your Urodynamics Coding

Posted on 22. Nov, 2009 by Editor.

Urodynamics income will go down by half, experts calculate.

You will have three new urodynamics codes to learn starting Jan. 1. CPT 2010 adds the following codes:

• 51727 — Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique

• 51728 — … with voiding pressure studies (ie, bladder voiding pressure), any technique

• 51729 — … with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique.

To make room for these three new codes, the AMA deleted urodynamics codes 51772 (Urethral pressure profile studies) and 51795 (Bladder voiding pressure studies). “To reduce costs and payments, CPT combined several of the urodynamic codes into one of several new codes,” says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York in Stony Brook. “So doctors will not be able to bill each individual urodynamic procedure as they have in the past.” What you must know about +51797 …

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AMA Symposium Report: Low-Level Consult Reporting in 2010

Posted on 18. Nov, 2009 by jennifer.godreau.

Hey, Coding News readers! It’s your turn to weigh in on the consult controversy.

Question: What should you do for Medicare 2010 coding if an inpatient consult on a patient’s initial hospital day does not support 99221?

Answer: Kenneth Simon, MD, MBA, FACS, CMS, senior medical officer at the CPT symposium was very adamant that you would have to use 99221. When questioners kept asking “But how could you use 99221 if the documentation didn’t support that level?” he continued to say, “On day 1, use 99221-99223.” His blunt repetition angered many attendees.

Ken, however, based his idea on data that Medicare used for the consult elimination that indicated most consult are coded as high-level consult. Therefore, he seemed to think the low levels would not be problematic.

How many of you currently are using low level consults (99251, 99252)? Let us know in a reply to this question.

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PQRI: No Coumadin Due to Fall Risk

Posted on 13. Nov, 2009 by jennifer.godreau.

Plus, experts at the AMA meeting in Chicago tell you what to do if you can’t get H1N1 vaccine for PQRI Measure 110 or other vaccine measures.

Question: My internist decided not to put a patient on Coumadin because the patient has a higher risk of falling than from having a stroke. Our group participates in PQRI easure 33 for risk of clotting. How can I indicate performing the measure wasn’t appropriate so that the physician isn’t penalized for not prescribing the anti-blood clotting medication?

Answer: You should report the measure and append the denominator exclusion indicator 1p. This indicator shows the physician chose not to prescribe the drug due to the art of medicine, or factors that make performing the measure not clinically appropriate.

If, however, the internist prescribed Coumadin but the patient isn’t taking it because she can’t afford the medication, you instead would use 2P. Your group can then have the patient referred to a social worker to help the patient figure out her financial hardship and find a way to obtain the medically necessary drug.

The third denominator exclusion in this group is 3p, which shows the medication was not available. Read on to learn what to do when you can’t get H1N1 vaccine supply …

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