Tag Archives: neurology
CPT 2010 Code Selection Chart for Paravertebral Facet Joint Injections
Posted on 10. Dec, 2009 by .
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.
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Can a Sleep Study Code Describe an Awake Test?
Posted on 29. Nov, 2009 by sanjay.aikat.
Question: A sleep study was ordered for a patient diagnosed with hypersomnolence. The neurologistincluded a multiple wake test in the sleep study. What CPT code should I use for the multiple wake test?
Answer: You should use 95805 (Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness). Code 95805 is the only sleep study code (95803-95811) that mentionswakefulness testing. Check if you need a modifier on 95805.
Sleep services codes (95805-95811) include recording, interpretation, and report. For cases when the neurologist does only the interpretation, use modifier 26 (Professional component) on the sleep study code.
All sleep studies must have a minimum of six hours. If the sleep study does not last that long, append modifier 52 (Reduced services) to your code.
The multiple wake test measures the patient’s ability to stay awake during a time when she is normally awake. During the wakefulness test the physician or technologist records the time it takes the patient to fall asleep during a course of four to five 20-minute nap opportunities provided during the testing period in the sleep lab.
The patient does not need to be asleep during the tests.
© Neurology Coding & Reimbursement. Download your 2 free sample issues here.
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Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010
Posted on 29. Oct, 2009 by .
Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready for a facet joint codes shift that preps for ICD-10.
The 2010 version of CPT attempts to organize the facet joint injection codes by deleting 64470-64476 and debuting 64490- 64495 in their place, as follows:
• 64490 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level
• 64491 — … second level
• 64492 — … third and any additional level(s)
• 64493 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level
• 64494 — … second level
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ICD-9 2010: More Coding Options for Brain Injury
Posted on 12. Aug, 2009 by .
Check out V80.01 and V80.09 for special screenings.
The newest edition of ICD-9 changes goes into effect Oct. 1, so adjust your system to reflect some new diagnosis codes for special neurological screenings — and one that’s about to become invalid — to be sure your claims stay on par.
Extend ‘Other Conditions’ Dx From 348.8 to 348.89
Diagnosis 348.8 (Other conditions of brain) will be invalid starting Oct. 1, but ICD-9 2010 introduces a new fifth-digit replacement: 348.89. The descriptor remains the same, so you’ll be able to use it for the same circumstances as 348.8.
“I seldom used 348.8 because I do mostly surgery coding and use the final pathology report for diagnoses,” says Kathryn Gemmell, RHIT, in the physician coding department of Luke’s Hospital in Bethlehem, Pa. “Something like calcium deposits on the brain or brain death could be coded to 348.89.” You might also turn to 348.89 to show a brain problem not identified with a specific ICD-9 code, Gemmell adds.
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MS-Related Dysphagia ICD-9 Coding That Gets You Paid for NMES, TENS, DPNS
Posted on 12. May, 2009 by .
Considering the close relationship between difficulty swallowing and multiple sclerosis (MS), you should get a handle on coding dysphagia in order to support medical necessity NMES, TENS, DPNS.
The swallowing disorder (dysphagia) that many MS patients experience is far more frequent than expected, according to doctors reporting in the December 2008 journal Neurological Sciences. Dysphagia, difficulty with swallowing, is considered a dangerous condition from its onset because of its potentially serious complications, the physicians report.
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Map Dysphagia Dx to Specific Type If Known
“If a person complains to his doctor about any type of swallowing problem, the first thing that is usually recommended is a swallow evaluation by a speech-language pathologist (SLP),” says Christine Lundblad, MA, CCC-SLP, a speech-language pathologist at Promise Hospital in Phoenix. “We are the ones who actually diagnose dysphagia, determine what type (oral, pharyngeal, or oropharyngeal) and develop a treatment plan.”
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Nerve Conduction Study Coding Tip
Posted on 03. Mar, 2009 by .
Did you know that new medical devices are opening doors for more specialties to perform nerve conduction studies?
The bad news: Coding and billing for these studies hasn’t gotten any easier, and there’s some bad coding advice floating around from some medical device companies that’s leading some coders astray.
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Get Those Injections Paid: 4 Tips for Peripheral Nerve ICD-9 Accuracy
Posted on 19. Feb, 2009 by .
350.1 or 729.2? Here’s where your doctor’s terminology will throw you off track.
You are coding a peripheral nerve procedure performed by your neurologist, but her documentation mentions only the trigeminal nerve — a type of cranial nerve. Do you know the right diagnosis code? Clear up any diagnosis code confusion with these inside secrets.
Marvel Hammer’s Pieces & Parts: Must-Know Anatomy Coding Tips for Office-Based Injections.
Tip 1: Note Differences In Physician’s/Coding Terms
The nervous system is divided into two parts: the central nervous system (or CNS), which consists of the brain and spinal cord; and the peripheral nervous system (or PNS), which consists of spinal nerves and cranial nerves.
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