Proper Coding for Endotracheal Intubation
CPT® provides a single code to report endotracheal intubation—31500 Intubation, endotracheal, emergency procedure—but application of this code isn’t always straightforward. Per CPT® and National...
View ArticleDiagnostic Endoscopy Reporting Depends on Circumstances
Most experienced coders are familiar with the rule, “surgical endoscopy always includes diagnostic endoscopy.” These guidelines are outlined in Chapter I of the “General Correct Coding Policies for...
View ArticleLooking Up Code Fees Just Got Easier
Palmetto GBA has added a nifty new feature on their website that coders and billers will enjoy: a Medicare Physician Fee Schedule (MPFS) Tool. This online tool allows the user to display or download...
View ArticleCMS to Cover Colorguard Test
The Centers for Medicare & Medicaid Services (CMS) announced October 9 in a decision memo that it will cover the Colorguard™ test — a multitarget stool DNA test — as a colorectal cancer screening...
View Article2014-15 Flu Vaccine Payment Allowances
For administration of the influenza vaccine to Medicare beneficiaries, report HCPCS Level II code G0008 Administration of influenza virus vaccine. This code bypasses deductible and coinsurance amounts...
View ArticleCoding Robot-assisted Surgery
Robotic surgery is covered by routine and customary laparoscopic CPT® and ICD-9-CM coding practices, existing medical policies for advanced laparoscopic surgery, and current payer contract rates. The...
View ArticleProper Use of Modifier 91
Modifier 91 Repeat clinical diagnostic laboratory test is used to report the same lab test when performed on the same patient, on the same day, to obtain subsequent test results. Modifier 91 causes a...
View ArticleBack to Basic: All the Ways (Not) to Unbundle
Coders learn early and are reminded often to avoid unbundling, or separately reporting procedures/services that are meant to be reported together, using a single code. As the introduction of the...
View ArticleDifferentiate Venous Injection from Blood Draw
Question: Is 36000 appropriate to report venous blood draw by butterfly catheter to obtain a lab specimen? Answer: According to the AMA’s CPT® Assistant (December 2008; volume 18: issue 12), the...
View ArticleThe Right (and Left) Time to Bill Modifier 50
Modifier 50 Bilateral procedure can sometimes cause confusion because of the seemingly redundant anatomical modifiers RT (right) and LT (left). Although these modifiers may seem interchangeable, they...
View ArticleNearly 550 New, Changed, and Deleted codes for CPT in 2015
Nearly 550 new, changed, and deleted codes in a number of body systems and services for the American Medical Association’s (AMA) CPT codes and descriptions affect a number of specialties. Significant...
View ArticleED E/M Codes Quick Tips
Any provider can use the emergency department codes (99281-99285), as long as the service is provided in the ED setting. There is not a requirement for the provider to be assigned to the ED to use...
View ArticleNot All Debridements Are Excisional
Recovery audit contractors (RACs) have recouped millions of dollars for excisional debridements that weren’t really excisional, or that weren’t fully documented to support the coding reported. In CPT®...
View ArticleAccurate Coding Requires Timely Codebook Revisions
Get out your shiny, new CPT® 2015 codebooks. There are changes and corrections to be made. The American Medical Association (AMA) released, Nov. 11, an Errata and Technical Corrections document for...
View ArticleQuick Tip: Always Bundle Fluoroscopy to Endoscopic Procedures
If the provider uses fluoroscopic guidance during an endoscopic procedure, you may never report the fluoroscopic guidance separately, for Medicare payers. Per Chapter VII of the National Correct Coding...
View ArticleCoding for “Incomplete” Colonoscopy
In some cases, a provider may plan to provide a colonoscopy (screening or diagnostic) but, due to unforeseen circumstances, may not be able to complete the procedure. When reporting services to...
View ArticleReporting Unlisted Procedure Codes
You may claim unlisted procedure codes only if an existing CPT® Category I or Category III code does not describe the procedure you wish to report. Per Chapter 1 of the National Correct Coding...
View ArticleUpdate Your Codebook: AMA Releases CPT Errata
December 9, the American Medical Association (AMA) released the 2015 Errata and Technical Corrections, and some may impact how you report certain CPT® codes on claims. The most recent entries include:...
View ArticleNew and Revised Vaccine Codes for Early Release
Influenza is constantly developing new viral strains, which in turn requires the constant development of updated flu vaccines. To keep up, the AMA publishes new and revised vaccine codes twice per...
View ArticleBladder Catheters Bundle to Surgery
When coding surgical procedures, do not attempt to report separately the insertion of urinary catheters. The “National Correct Coding Initiative Policy Manual for Medicare Services” specifies, “The...
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