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Office E/M + Inpatient Admission = One Code

Occasionally, a physician may see a patient in the office and send that patient immediately to the hospital for admission. In such a case, you may consider the history and physical (H&P) taken in...

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Split Billing Is Risky Business

Danger is imminent if the chief complaint and unique documentation don’t support separately billed services. An example of so-called “split billing” is when the provider performs a physical exam and...

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Visit the Facility Side of ED Coding

Improve your coding acumen by understanding the differences between ED facility and ED physician coding. When coding for the emergency department (ED), there are differences in how facility and...

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Skin Lesion Excisions

Three answers in the report will help you piece together the coding puzzle. To accurately code for excision of a skin lesion, you need to be able to extract from the documentation the answers to three...

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Omental Pedicle Flaps

Recognize the procedure, learn about it, and code it right. It isn’t uncommon for one or two lines to be buried within an abdominal surgery operative report documenting a procedure involving the...

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Q&A: Selecting a Follow-up Excision Code

Question: A patient had a biopsy done at another facility by a different provider. The biopsy showed squamous cell carcinoma, and our dermatologist performed a further excision to obtain clear margins...

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CMS Proposes “One Code Fits All” for ED and Hospital Outpatient

By Jim Strafford, CEDC, MCS-P The Center for Medicare & Medicaid Services (CMS) has proposed a landmark change to emergency department (ED) and Clinic Facility coding methodology. If enacted, the...

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Observe Documentation Requirements for Proper Modifier 62 Reimbursement

If two surgeons act as co-surgeons, they must likewise coordinate their documentation and billing to ensure that each receives proper reimbursement. When two surgeons work together to perform distinct...

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AMA Releases CPT® 2013/2014 Errata

The American Medical Association (AMA) released, Nov. 11, errata and technical corrections updates for CPT® 2013 and 2014. To ensure accurate medical coding, you will need to update your codebooks with...

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Canalith Repositioning/Epley Maneuver Update

Question: Our therapist recently saw a patient for whom she performed an Epley maneuver for the treatment of benign paroxysmal positional vertigo (BPPV). In researching how to code for this, I came...

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Proper Coding for Tissue Adhesives

Tissue adhesives, such as Dermabond®, may be used alone or in combination with other methods (e.g., sutures or staples) for laceration repair or to close surgical wounds. The adhesive is applied...

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CMS Adopts “One Code Fits All” for Hospital Clinic Visits

This past summer, the Center for Medicare & Medicaid Services (CMS) issued notice that it was considering a radical change for emergency department (ED) and hospital clinic evaluation and...

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Essentials of CMS’ New “Two Midnight” Rule

As part of the 2014 Inpatient Prospective Payment System (IPPS) final rule, the Centers for Medicare & Medicaid Services (CMS) redefined the meaning of “inpatient” vs. “outpatient” in the facility...

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Modifiers 25 and 57: A Quick Lesson

When a patient is seen for a new condition/diagnosis and a procedure is rendered that day, you should report the evaluation and management (E/M) visit with modifier 25 Significant, separately...

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Open Vs. Closed Fracture Care

Open fracture care is reported when the provider creates an opening to expose the bone to treat the fracture. Open fracture care is not performed in the emergency department; instead, the patient is...

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Straight Up Coding for Sacroiliac Joint Injections

Proper reporting requires modifier and radiological guidance knowledge.  by Thangaraj Arunachalam, CPC Sacroiliac (SI) joint injection, or SI joint block, is used primarily either to diagnose or to...

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Cure What Ails Your Physician Documentation

Three common cases illustrate how to match presenting problems with documentation and coding. Providers are in the midst of the hustle and bustle of cold and flu season. To meet the challenge with a...

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Medical Necessity Audits Rise for Hospitals and Physicians

Be sure providers are aware of medical necessity criteria and DRG 470 reviews. In March 2013, Noridian Healthcare Solutions introduced an especially challenging service-specific probe review of...

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PILD for LSS Remains Non-covered Under Medicare

In a decision memo released Jan. 9, the Centers for Medicare & Medicaid Services (CMS) announced its national coverage determination for percutaneous image-guided lumbar decompression (PILD) for...

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CPT 97610 Makes the “Sometimes Therapy” List

Replacing Category III code 0183T, new CPT® medicine code 97610 Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and...

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