Ask the Expert Articles
Below is a complete listing of all Ask the Expert articles that have appeared in JustCoding News.
March 8, 2011
QUESTION: We have a patient that was seen in the emergency department (ED) and the physician ordered a Holter monitor for seven days. May we report CPT® codes 93224–93227 for each of the seven days separately? For example, would we report 93225x7 (external electrocardiographic [EGC] monitor recording up to 48 hours by continuous rhythm recording and storage; recording) and 93226x7 (EGC monitor recording up to 48 hours by continuous rhythm recording and storage; scanning analysis and report)?
February 28, 2011
QUESTION: We have different views in our coding department for how to code a coccyx pressure ulcer. Various staff members say that we should report one of the following ICD-9-CM codes:
- 707.03 (pressure ulcer of the lower back [coccyx, sacrum])
- 707.05 (pressure ulcer of the buttock)
- 707.09 (pressure ulcer of other site)
In my view, code 707.09 is correct, as the coccyx is the bone between the buttocks. Your help is greatly appreciated.
February 22, 2011
QUESTION: I have two questions about Unna boots. Can we bill two Unna boots on the same day? If so, do we need to use a modifier? Also, can we bill CPT® code 97602 (nonselective debridement, wound assessment, and instructions for ongoing care) and CPT code 29580 (application of an Unna boot) on the same day? If so, do we need to use a modifier?
February 15, 2011
QUESTION: A 59-year-old man with metastatic lung cancer presents for an electroencephalogram (EEG) in the office with a diagnosis of status epilepticus. For the diagnosis, I reported the following codes:
- 345.3 (status epilepticus not otherwise specified)
- 197.0 (secondary malignant neoplasm of the lung)
- 199.1 (malignant neoplasm without specification of site, other)
I was advised to report codes 345.3, 162.9 (malignant neoplasm of bronchus and lung, unspecified), and 199.1. But shouldn't I code the metastatic lung cancer as a secondary neoplasm?
February 8, 2011
QUESTION: A non-Medicare patient was seen for a migraine and received two injections. Can we bill an administration charge (CPT® code 96372) along with the evaluation and management (E/M) code?
February 1, 2011
QUESTION: Could you explain how we will report a total hip replacement using ICD-10-PCS?
January 25, 2011
QUESTION: What is the Gustilo-Anderson classification of fractures and why is it important for ICD-10 coding?
January 18, 2011
QUESTION: Can you define "ventilator dependent"? Does it refer to long-term dependence or can it also refer to short-term situations (e.g., failed weaning parameters, brain injuries/strokes, or trauma)?
January 11, 2011
QUESTION: Can you provide clarification on the drugs that cannot be charged during a procedure, for example when staff give a patient CPR in the emergency room. Usually my department codes the medication given during CPR. Is there a website that describes which drugs cannot be picked up before, during, after a procedure?
January 4, 2011
QUESTION: A consultant recently suggested that if we ask a physician to clarify systolic/diastolic on a query form for congestive heart failure (CHF), it might be construed as leading the physician if there had been no previous mention of systolic/diastolic anywhere else in the chart. We never place a query unless the physician states CHF in chart, but we query for it if the physician does not specify the type. If we include the phrases systolic/diastolic on the query form, is that considered introducing new information?