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    JustCoding Outpatient

    Build a foundation for coding genetic testing and screening in obstetrics and maternal fetal medicine

    February 20, 2013
    Genetic screening is often used to detect abnormal genes or possible fetal anomalies during antepartum care. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews some of the most common genetic tests and what diagnosis codes to report.
    JustCoding Outpatient

    Determine whether drug is integral to procedure before billing

    February 20, 2013
    CMS defines self-administered drugs as drugs patients would normally take on their own. In general, Medicare will not pay for self-administered drugs during an outpatient encounter or for drugs considered integral to a procedure. Kimberly Anderwood Hoy, JD, CPC, and Valerie Rinkle, MPA, explain how to determine whether a drug is integral, self-administered, or both.
    JustCoding Outpatient

    Unravel complexities of billing self-administered drugs

    February 20, 2013
    As more patients are being impacted by noncoverage of self-administered drugs, coders and billers need to know when and how to report drugs and drug administration services. Kimberly Anderwood Hoy, JD, CPC, and Valerie Rinkle, MPA, discuss the differences in how drugs are paid under Medicare Part A and Part B.
    JustCoding Outpatient

    Healthcare News: CMS announces change to Medicare claims editing

    February 20, 2013
    CMS is making a significant change to the Medically Unlikely Edits by changing the edits from line item edits to date of service edits. The change will become effective April 1.
    JustCoding Outpatient

    Q/A: Reporting a HCPCS code for medications without an LCD

    February 20, 2013
    Q: The rule our institution has followed with respect to HCPCS coded medications without a local coverage determination (LCD) is to limit prescribing to the FDA-approved indications. The question that arises is how closely do the physicians need to follow the package insert? For example, the drug basiliximab does not have an LCD and the FDA indication is: For acute kidney transplant rejection prophylaxis when used as part of an immunosuppressive regimen that includes cyclosporine and corticosteroids. Generally, physicians performing transplants at our institution do not use steroids or cyclosporine. They use tacrolimus, sirolimus, mycophenolate mofetil, and/or mycophenolate sodium. If the physician performs a transplant without cyclosporine or steroids, do we need to have the patient sign an advanced beneficiary notice?
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