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    JustCoding Outpatient

    Asthma specificity and tobacco use highlight ICD-10-CM respiratory changes

    March 19, 2014
    Even though ICD-10-CM respiratory changes are relatively minor, coders will still have to learn the new guidelines and review anatomy and physiology in order to report them accurately. Tara L. Bell, RN, MSN, CCM, AHIMA-approved ICD-10-CM/PCS trainer, and Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, CHA, AHIMA-approved ICD-10-CM/PCS trainer, highlight the changes and new guidelines.
    JustCoding Outpatient

    HCCs: Easy as 1, 2, 3 (the culture of MEAT)

    March 19, 2014
    Hierarchical Condition Category (HCC) coding may be a foreign concept for some coders, but making sure documentation for Medicare Advantage patients supports it can be critical. Holly J. Cassano, CPC , discusses what criteria needs to be met for complete documentation.
    JustCoding Outpatient

    CMS’ packaging trend has major impact on I/OCE update

    March 19, 2014
    Changes implemented by the 2014 OPPS Final Rule resulted in the addition and deletion of many codes in the January I/OCE update. Dave Fee, MBA , reviews some of the most important modifications, including changes to evaluation and management services and device reporting.
    JustCoding Outpatient

    Healthcare News: Auditors find MRI scan claims do not meet medical necessity

    March 19, 2014
    In the Medicare Quarterly Provider Compliance Newsletter , CMS writes about auditor findings for MRI scans that did not meet medical necessity and how to ensure documentation that supports it.
    JustCoding Outpatient

    Q&A: Edits when reporting breast mass excisions

    March 19, 2014
    Q: When coding excision of a breast mass with needle localization using stereotactic guidance, we report CPT ® code 19125 (excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion) and new code 19283 (placement of breast localization devices, percutaneous; first lesion, including stereotactic guidance). The 3M system says Medicare NCCI edits consider this separate reporting of codes that are components of the comprehensive procedure if billed for services provided to the same beneficiary by the same physician on the same day. These codes will be rebundled by the Medicare payer and payment will be based on code 19125 only. Does that mean to only report 19125 for this kind of case? If there is an excision of a lesion by one surgeon and needle localization done by a radiologist, can we report 19125, with 19283 and modifier -59 (distinct procedural service)? We can’t find any official reference for this issue for 2014. How do we code excision of a breast mass with needle localization now?
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