A surgeon performs a diagnostic shoulder arthroscopy before repairing a patient’s rotator cuff. The surgeon knew ahead of time that he or she would be repairing the rotator cuff. Should a coder or biller append modifier -59 (distinct procedural service) to the CPT® code for the diagnostic shoulder arthroscopy to ensure reimbursement for both procedures?
The thought of learning ICD-10 is intimidating for many coders, but does it need to be? Robert S. Gold, MD, and Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explain why coders may not need to fear the transition quite as much as they think.
ICD-10-CM coronary artery disease and myocardial infarction codes will undoubtedly differ from their ICD-9-CM counterparts in some ways, but some aspects will remain the same.
Pain is an expected component of injuries, illnesses, and surgical procedures. Let's face it, breaking your leg hurts. In some instances, however, the patient's pain is unexpected or is worse than predicted. Sometimes, the pain can last well beyond the time it should have resolved.
Consider this scenario: A physician orders three hours of hydration as well as a one-hour therapeutic antibiotic infusion for a patient. A nurse documents the hydration start time as 10 a.m. and the antibiotic start time as 11 a.m. Neither provider documents a stop time. What should coders report?
Coders and billers may not completely understand how to charge for inpatient supplies. One misconception is that the room rate incorporates all supplies used for every inpatient. Another misconception is that payers will not separately pay for inpatient supplies.
Coding isn't just about reading documentation and selecting codes based on certain words. It's about processing information and assessing whether the codes reported accurately depict the clinical picture and medical necessity for an admission.
