Ask the Expert

Q: I am confused about the difference between the laterality modifiers -LT and -RT and modifier -50. Can you explain?

Q: If a patient comes into an outpatient facility for a surgical procedure and the physician evaluates the patient before performing the procedure, can you append modifier -25 to the E/M service?

Q: Is it appropriate to query whether a pressure ulcer was present on admission (POA) if it was not documented until later in the admission?

Q: A patient receives treatment for two ulcers, one on his foot and one on his hip. The physician performs a subcutaneous debridement to treat the foot ulcer and a muscle debridement to treat the hip ulcer. How would this be reported?

Our experts answer questions about responding to PTP edits, charging for drug administration that crosses midnight, and more.

Q: Our coders are having trouble determining how much clinical evidence to cite in our queries. Is there a general rule for how much to include?

Q: If a patient is seen for a pressure ulcer on the foot related to diabetes, would you report a diabetes diagnosis code? If surgical debridement is performed and the patient receives treatment for their diabetes, can you charge for both an office visit and debridement?

Q: We have gotten conflicting advice regarding ICD-10-CM code categories B95-B97 (Bacterial and viral infectious agents) regarding CCs, MCCs, and severity of illness/risk of mortality. Could you clarify the impact of reporting causative organisms?

Q: If a wound is 68 cm and the application used is 44 cm, would we report one unit of 44 cm? Would this cover the wound?

Our experts answer questions about the –X{EPSU} modifiers, therapy cap changes for 2018, reporting multiple infusions, and more.