Ask the Expert

Q: Aside from Coding Clinic , Third Quarter 2005, pp. 19–20, is there any more up-to-date advice on reporting ICD-10-CM diagnoses from physician orders?

Based on Coding Clinic guidance, is the primary diagnosis of stenosis no longer needed to report CPT code 63047?

Q: Have you heard of third-party payers requiring a creatinine change of 1.5 times the baseline when chronic kidney disease (CKD) is present?

Our experts answer questions about querying differential diagnoses, reporting cervical spondylosis in ICD-10-CM, and more.

Q: How would a coder report weight loss management services furnished by an orthopedic provider certified in weight loss counseling?

Q: What does a provider need to document for ICD-10-CM code G89.4 (chronic pain syndrome) showing there is a psychosocial reason for the pain?

Our experts answer questions about conflicting payer and MAC guidance, identifying CPT/HCPCS services and supplies that are not separately reportable, and more.

Q: Can HCPCS add-on code G0136 be reported on the same day as an E/M visit by the provider in the patient’s home?

Q: Would coders need to query a differential diagnosis to rule it in or out, especially if it is in the discharge summary?

Q: How should we report services with modifier -50 (bilateral procedure) for physician claims when a private payer’s instructions contradict our Medicare administrative contractor (MAC)?