Comprehensive APCs (C-APC) have added another complication to coding and billing for outpatient services. Valerie A. Rinkle, MPA, writes about recent changes that could impact the reporting of physical and occupational therapy and speech-language pathology services provided in support of or adjunctive to a C-APC.
Choosing the correct E/M level can be difficult enough, but coders may also face scenarios where it’s necessary to append a modifier to the code. Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, reviews when to report modifiers -25 and -27 and instances when the modifiers would not be appropriate.
Congressional legislation is often written in a way that obfuscates or, at the very least, makes it difficult to discern the impact or intent of a bill.
Anatomical modifiers qualify a HCPCS/CPT® code by defining where on the body the service was provided. These modifiers are especially helpful to indicate services that would normally be considered bundled but were actually performed on different body sites.
In addition to laterality modifiers for right and left (-RT and –LT, respectively), coders can also report bilateral procedures with modifier -50. Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, analyzes the guidelines for these modifiers and offers tips on how and when to report them.
ICD-10-CM has brought codes to more specifically report obesity and related conditions. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, describes these codes and when to report them, while also taking a look at operative reports for bariatric surgeries.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, looks at the different types of bariatric surgical procedures and documentation details providers may include for them. She also reviews which CPT codes can be used to report these procedures
Anatomical CPT modifiers aren’t used just to distinguish laterality. Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, reviews how to report modifiers –LC, -LD, -LM, -RC, and –RI for percutaneous coronary interventions.
CMS' coding modifiers are not always used to report clinical components of a service. Sometimes they can be used in order to provide information about how a service relates to Medicare coverage policies.
The April 2016 I/OCE update brought a host of code and status indicator changes, as well as corrections to CMS' large January update that instituted policies and codes from the 2016 OPPS final rule.
