Coders will find plenty of changes throughout the musculoskeletal, respiratory, and cardiac sections of the CPT® Manual for 2013, as well as guidelines changes, deletions, and editorial revisions. Andrea Clark, RHIA, CCS, CPC-H, Georgeann Edford, RN, MBA, CCS-P, and Marie Mindeman walk through some of the major changes for 2013.
When a physician determines the patient has a coronary artery blockage, the physician can choose from several options for treating the patient, depending on exactly what is wrong. John F. Seccombe, MD, and Betty Johnson, CPC, CPC-I, CPC-H, CPCD, CCS-P, PCS, CCP, CIC, RMC, discuss invasive and non-invasive treatments, as well as the heart’s anatomy.
With no national guidelines in place for facilities to use to determine evaluation and management (E/M) level, coders must apply their facility’s guidelines when coding an outpatient visit. Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, and Joanne M. Becker, RHIT, CCS, CCS-P, CPC, CPC-I, use three ED case studies to highlight potential pitfalls for ED E/M leveling.
Reporting procedures for the skin can require a variety of documented details, such as location, severity, and size. John David Rosdeutscher, MD, and Gloria Miller, CPC, CPMA, CPPM, explainwhich details coder should look forto accurately report excisions, closures, and other wound care services.
Breast biopsies should be easy to code because coders have so few codes to assign, but it is one area where documentation is lacking. Stacie L. Buck, RHIA, CCS-P, RCC, CIC, reveals what key elements coders should look for in a breast biopsy note.
Misusing modifier -25 (significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service) can be an expensive proposition. Sarah L. Goodman, MBA, CHCAF, CPC-H, CCP, FCS, and Debbie Mackaman, RHIA, CHCO, explain how to determine when an E/M service is significant and separately identifiable.
The AMA significantly changed how coders report cervicocerebral imaging in 2013. Andrea Clark, RHIA, CCS, CPC-H, and David Zielske, MD, CIRCC, CPC?H, CCC, CCS, RCC, discuss the changes and provide tips for coding these services.
Steven Espinosa , CCS , AHIMA-approved ICD-10-CM/PCS trainer, and Denise Williams, RN, CPC-H, outline the anatomy of the upper gastrointestinal system and how anatomical details, along with the provider's approach and intent, help determine the proper procedure code.
The ultimate goal of fetal surveillance is to prevent fetal death. Part of this process is a fetal non-stress test (FNST), the monitoring of the fetal heart rate in response to fetal movement. Lori-Lynne A. Webb, CHDA, CCS-P, CCP, CPC, COBGC, details what the FNST includes and how to code for it.
Physician coders won't be able to just report the CPT ® code that best describes the procedure for some digestive system services in 2015. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, explain why some payers, including CMS, may require new G codes for certain procedures and how the G codes map to related CPT codes.