Q: We are trying to verify whether we should bill for two units of the CPT® code when the provider performs a service with and without magnetic resonance angiography (MRA), such as an MRA of the abdomen, with or without contrast material (code 74185). The description of the MRA CPT codes say "with or without," not with and without for billing all non-Medicare payers. We realize for Medicare we are to use HCPCS codes C8900-C8902.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, reviewsCPT® coding for interrupted pregnancies, while also highlighting changes coders can expect for related diagnoses in ICD-10-CM.
You may recall that Steve’s super streak at the Vegas craps table ended with a torn right ulnar collateral ligament. On the recommendation of his primary care physician, Steve consulted an orthopedic...
You know us and the staff at the Acme ED, Fix ‘Em Up Clinic, and the Stitch ‘EM Up Hospital. Now, we want to get to know a little bit about you, our readers. Please complete this short survey to tell...
Q: A patient came to the ED with shortness of breath (SOB). The admitting diagnosis was possible acute coronary syndrome (ACS) due to SOB and elevated troponin levels. The ACS was ruled out. Elevated troponin levels were assumed to be due to chronic renal failure (CRF), and no reason was given for SOB. Before discharge, the patient was noted with an elevated temperature and found to have a urinary tract infection (UTI). All treatment was directed at the UTI, and the doctor noted the discharge diagnosis as the UTI. What would be the principal diagnosis in this case?
When providers use different definitions for the same disease, confusion and chaos result. Trey La Charité, MD , discusses how coding and clinical documentation improvement specialists can clear up the situation.
PSI 15 measures the hospital’s risk-adjusted rate of accidental punctures and lacerations. Shannon Newell, RHIA, CCS, Steve Weichhand , and Sean Johnson explain inclusions, exclusions, and risk adjustment factors for this measure.
Heart failure is the intrinsic inability of the heart to supply target organs with sufficient nutrient flow to function normally. Robert S. Gold, MD, and Gloryanne Bryant, RHIA, RHIT, CCS, CDIP, CCDS, review the clinical and coding guidelines for heart failure.
I spent the weekend reading the 2016 Inpatient Prospective Payment System (IPPS) proposed rule. Not the most thrilling reading ever (government-ese should be classified as a foreign language). I did...
Last week, Steve spent some serious time at the craps table in Las Vegas. He was on a real roll with those dice, racking up a 14-hour winning streak. However, on that last throw, something went very...
The endless last-minute patches for the Sustainable Growth Rate (SGR) are almost history. Late last night, the Senate overwhelmingly passed H.R. 2, which repeals the SGR. The House overwhelmingly...
Q: If a patient is given Reglan ® intravenously at 12:20, 13:00, and 13:20, would this be considered an IV push because the clinician did not document a stop time?
Peggy Blue, MPH, CPC, CCS-P, CEMC, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, review code changes in the 2015 CPT® Manual's Medicine section, including newly available products and services.
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.
A Comprehensive Error Rate Testing (CERT) study of transcatheter aortic valve replacement/implantation (TAVR/TAVI) services found that approximately one third of the claims received improper payments, mostly due to insufficient documentation, according to the latest Medicare Quarterly Compliance Newsletter.
CMS is asking for some social media help in support of ICD-10. The agency is planning a social media rally to encourage the healthcare community to get ready for the ICD-10 transition. You can sign...
I’m always fascinated by new medical research and information about diseases I’ve never heard of. They also make great fodder for this blog. I recently came across an article on REM sleep behavior...
Fifteen-month-old Finn is back at the Fix ‘Em Up Clinic today to see Dr. Spock. Finn is currently suffering from a fever, reduced appetite, and sore throat, according to his mom Melissa. Finn just...
