Genetic screening is often used to detect abnormal genes or possible fetal anomalies during antepartum care. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews some of the most common genetic tests and what diagnosis codes to report.
Interventional radiology cases are often complex with confusing coding rules, especially for radiologic supervision and interpretation. Stacie L. Buck, RHIA, CCS-P, RCC, CIC, and Karna W. Morrow, CPC, RCC, CCS-P, lead you through the maze of coding these procedures.
One of the major changes to the 2013 CPT ® Manual is the replacement of the term "physician" with "physician or other qualified healthcare professional" in a wide range of codes. Marie Mindeman and Andrea Clark, RHIA, CCS, CPC-H, discuss how this change affects code assignment.
The American Medical Association completely overhauled the CPT ® Manual’s psychiatry subsection for 2013. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explains the new codes and guidelines associated with psychiatric services.
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.
The AMA added new CPT ® codes to report transcatheter aortic valve replacement for 2013. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, details these and other code changes for cardiology.
Coders will find significant changes in the medicine section of the 2013 CPT® Manual . Denise Williams, RN, CPC-H, and Georgeann Edford, RN, MBA, CCS-P, review the changes to nerve conduction studies, vaccine administration, ophthalmology, and allergy testing.
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.
Five new CPT ® codes will be used to report services in two new evaluation and management categories: complex chronic care coordination services and transitional care management services. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, details the codes and guidelines for these services.
As tempting as it might be to append modifier -59 (distinct procedural service) to a claim in order to get paid, doing so poses a huge compliance risk. Karna W. Morrow, CPC, RCC, CCS-P, Sarah L. Goodman, MBA, CHCAF, CPC-H, CCP, FCS , Peggy Blue, MPH, CPC, CCS-P, and Kimberly Anderwood Hoy, JD, CPC, walk through five case studies to help coders chose the correct modifier.
In order to accurately code physician and provider services, coders must know and understand the place of service (POS) codes. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, details the specific POS codes and how to appropriately report them.
The CPT ® Editorial Panel revised its guidance for critical care codes to specifically state that, for hospital reporting purposes, critical care codes do not include specified ancillary services. Denise Williams, RN, CPC-H, and Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, discuss how coders should code for critical care services and review which services are bundled into critical care.
Physicians and facilities use the same codes to report evaluation and management (E/M) levels for emergency department (ED) services, but follow different rules. Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, and Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, explain how to correctly choose the most appropriate E/M code for ED services.
When is in appropriate to use modifier -59 to override coding edits? When is another modifier more appropriate? Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, and Sarah L. Goodman, MBA, CHCAF, CPC-H, CCP, FCS , explain the appropriate use of modifier -59.
The Rh factor of positive and negative can lead to problems between a mother and the developing fetus, a condition known as mother-fetus incompatibility. In some cases, the mother must receive the Rho(D) immune globulin. Lori-Lynne A, Webb, COBGC, CPC, CCS-P, CCP, CHDA , explains the diagnostic and procedure coding options for Rho(D) immune globulin.
Cardiac catheterization is a common procedure performed to study cardiac function and anatomy and to determine if a patient is a candidate for intervention. Terry Fletcher, CPC, CCC, CEMS, CCS-P, CCS, CMSCS, CMC, and Jillian Harrington, MHA, CPC, CPC-P, CPC-I, CCS-P, MHP, explain how to code the different catheterization procedures.
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.
To correctly assign codes for any surgical procedure, coders need to have an operative (OP) report. But simply having an OP report isn’t enough. Coders also must be able to read the OP report and pick out the important information. Lynn Pegram, CPC, CEMC,CPC-I, CGSC, breaks down the OP report to help coders find the information they need.
As charges become more specific to provide additional concrete and transparent cost data, providers must consider what procedures they routinely provide to patients and what procedures are specifically related to the patient's condition. Denise Williams, RN, CPC-H, and Kimberly Anderwood Hoy, JD, CPC, reveal tips for determining when to separately bill for ancillary bedside services provided to inpatients.
Otolaryngology coding covers a wide range of procedures and four parts of the respiratory system—the ears, nose, sinuses, and throat (ENT). Stephanie Ellis, RN, CPC, and Kim Pollock, RN, MBA, CPC, explore some common ENT coding trouble spots.
