Because lower extremity diagnoses are often associated with issues in other parts of the body, assessing the severity of a patient’s podiatric condition can be challenging. Shelley Safian, PhD, RHIA, HCISPP, COC, CPC-I , reviews physician E/M coding for patients seeking treatment for foot and lower leg problems.
A May report from the Office of Inspector General (OIG) found that some physician practices were at the root of basic coding errors that caused federal overpayments. Although the Essence audit was small, the findings have significant implications for physician coders.
CMS released Transmittal 4313 on May 24 describing changes that will be implemented in the July 2019 quarterly update to the OPPS. These changes included several new HCPCS codes for reporting certain drugs and biologicals.
Q: A physician orders a comprehensive metabolic panel and a quantitative blood sample to measure blood glucose level. How would a coder report these services using CPT codes, and what modifier would he or she use to indicate that the blood sample was performed separately from the panel?
The month of May is designated Skin Cancer Awareness Month by the American Academy of Dermatology. In this article, Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, HCS-D , writes about ICD-10-CM/CPT coding for common types of skin cancer and their treatments.
With the addition of the two new telehealth service codes for 2019, providers now have 98 CMS-approved telehealth services to report. Yvette DeVay, MHA, CPC, CPMA, CIC, CPC-I , describes the two newest telehealth HCPCS codes and breaks down 2019 billing regulations surrounding telehealth.
Q: A patient presents to the ED seeking treatment for impacted cerumen affecting both ear canals. How would you report a bilateral cerumen removal using CPT codes?
At a Senate Committee on Finance hearing on May 8, physician groups urged Congress to work with CMS to improve the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) by establishing new performance measures and providing greater financial incentives for participating providers.
Diagnosis coding for skin ulcers can be particularly confusing as different kinds of ulcers have their own etiology and associated ICD-10-CM code. Review ICD-10-CM coding and reporting for venous, pressure, and diabetic skin ulcers. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The spread of acute flaccid myelitis (AFM), a serious, paralysis-inducing syndrome, is beginning to alarm epidemiologists who have yet to identify its cause. Recognize the first signs of AFM and learn how to report the condition using ICD-10-CM codes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: I was recently informed that providers use cellular-based tissue products to treat ulcers when a patient fails to respond to more conservative treatment options. What constitutes a failed response to treatment and how would this be documented?
Anthem announced that it may reject claims that contain a subsequent E/M service that’s linked to the same diagnosis as an earlier E/M encounter. Learn what Anthem’s modifier -25 policy means for providers and physician coders.
The role of the coder has transitioned over the past few years to one that is more auditing-heavy. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , describes how to effectively perform internal audits and educate providers on coding best practices.
CMS’ recently released fiscal year (FY) 2020 Inpatient Prospective Payment System (IPPS) proposed rule includes 273 proposed ICD-10-CM code additions mainly affecting reporting for legal interventions, orbital roof fractures, and pressure-induced deep tissue damage. The code changes, if finalized, will take effect October 1, 2019.
Q: The American Medical Association added three new CPT codes for skin biopsies, effective January 1. What are the new biopsy codes and CPT guidelines for reporting them?
Hospital/physician practice integration has contributed to an increase in chemotherapy drug treatment and injection administration spending under Medicare, according to a study recently published in Health Economics.
Providers will find significant leeway in how they can report advance care planning (ACP) services for physicians given CMS’ open-ended coding requirements. Review potentially confusing CPT time rules and other obstacles that may be holding back providers from engaging in ACP services.
The most commonly reported CPT codes are getting a much-needed makeover. Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS , writes about E/M code changes implemented this year and changes for implementation over the next two years.
The endocrine system is an intricate collection of hormone-producing glands that help to control mood, metabolism, tissue function, and sexual development. This article breaks down endocrine anatomy and ICD-10-CM guidelines for reporting diabetes mellitus and Cushing’s disease. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A spinal fusion is a major surgery used to fuse together two or more vertebrae so they can heal into a single bone. This article breaks down spinal anatomy and simplifies CPT and NCCI guidance for reporting spinal fusions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
