Jugna Shah, MPH, and Valerie A. Rinkle, MPA, examine the 2014 OPPS Final Rule and explain which services are now packaged, including drugs and biological that function as supplies when used in diagnostic or surgical procedures, clinical diagnostic lab tests, and device removal procedures.
While the digestive and integumentary sections had extensive edits in the latest CPT ® update, many sections were left relatively unchanged. Joanne Schade-Boyce, BSDH, MS, CPC, ACS , and Denise Williams, RN, CPC-H, review which sections only had minor updates and take a closer look at evaluation and management and chemodenervation changes in the 2014 CPT Manual.
The added specificity available in ICD-10-CM allows for more details to be included when reporting bacterial skin infections, such as the location of the infection. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explains how to identify various types of infection and which codes to use to report them.
Q: I am looking for information about to how to bill for a transnasal-endoscope approach in removing a skull-base tumor. I have never been comfortable with the doctors wanting to use CPT ® 61600 (resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural) to bill a non-invasive procedure. I am perplexed about which CPT code(s) to report for this type of procedure.
With the ICD-10-CM implementation date approaching, training and retaining staff that knows the new system is paramount for coding departments. Sabita Ramnarace, MS, RHIA, CCS, CHP , and Rudy Braccili, Jr., MBA, CPAM, review strategies that can help providers develop retention plans in their organization.
The transition to ICD-10-CM may require coders to brush up on their anatomy and physiology in order to report the most accurate codes. We take a look at the anatomy of the knee and how coding for knee injuries will change in ICD-10-CM.
A recent survey of healthcare payers and providers by accounting firm KPMG shows that many organizations are lagging when it comes to ICD-10 testing. Nearly three-quarters of respondents said they had yet to begin end-to-end ICD-10 testing or were not planning on conducting it.
Skin and dermatology coding includes unique challenges with its extensive terminology and the need to calculate wound and lesion sizes. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , discusses common documentation problems and how coders can improve their efficiency and proficiency.
Coders have until September 30, 2015, to pass AAPC’s ICD-10 proficiency test in order to retain their credentials. AAPC recently added another way to prove proficiency that includes an online training portion, in addition to the previously available timed assessment.
Joanne Schade-Boyce, BSDH, MS, CPC, ACS , and Denise Williams, RN, CPC-H, look at the changes in the integumentary and cardiovascular systems and how they demonstrate a trend toward bundling in the 2014 CPT® Manual.
Q: A patient presents with lower back pain and the physician documents findings of stenosis, degenerative “changes,” and mild facet arthropathy. Which diagnosis codes should we report? I would code 724.02 (stenosis, lumbar region, without neurogenic claudication) and 721.3 (lumbosacral spondylosis without myelopathy) for the facet degeneration. Another coder has stated that I cannot code 724.02, as the 721.3 diagnosis code will exclude the use of 724.02. Can you help with this scenario?
CMS did not finalize a proposal to collapse all evaluation and management visits into three codes, but did change clinic visit level coding. Jugna Shah, MPH, and Valerie A. Rinkle, MPA, review some of the major changes to E/M levels for 2014 and the new codes introduced. introduced.
Q: When we send in a claim for CPT ® code 29898 (arthroscopy, ankle, surgical; debridement, extensive) to Aetna with modifier –AS (non-physician assisting at surgery) for our physician’s assistant, Aetna will deny the claim saying “assistant not covered.” However, that procedure code says it is covered for an assistant surgeon. I have sent appeal after appeal and printouts from the American College of Surgeon’s (ACOS) Coding Today website showing this procedure code is payable to Aetna, and Aetna still denies the claim. Medicare pays on this claim, why wouldn’t Aetna?
With the added specificity available in ICD-10-CM, coders have many more options for reporting malignancies of the skin. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , compares ICD-9-CM codes with their ICD-10-CM counterparts and notes where more documentation may be needed to select the proper code.
Hydration services, located on the bottom of the drug administration hierarchy, present challenges for coders due they are used with other injections and infusions. Jugna Shah, MPH, and Valerie A. Rinkle, MPA, review how to code hydration, along with other special considerations for drug administration.
Documentation for vertebral augmentation procedures (VAPs) must adhere to Local Coverage Determination (LCD) policies in order to be paid by Medicare. CMS recently provided guidance for these claims in the Medicare Quarterly Provider Compliance Newsletter .
More than 330 codes have been added, deleted, or revised in the 2014 CPT ® Manual . Almost one quarter of those changes appear in the digestive system. Joanne Schade-Boyce, BSDH, MS, CPC, ACS , notes important code and guideline changes to be aware of for 2014.
In order to report accurate evaluation and management codes, coders need accurate, complete documentation. Coders can play a critical role in ensuring proper documentation. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, looks at methods coders can use to promote better documentation.
Q: How does CPT ® define "final examination" for code 99238 (hospital discharge day management; 30 minutes or less)? Does the dictation have to include an actual detailed examination of the patient? We have been coding 99238 for discharges that include final diagnosis, history of present illness, and hospital course along with discharge labs, medicines, and home instructions. Very few contain an actual exam of the patient. Have we been miscoding all this time?
In its 2014 OPPS Final Rule , CMS finalized its proposal to replace existing evaluation and management CPT ® clinic visit codes with a single HCPCS G-code.
