The dogs days of summer have arrived so the residents of Anytown descended on the dog park with their furry friends today. Sadly, not all of the puppies (and people) play well together and some of...
Observation services can generate so much confusion that CMS actually asked for comments on observation and inpatient status as part of the 2013 OPPS proposed rule. Kimberly Anderwood Hoy, JD, CPC, and Deborah K. Hale, CCS, CCDS, help coders unravel the complexities of observation services.
QUESTION: A patient complained of intractable pain from compression fracture (sustained the day prior to admission). The guidelines state if pain is not documented as acute or chronic, don't assign codes from the 338 category. Should we query the physician if the pain was acute or chronic rather than just using the fracture code if it appears that pain control was the main reason for the visit?
As part of the July update to the Intergrated Outpatient Code Editor, CMS reinstated HCPCS C1882 to the list of acceptable devices for CPT code 33249. Dave Fee, MBA, explains the implications of the change and reviews code changes included in the update.
Inpatient facilities received mixed news on proposed changes to the list of complications and comorbidities (CC) and major CCs (MCC) in the fiscal year (FY) 2013 Inpatient Prospective Payment System (IPPS) final rule , released August 1.
Physicians can perform three different types of wound debridement and coders will find different codes for each type. Gloria Miller, CPC, CPMA, and John David Rosdeutscher, MD, discuss the different types of debridement, as well as coding and documentation requirements.
When a physician places a device that takes the place of all or some of a body part, assign a code from ICD-10-PCS root operation replacement (third character R). Think of a total knee replacement or...
Patience may be a virtue, but knowledge is power. Okay, enough clichés. The bottom line is we’re still waiting for a new ICD-10 implementation date. HHS published the proposed rule, moving...
CMS released its latest MLN Quarterly Provider Compliance Newsletter, volume 2, issue 4 in July. The newsletter addresses common billing and coding errors, with the latest issue addressing frequently cited Recovery Auditors and Comprehensive Error Rate Testing (CERT) findings.
A surgeon performs a diagnostic shoulder arthroscopy before repairing a patient’s rotator cuff. The surgeon knew ahead of time that he or she would be repairing the rotator cuff. Should a coder or biller append modifier -59 (distinct procedural service) to the CPT® code for the diagnostic shoulder arthroscopy to ensure reimbursement for both procedures?
Learn about documentation and principal diagnoses, coders and EHR implementation, clarifying IBS and IBD for accurate code assignment, and ICD-10 fracture codes.
In this month's issue, our coding experts answer questions about how to differentiate between modifiers -52, -73, -74, coding for negative pressure wound therapy, and billing the technical component of pathology services.
QUESTION: I'd like to address our coders' questions on how to code poisoning due to bath salts. Internet research has led me to many different options: codes 977.8 (other specified drug/medicinal), 970.89 (other CNS stimulant), 969.70 (psychostimulant, unspecified), among others. What would you suggest? There don't seem to be any guidelines out there and the coding for this seems to be all over the place.
HCPCS code C1882 (cardioverter-defibrillator, other than single or dual chamber [implantable]) will once again meet the criteria to override the device-to-procedure edit for CPT® code 33249 (insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead[s], single or dual chamber).
There is nothing new about stress; humans have felt stress since the beginning of time, and coders are certainly no exception. Lois Mazza, CPC, discusses how coders can mitigate the many effects of stress while they handle the pressures of their jobs and lives.
Coders can run into two types of edits that may require them to append modifier -59 (distinct procedural service) to override: NCCI edits and medically unlikely edits (MUE).
A lack of funding shouldn't prevent you from getting creative in your morale-boosting celebrations, according to Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, and Nicolet Araujo, RHIA. So when your staff members are around, this time of year can be a great time to boost their morale with summer outings and special staff recognition for jobs well done.
Coding for physician services doesn’t always match coding for facility services, which can cause problems for coders who code records for both. ED E/M is one area where different rules come into play.
In this month's issue, we unravel confusion surrounding use of modifier -59, explain the difference between NCCI and MUE coding edits, discuss building E/M ED visit level, review the updates to the I/OCE, and answer reader questions.
