Coding 101: Master the Meaning of CCI Modifier Indicators   (October 2011)

Denial prevention starts with understanding the difference between 0 and 1.Correct Coding Initiative (CCI) edits are a fact of life for coders, and they come with a rule book all their own. Here’s a quick reminder of when CCI says it’s OK to report two codes from an edit pair on the same claim.How it works: CCI edits are updated quarterly. They are created for Medicare, but many private payers apply the edits, as well. [...]

ICD-10: I45.6 Displays New Descriptor for WPW Code   (October 2011)

Beware: You won’t see identical ICD-9 and ICD-10 inclusion lists.When you code Wolff-Parkinson-White (WPW) syndrome under ICD-10, you might be surprised to see a code definition that doesn’t match the one you know under ICD-9.ICD-9 code: WPW falls under 426.7 (Anomalous atrioventricular excitation) in ICD-9. Anomalous atrioventricular excitation is a heart rhythm disorder. In WPW, the patient has an extra electrical pathway which can cause rapid heart rate.Notes in ICD-9 tell you that 426.7 is [...]

You Be the Coder: 93458 Applies When Approach is Radial?   (October 2011)

Question:  If the cardiologist performs a left heart cath by a radial approach, would 93458-26 still be appropriate?SuperCoder.com MemberAnswer: The radial approach will not change your left heart catheterization (LHC) code choice. If the cardiologist provided the services described by 93458 (Catheter placement in coronary artery[s] for coronary angiography, including intraprocedural injection[s] for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection[s] for left ventriculography, when performed), then you may use [...]

Reader Question: 413.x Codes Support G0166 for ECP   (October 2011)

Question: When a national coverage determination doesn’t specify which codes to use, how do we know which particular codes apply?Nevada SubscriberAnswer: When a national coverage determination (NCD) doesn’t list specific codes for use, your next step should be to check for a local coverage determination (LCD) or local payer policy.For example: Palmetto GBA offers a list titled “J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National Coverage Determinations.” It doesn’t supply codes for all [...]

Reader Question: Modifier KX Keeps These MRI Claims Compliant   (October 2011)

Question: Do the new rules on coverage for MRI with pacemaker affect coding?New Jersey SubscriberAnswer: Yes. Medicare has released instructions via MLN Matters MM7441 on how to code MRIs for patients with implanted pacemakers. Remember that the pacemaker must be used according to FDA-approved labeling for MRI scans. (For now, stay alert for the Revo MRI SureScan Pacing System, labeled as MR Conditional. That means patients with the device implanted can undergo an MRI scan [...]

Reader Question: V72.83 Lands Top Spot on NGS Mapping Claim   (October 2011)

Question: What diagnosis code should be used for vein mapping prior to hemodialysis?SuperCoder.com Member Answer: Your best bet is to check your local coverage determination (LCD).For example: The New York LCD for National Government Services (NGS) instructs its providers to list V72.83 (Other specified pre-operative examination) as the primary diagnosis followed by a secondary diagnosis to identify the reason for the study or to indicate the findings. The LCD lists the possible secondary codes, such [...]

Reader Question: 440.2x Key Words Are ‘Native’ and ‘Extremities’   (October 2011)

Question: What is the ICD-9 code for stenosis, popliteal artery?SuperCoder.com MemberAnswer: You should look to 440.2x (Atherosclerosis of native arteries of the extremities). The popliteal artery is an extension of the femoral artery and bifurcates into the tibial arteries. That places the popliteal arteries in the lower extremities. Code 440.2x applies to arteries in the extremities, so you know you’re on the right track.Look in the ICD-9 index under “Stenosis; artery; extremity,” and the entry [...]

Coronary Intervention: +92973 Debate Heats Up Around Aspiration Catheters   (September 2011)

New information stresses a ‘mechanical’ requirement for the thrombectomy code.If you’ve been using coronary thrombectomy code +92973 to report a variety of methods, take heed. Thrombectomy by aspiration catheter is included in the intervention, according to the American Medical Association (AMA) and American College of Cardiology (ACC).Take a Closer Look at +92973The code under discussion is +92973 (Percutaneous transluminal coronary thrombectomy [List separately in addition to code for primary procedure]).For years, many resources have based [...]

ICD-10: 453.42 Explodes Into Multiple Site-Specific I82.4- Codes   (September 2011)

You’ll need quick access to documentation of right, left, or bilateral.Coding for deep vein thrombosis (DVT) will get a lot more detailed under ICD-10. Here’s what you can expect.Diagnosis: Embolism is the obstruction of a vessel by a clot or foreign substance (such as plaque or fatty deposits). Thrombosis is obstruction by a blood clot. The codes featured here are specific to deep vessels, and that means the codes are appropriate for DVT. The codes [...]

ICD-9: 9 Rules Polish Your HTN Coding to Perfection   (September 2011)

Keep these guidelines on assumptions, renal disease, and heart disease handy.Hypertension (HTN) is on the rise – perhaps a third of the U.S. population is already affected. That means that if your HTN coding skills aren’t top notch, many of your claims are at risk of errors.To keep your coding compliant, apply these nine rules based on the ICD-9 official guidelines. (You can download the guidelines from www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm. See section I.C.7.a.)1: ICD-9 Has a Hypertension Table; [...]