CCI 18.0 Update: Include Compression Therapy in Many Skin Graft Codes (January 2012)
Look for different sessions or sites before you try to break these bundles. If your dermatologist is performing venous compressions to treat ulcers, you may already know about new procedure codes 29582-29584 (Application of multi-layer compression system…), introduced in CPT® 2012. And now you need to know how that code is affected by the latest round of Correct Coding Initiative (CCI) edits, effective January 1, 2012. CCI 18.0 includes 15,530 new edit pairs, according to [...]
Medicare Errors: Providers Underbilled More Than $1 Billion to Medicare in 2010 (January 2012)
CERT results reveal $34.3 billion in improper Medicare payments – $1.1 billion of which was underpaid.If your practice’s collections rate was off by 10.5 percent, you’d be in big trouble, right? Well, that’s the 2010 Medicare Fee-for-Service improper payment rate, and your MAC may come looking for money you still owe to them.CMS’s new Comprehensive Error Rate Testing (CERT) results, which were released in November, show that practices actually made fewer errors in 2010 than in [...]
Part B Payment: Congress Votes to Boost Conversion Factor Through February 29 (January 2012)
At nearly the last minute, lawmakers ensure that you won’t lose 27 percent.Although the government appeared poised to take a big bite out of your next Part B payments, you have another two months before you need to worry about losing pay. That’s because the 27 percent Medicare pay cuts that practices have feared since last fall were once again kicked to the curb by Congress, resulting in a Medicare Physician Fee Schedule conversion factor [...]
See how changes affect your use of 99201-99205, 99460-99461, and more. Coding guidelines can sometimes seem confusing when you’re trying to decide whether to classify a patient as new or established. For example, when an established patient presents to your practice to see a new physician, should you report a new patient office visit code? CPT® 2012 attempts to clarify this question and one other E/M stumper: Who counts as a “qualified healthcare professional” to [...]
You Be the Coder: Chemical Peel (January 2012)
Question: Our dermatologist used glycolic acid to remove actinic keratoses from around a patient’s eyes and face. How should I code this?Arkansas SubscriberAnswer: The procedure you describe is also known as a chemical peel. You should report this procedure with 15788 (Chemical peel, facial; epidermal) for the removal of wrinkles and abnormal pigmentation using a chemical agent. However: If you receive a denial, check whether your dermatologist administered chemical peel treatment for the purpose of necessity [...]
Reader Question: 692.x May Be Good Choice for Unknown Skin Rashes (January 2012)
Question: We recently treated a patient for a skin rash that seemed to be an allergic reaction to some unknown cause. Which diagnosis code should we use?Virginia SubscriberAnswer: There are several possibilities for coding the unknown skin rash. More information from the physician will help to identify the best choice. When deciding the most appropriate code, consider these options: You may consider selections from category 692.x (Contact dermatitis and other eczema). This category includes “Dermatitis: Not [...]
Reader Question: ICD-10 Prep Is Different for Paper Claims (January 2012)
Question: If we file paper claims to Medicare, will the claims form change once we begin using ICD-10? Will the form be updated, and will there be any changes for filing paper claims?Louisiana SubscriberAnswer: No, there is no current change to the CMS-1500 form used for filing paper claims for Medicare beneficiaries. CMS may announce changes as we move closer to the Oct. 1, 2013, deadline for implementing ICD-10, but no revisions to the form or [...]
Reader Question: Only Add Lacerations at Same Site and Level (January 2012)
Question: A patient with a 1.5-cm laceration on his eyebrow presented to our practice. Our dermatologist performed an intermediate repair. The patient also had a 3.6-cm forehead laceration that required a simple repair. Should we add these two wound lengths together and then code the intermediate repair, or does each get its own code?New York SubscriberAnswer: In this instance, you should report code 12051 (Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous [...]
Reader Question: No HPI Equals No Coding for New Patient (January 2012)
Question: A new patient visits the physician with a chief complaint. I don’t have a review of system (ROS) or full history because the doctor didn’t document a history of present illness (HPI). He did include a brief HPI in the medical assessment that I credited toward the chief complaint. The physician completed an extended, problem-focused exam and medical decision making of low complexity. Can we bill for this encounter? Minnesota Subscriber Answer: According to [...]
Boost claims accuracy by avoiding these common biopsy coding pitfalls. If you automatically assign 11100 when your dermatologist specifies the biopsy site, you could be forfeiting deserved pay. Site-specific codes increase coding accuracy. Plus, they pay more than the most widely used code, 11100 (Biopsy of skin, subcutaneous tissue and/or mucous membrane [including simple closure], unless otherwise listed; single lesion). Don’t Miss More Pay for More Work Site-specific biopsy codes tell the payer that the [...]
