ICD-9 Coding: 700 Basics: Take the Rough Edge Off Corn and Callus Coding (November 2011)
Will you know what to do when these little-known terms show up in your doctor’s documentation?For dermatologists treating the skin of a patient’s foot, one of the most commonly coded diagnoses is corns (and calluses). The condition has a slew of confusing names that may be hard to find – or may not even be in your coding book – and could quickly derail your claims. Deciphering all of the corn and callus terminology can be especially [...]
E/M: HPI Know-How Helps You Catch Level 4 and 5 E/M Opportunities (November 2011)
Beware of CPT® and Medicare differences when counting HPI elements.Not accurately accounting for the history of present illness (HPI) documented by your dermatologist could result in missing appropriate opportunities to report level 4 or 5 E/M visits. Ensure you’re not missing higher paying possibilities by reviewing this guide to capturing HPI elements.Brush Up on What Qualifies as an HPI ElementHPI is one of the three parts comprising an outpatient E/M history. It describes the patient’s [...]
You Be the Coder: Full-Thickness Graft (November 2011)
Question: The dermatologist excises a basal cell carcinoma tumor from a patient’s nasal tip. He submits micrographic margins until he obtains tumor-free margins. The resulting defect occupies most of the nasal tip, exposing the lower lateral cartilages. The excised diameter (including margins) totals nearly 3 cm. The dermatologist uses a full-thickness skin graft from the right pre-auricular crease and closes the deep defect. Should I report the graft? What other codes should I use?Texas SubscriberAnswer: When [...]
Reader Question: Include Dressings in Debridements (November 2011)
Question: Can our practice be reimbursed for the surgical dressing (supplies) of a partial-thickness burn?Georgia SubscriberAnswer: Medicare and most private carriers already factor supplies such as surgical dressings into the value of debridement codes. In these cases, you cannot recoup additional reimbursement using any codes.Some commercial carriers may accept 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, [...]
Reader Question: 25 or 57? Don’t Mix Modifiers (November 2011)
Question: I’m always at a loss on whether to use modifier 25 or modifier 57 when the dermatologist unexpectedly finds the need to do a biopsy of a minor growth during a consultation E/M. What is an example of when these individual modifiers are appropriate?Oregon SubscriberAnswer: Modifiers 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) and 57 (Decision for surgery) are [...]
Question: I work in a physician’s office handling the collection of past due copays, deductibles, and coinsurance as well as the coding and claims. Can I send extremely delinquent accounts to the credit bureau or a collections agency even if the patient is paying a few dollars a month if the practice didn’t agree to a payment plan?Washington SubscriberAnswer: Yes, you can send information about delinquent accounts to collections agencies and/or credit bureaus – even if [...]
Reader Question: Collect Surgical Deductibles Up Front (November 2011)
Question: We often have patients who don’t pay their deductible after surgery. Is there a recommended way to collect these payments up front?South Dakota SubscriberAnswer: Yes, you may collect a deductible upfront. The first step is to confirm the deductible amount with the payer. Insurance verification services now make it possible for practices to determine if a patient has met his deductible, or how much deductible remains unpaid. Others provide just information on what the [...]
AK Treatments: 17000 or 96567? Base AK Treatment Coding on Method, Number of Lesions (October 2011)
Freezing. lasers, PDT, or shaving – the correct code can be worth over $170. Millions of Americans have actinic keratoses, according to American Academy of Dermatology research, and since AK is also the most common premalignant skin condition, your practice is likely to see a fair share of them. Dermatologists have a wide array of options for treatment, so proper coding for each procedure option is essential to a large portion of your bottom line. Diagnosis: [...]
ICD-10 Countdown: Get Ready or Get Fined — That’s the CMS Message (October 2011)
Explore 6 FAQs to ramp up your ICD-10 coding know-how.Denials aren’t the only thing you have to fear if your practice doesn’t implement ICD-10 by the Oct. 1, 2013 deadline. You could face fines, too, according to CMS. Based on comments from CMS representatives in recent CMS ICD-10 teleconferences, we’ve broken down six FAQs that promise to help you ramp up ICD-10 coding for your general surgery practice.Prepare for Medicare and Other PayersCMS has no [...]
Diagnosis Coding: 6 Tips Help Keep Your ICD-9 Coding on Track (October 2011)
Cheat sheets come with a warning label.To help ensure your coding complies with ICD-9 guidelines, there are several tactics you can use:1. Always read the notes in the ICD-9 manual that apply to the code you’re considering, says Denae M. Merrill, CPC, HCC coding specialist in Michigan. 2. Read the ICD-9 official guidelines that apply to your “specialty periodically as a refresher. If we only read them when the codes change once a year, it [...]
