Family Practice Coding Alert: Bone Density Scans Boost Revenue If You’ve Got the Correct Combo   (July 2010)

DEXA, SEXA, CT: Use a unique code for each to firm up pay.
Paying attention to three details for your patients’ bone density scans can make or break your claims’ success. Follow our experts’ advice regarding the types of tests, appropriate diagnoses, and acceptable timeframes, and you’ll build strong claims and healthy bottom lines.
1. Report the Correct Type of Scan
Bone density scans (also known as bone mass measurements, or BMM) fall into five general categories. Your [...]

Auditing: Is the Problem New to a Partner’s Patient?   (July 2010)

You’ve hunted for new problem specifics; we’ve found the details for you.
Your FP gets more medical decision making points for a new problem, but when his partner has already seen the patient for the problem, determining if the problem is still ‘new’ proves elusive. Here’s the skinny on the rules you’ve got to follow before giving new problem credit.
Capture More MDM Points Depending on Problem’s Status
Under Medical Decision Making Number of Diagnoses or Treatment Options, [...]

MPFS: Up 2, After Down 22   (July 2010)

After a week of 1994 rates, CMS increases conversion factor.
MACs distributed substantially lower Medicare payments last week, due to a 21 percent cut that hit your Part B claims — but the House of Representatives reversed those cuts on the evening of June 24, with a vote that will also give you a 2.2 percent pay increase through November 30.
On June 18, 17 days’ worth of claim holds expired, and with Congress slow to come [...]

Fast Tips: Jen Godreau’s Top 3 AAPC Takeaways   (July 2010)

Thousands of American Academy of Professional Coders members gathered in Jacksonville, Fla. for 3 jam-packed days of coding advice, camaraderie, and learning. Coders’ biggest struggle was narrowing down which sessions to attend. For those of you who wonder what you missed and for coders who couldn’t make this year’s national conference, here’s a sneak peak at the documentation improving tips and scenario solutions experts offered.
These are my top 3:
1. Eliminate stress with a wacky [...]

You Be the Coder: Cyst Expression: I&D or Excision?   (July 2010)

Question:
Documentation reads, \”The cyst was excised after performing a central incision directly on the cyst. All the material was expressed, then cyst capsule was removed completely and excised completely. Packing was performed.\” Should I code the procedure as an I&D or an excision?
Supercoder.com/forum/
Answer:
You should look at the pathology report and any further excision description to reach the correct code set. \”Excision is defined as full thickness [through the dermis] removal of a [...]

Reader Questions: Change to ‘70’ Code for New Prevnar Vaccine   (July 2010)

Question:
We started receiving Prevnar 13 vaccine instead of Prevnar 7. Do I use the same coding?
Ohio Subscriber
Answer:
You will switch the CPT code you use from 90669 (Pneumococcal conjugate vaccine, 7 valent, for intramuscular use) to 90670 (Pneumococcal conjugate vaccine, 13 valent, for intramuscular use). Prevnar 13 (PCV13) replaces Prevnar 7 (PCV7). Prevnar 13 adds protection against six more strains of the pneumococcal bacteria, according to The New York Times.
Keep these points in mind for proper [...]

Reader Questions: Limit Prolonged Services to Highest Category in 1 Instance   (July 2010)

Question:
Can the prolonged codes (+99354, Prolonged physician service in the office or other outpatient setting requiring direct [face-to-face] patient contact beyond the usual service; first hour [List separately in addition to code for office or other outpatient Evaluation and Management service]) and +99355 (Prolonged physician service in the office or other outpatient setting requiring direct [face-to-face] patient contact beyond the usual service; each additional 30 minutes [List separately in addition to code for prolonged physician [...]

Reader Questions: Autism Screenings Falls Under 96110   (July 2010)

Question:
Is there a CPT code for administering the M-CHAT screening? Do we need to include a modifier?
West Virginia Subscriber
Answer:
Submit 96110 (Developmental testing; limited [e.g., Developmental Screening Test II, Early Language Milestone Screen], with interpretation and report) when you administer the Modified Checklist for Autism in Toddlers (M-CHAT). If, at the same visit, staff administer a second different screening tool (such as the ASQ, Ages and Stages Questionnaire), some payers will allow you to report 96110 [...]

Reader Questions: Any PFSH Item Fulfills Category   (July 2010)

Question:
When a new patient is seen in our office, the patient is required to fill out a review of systems (ROS) form and history (hx) form. The hx form goes over PFSH. The patient signs and dates the form, and the physician reviews the forms and signs and dates them. The physician dictates an office note, such as patient being seen for ventral hernia. Within the physician note, he dictates past and social history but [...]

Reader Questions: Look for Local Txt to Up Sunburn Pay   (July 2010)

Question:
A patient comes in with swelling and minor blisters on the tops of his feet. The physician diagnoses sunburn and treats it with a cold, wet compress on the area. He discusses several factors (the sunburn, expected progression, proper treatment, pain management, prevention). Should I use an E/M code for the burn treatment?
Answer.
Since the burn care involves treatment, you can report 16000 (Initial treatment, first degree burn, when no more than local treatment is required) [...]