Money-Making Procedures: 5 Principles Take the Tricky Out of FBR Coding   (August 2010)

Snag $100 more for removal from foot – Supercoder.com shows you how.
If you automatically look to 10120 when your FP removes a tick, splinter, or other foreign body from a patient’s foot, you could be forfeiting almost $100 per claim.
Better: You won’t shortchange your physicians on foreign body removal (FBR) provided you follow these guidelines.
1. Before Using 10120, Check for Incision
Don’t assume foreign body removal is a shoe-in for CPT integumentary section code 10120 (Incision and [...]

Coding Changes: ICD-9 2011 Solves Partial Removal Stumper   (August 2010)

Squeeze these V90 retained fragment codes onto fall tickets.
When you can’t get all of a splinter out, a new diagnosis code series will soon tell the story. FPs are all too familiar with foreign body removal that gets only part of the object – and come this fall they’ll have a diagnosis code that explains the condition.
Pieces of wood, glass, or bullet shrapnel might be left in during foreign body removal. The fragment may break or [...]

You Be the Coder: SI Joint Area: Hunt for the Correct Injection Code   (August 2010)

Question: FP dictates, “Injection (L) sacroiliac joint, depo medrol 80mg, lidocane 4 ml, marcaine 1 ml” and diagnosis sacroiliitis. Notes indicate “SI joint area”. When I asked the physician, he said it isn’t really a muscle or directly in the joint. What procedure code should I use?Supercoder.com/coding-community/discussion-group/
Answer: Your FP is not describing a trigger point injection or a sacroiliac (SI) joint injection, because he’s not injecting the muscle or the joint. If he’s injecting the [...]

Auditing: Check Your HPI, Risk IQ With Pre-op Exam Case Study   (August 2010)

Hint: Your FP’s recs are the ones to count under mgt options.
When a patient needs preoperative clearance for a major surgery, don’t scratch your head over the applicable table of risk selections – focus on your doc’s role. Test your major versus emergency surgery savvy and who gets the credit for surgical recommendations with this real world case.
A 45-year-old patient fell from a ladder, hit a fence on the way down, and fractured his elbow. Ortho [...]

Auditing: MDM Weigh Surgical Risk to Snag the Correct E/M Level   (August 2010)

These definitions take the mystery out of moderate vs high surgical management options.
If you audit surgery in addition to family medicine, you could be losing E/M credit unless your emergency, elective, and risk factor vocab is rock solid. Under the Table of Risk’s Management Options Selected column, these factors can change whether the level of risk is moderate or high, affecting the encounter’s type of medical decision making and potentially changing the E/M service’s level.
To [...]

Reader Questions: 3 Ways to Handle Trays   (August 2010)

Question: How do I code products like laceration trays for minor wounds, suture trays, facet tray, lumbar puncture tray, etc.?
Maryland Subscriber
Answer: Some private payers may pay for trays with either the HCPCS level II code (A4550, Surgical trays) or the generic CPT supply code (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, trays, supplies, or materials provided]). [...]

Reader Questions: The Hard Truth about Phone Call Pay   (August 2010)

Question: Another physician told my doctor that he’s receiving payment from his contractor for telephone calling codes. My FP would like to start using these codes as well. Does Medicare pay for telephone calls?
Colorado Subscriber
Answer: Medicare considers telephone call codes (99441- 99443) to be non-covered services. You can find a code’s status in column D of the 2010 Medicare Physician Fee Schedule.
Time saver: Hate searching the Excel file? Look under Supercoder.com’s code fee schedule [...]

Reader Questions: Unplanned Departure = No 99315-99316   (August 2010)

Question: A patient leaves a nursing facility (NF) against medical advice (AMA). Can the FP charge a discharge service?
Supercoder.com/forum
Answer: Check if the FP provided a face-to-face service before the patient left the NF. If the physician saw the patient on the same day prior to his or her departure from the nursing facility, you should bill subsequent nursing facility care (99307-99310). Since the FP did not discharge the patient, no discharge management should have occurred. [...]

Reader Questions: Drug Index Requires Generic Code Name   (August 2010)

Question: I can’t find the HCPCS Level II codes for Ethyol, Treanda, Trisenox, and Zoladex. I’ve looked them up in the HCPCS Level II Index but do not see these drugs listed. How can I find the supply codes to use?
Supercoder.com Member
Answer: If your HCPCS reference material does not include these names, you will need to look up the generic names for the brand name drugs you are trying to bill. You can either [...]

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 [...]