Question: I am facing a reporting dilemma over here. My question is if a diagnostic endoscopy has been performed with an endoscopic ultrasound, how should it be reported? One of my colleagues says that both the procedures should be reported separately using a modifier, but I think only the endoscopic ultrasound should be reported. Who is correct?
Oklahoma Subscriber
Answer: As per the CPT® manual, whenever a diagnostic endoscopy has been performed along with an endoscopic ultrasound [...]
CPT® 2012 Update: 49082-49083 Redefines The Way You Report Paracentesis (January 2012)
Checking for imaging guidance now helps improve reporting accuracy.If accurately reporting a paracentesis service has been a challenge for you, particularly trying to determine whether the services were initial or subsequent and how to report any lavage that’s included, there’s good news. CPT® 2012 rings in some welcome modifications to the way you report paracentesis making it simple and uncomplicated.Read on for advice on applying these changes.Heed These Lavage, Imaging Adjustments Before the CPT® 2012 [...]
ICD-10: Don’t Let Complications Complicate Your Hemorrhoid Dx Coding in 2013 (January 2012)
Heads up: Single ICD-9 code spans to eight codes in ICD-10When ICD-10 goes into effect in 2013, you will need to pay more attention to detail when reporting hemorrhoids. You should specifically look for the type of hemorrhoid as chossing the right code is principally based on the type of hemorrhoid i.e. internal, external or unspecified. So, you will need to know if the hemorrhoid is of internal or external type to correctly report it. [...]
Coding Tips: Brush up Your ERCP Coding Skills With This Guidance (January 2012)
Intent and method guide you to appropriate codes. When your gastroenterologist performs an endoscopic retrograde cholangiopancreatography (ERCP), you’ll definitely report accurate codes if you observe specifically the reason and method used for the procedure. This coding refresher will help point you in the right direction.Check Reason for the ProcedureYour gastroenterologist can perform an ERCP procedure with diagnostic or therapeutic intent. “A typical scenario for an ERCP is that the patient has continued epigastric pain in [...]
Don’t Report Imaging Guidance as Separate Procedure (January 2012)
Learn the rules that govern reporting imaging guidance with ERCP.CPT® does not allow the reporting of any fluoroscopy procedures that are performed with the ERCP. CPT® states that this is a bundled procedure and forms a component of the ERCP and it should not be reported separately.However, in some situations, you might be able to report 74328 (Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation); 74329 (Endoscopic catheterization of the pancreatic ductal [...]
You Be the Coder: Reporting Different Techniques for Polypectomy (January 2012)
Question: Our gastroenterologist recently performed a colonoscopy. During the procedure, using the snare, he removed two polyps, one in the ascending colon and the other in the descending colon. He also conducted a biopsy of another large mass that was present in the sigmoid colon. How should I report this as two different techniques have been employed?Florida SubscriberAnswer: If multiple polyps are removed by using the same technique, you only code once (with the correct [...]
Reader Question: Confusion Over Screening Criteria? You Are Not Alone (January 2012)
Question: We have a 39-year-old patient who is asking for a routine screening of the colon, as some of his cousins and his uncle have been diagnosed with colorectal cancer. Can this be billed under V16.0? Also, can you let me know the criteria for high risk screening under V76.51?Virginia SubscriberAnswer: For the screening to be billed under V16.0 (Family history of malignant neoplasm of gastrointestinal tract), the person should have a family history of [...]
Reader Question: Address the Keofeed Reporting Dilemma (January 2012)
Question: Our gastroenterologist recently performed a Keofeed feeding tube placement at our facility. How do I report this? New York SubscriberAnswer: The placement procedures for feeding tubes is reported based on the type and method that was used. A Keofeed feeding tube is a type of nasogastric tube. Nasogastric tubes, as the name indicates, are inserted via the nose into the stomach. The tube insertion is performed mainly for feeding purposes and also for the [...]
Reader Question: Distinguish Whether Observation Patients are Inpatient or Outpatient (January 2012)
Question: For all patients under observation admitted in our facility we have been using outpatient consult codes with POS 22 (outpatient). Recently, we were told that if the patient continues to remain under observation for another day, we should use a hospital visit code with POS 21 (inpatient). This is contradictory to how we have been reporting it as we continue to use POS 22. Please tell us what is appropriate?Texas SubscriberAnswer: For patients under [...]
Regardless of findings, stick to V10.05 to describe condition.Accurately reporting colorectal cancer screenings on patients at high risk for the disease can hinge on fine points like assigning the right V code. Examine the following scenario sent in by Dawn Duchesney of DeMasi Digestive Health, Venice, FL and the coding advice that follows to finesse these claims — and recoup your deserved reimbursement for these services:Scenario: Our patient has a personal history of colon cancer, [...]
