CCI 18.0 Update: Include 29582 in All Fracture, Dislocation (January 2012)
Look for different sessions or sites before you try to break these bundles. If your podiatrist is performing venous compressions, you may already know about new procedure code 29582 (Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed), 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. According to CCI [...]
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 [...]
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 [...]
Hint: Collecting early is often the key.As payer contracts get more and more complicated and payment continues to dwindle, many practices are choosing to not participate, or become “non-par,” with some or all payers. But non-par collections can be a losing proposition that is complicated and time consuming, if you don’t implement a solid, consistent plan of action. Let our experts help you start off on the right track to ensure you bring in every [...]
You Be the Coder: Cuboid Syndrome (January 2012)
Question: How should I code for cuboid syndrome and its treatment through manipulation? Which HCPCS codes should I use for the strapping?Nevada SubscriberAnswer: There is no specific diagnosis code for cuboid syndrome. You can code for the signs and symptoms presented by the patient: pain (729.5, Other disorders of soft tissues; pain in limb) and tendonitis (726.90, Unspecified enthesopathy; enthesopathy of unspecified site).There is also no code for manipulation of the foot in a non-fracture [...]
Reader Question: Do Not Report Casts Independently (January 2012)
Question: When correcting club feet by releasing the Achilles and then applying the cast do we need a 59 modifier to bill both? Would the casting be considered separate treatment since a cast is part of the treatment not just part of the surgery?New York SubscriberAnswer: You will not append modifier 59 to report the cast application with the release procedure. The cast is a part of the postoperative dressing and care and is always [...]
Reader Question: Base Billing Order on RVU Order (January 2012)
Question: I know that as a general rule the highest RVU has a higher billed amount and that when you bill you should always put the highest amount first. But when it comes to bilateral surgeries is it true that you would sometimes be prudent to put another procedure first because a bilateral code that was done bilateral/unilateral would still be paid at a reduced allowable? Texas SubscriberAnswer: Yes, you should sometimes put another procedure [...]
Wound Care: 1101x, 28485 Tell Accidental Foot GSW Story (December 2011)
Also: Got ulcer care, Dermagraft, and VAC questions? Read on for our expert wound care answers. Incorrectly coding wound care claims can cause a breakdown in your bottom line. Study these wound care questions and answers to determine if your wound coding knowledge means a speedy reimbursement or needs immediate treatment. Question #1: If our podiatrist sees a patient in the ED for a hunting gunshot wound to the foot that includes broken metatarsal bones [...]
Once ICD-10 is implemented in 2013, the diagnosis codes in the above story will be different. For example, check out this crosswalk for the correct varicose vein and non-pressure ulcer diagnoses:
Medical Necessity: 3 Steps Focus Diagnosis Coding for Your Surgical Claims (December 2011)
Add these tips to your ICD-9 toolbox.You won’t get paid for your podiatrist’s work if you only focus on what he did; you also need to focus on why he did it. Choosing the right ICD-9 code tells the “why” story – and that’s the basis for demonstrating medical necessity for the procedure.Follow our experts’ tips to make sure you pick the right ICD-9 code to reflect your surgeon’s diagnosis documentation, and to make sure you [...]
