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Internal Medicine Coding Alert

CPT® Coding Strategies:
Perfect Your Flu Vaccine Coding With These 4 Tips
Hint: Don’t forget to report administration with separate codes. As your code ch... Read more
Back to Basics:
3-Year Rule Determines Patient Status
Hint: The place of service(POS) won’t influence your choice. Many times, the fir... Read more
ICD-10 Update:
Concentrate on Severity While Coding Asthma With J45
Hint: Identify symptoms and medication use for accurate reporting. When your internist... Read more
Reader Question:
Facing Denials For Same Session ''Tobacco Counseling'' and E/M? Check This
Question: I am billing ‘99407’ with ‘99213’ and getting denials.... Read more
Reader Question:
Time and Provider Holds Key For Appropriate DSMT Coding
Question: A patient seen for diabetes (250.02) in the doctor’s office and the phys... Read more
You Be the Coder:
Count Number of Muscle Groups For TPI Coding
Question: Our internal medicine specialist recently performed trigger point injections t... Read more
CPT® 2014 Update:
New E/M and Ultrasound Wound Care Therapy Codes in 2014
Good n ews: Common TCM guidelines will rid confusion while reporting transitional care. ... Read more
2014 Physician Fee Schedule:
Possibility of Fee Deductions If Proposed MPFS Gets Accepted
Sunny side: Chronic care non-face-to-face services might bring in bonuses in 2015. Whi... Read more
ICD-10 Update:
Bust Major ICD-10 Myths and Mysteries
Don’t assume that ICD-10 will allow you to use the same code twice. With the hea... Read more
Reader Question:
EF Modifier For EPSDT Examination Codes
Question:  We are receiving denials from Medicaid stating 92551 (hearing exams) whi... Read more
Reader Question:
Supply Codes Can Be Reported With Administration For Depo Provera
Question: Our FP saw a patient for her third Depo Provera shot. What is the appropriate ... Read more
Reader Question:
Modifier to Report Destruction and Excision Procedures
Question: One of our physicians destroyed a premalignant lesion on a patient’s arm... Read more
You Be the Coder:
Choose Appropriate Vaccine Administration Codes
Question: Rotovirus vaccine is only given to children less than the age of eight at 2, 4... Read more
CPT® 2014 Update:
2014 Changes: Gear Up With New Year CPT® Codes
Good News: You will now have a new code set for inter-professional discussions. If you... Read more
EHR Mythbuster:
Get The Ground-Reality On 3 EHR Myths That Could Cost Your Practice Heavily
Warning: Blindly relying on your electronic system could mean payer audits. If you are... Read more
ICD-10 Update:
More Specificity For Pressure Ulcer Coding in ICD-10
Separate codes for bilateral locations reduce confusion while reporting multiple ulcers.... Read more
Reader Question:
DOS Decides Bundling Between Epidurals and E/M Depending
Question: I have done continuous epidural for my patient and injected different concentr... Read more
Reader Question:
TPI Coding Depends On Number of Muscles
Question: Our physician administered bilateral trigger point injections in three locatio... Read more
Reader Question:
Report Appropriate E/M for Suture Removal by Another Physician
Question: We recently had a patient coming into our practice to meet our family physicia... Read more
You Be the Coder:
Joint Codes for Sinus Tarsi Injection
Question: I recently received a denial for a cortisone injection to the sinus tarsi that... Read more
CCI Bundling:
Changing Code Reporting Rules: E/M With Office Procedures
In addition: Watch for these bundles affecting negative wound pressure therapy. Apply ... Read more
Money Matters:
PQRS Reporting: Ethical Coding By Selecting Right Options
Hint: Base your decisions by analyzing the number of providers in your group. If you&r... Read more
ICD-10 Update:
Broader Reporting Options For Anorectal Abscess
Hint: Use separate code when you clinician diagnoses anal and rectal abscesses. When y... Read more
Check These Anorectal Abscess Types
Based on location of the abscess in the anal and rectal regions, anorectal abscesses can... Read more
Reader Question:
Include 94010 for Spirometry During Office Visit
Question: What is the proper way to bill an E/M visit when performing spirometry during ... Read more
Reader Question:
Pay Heed to Complex Repair 'Anatomic Groups'
Question: We had a case with multiple lacerations requiring complex repair to the follow... Read more
Reader Question:
Block Scheduling to Balance Late Patient Back-Ups
Question:  We’ve had a lot of patients showing up late for their appointments... Read more
Reader Question:
Clear Documentation Required for Unexpected Shot for Nerves
Question: One of our patients was on his way to have an MRI at the hospital. His daughte... Read more
You Be the Coder:
Debridement With Foreign Body Removal
Question: Is it acceptable to code 11042 and 10120 together? If so, do I need to include... Read more
Well Visit/Problem Oriented Visit:
Guidance to Accurate Newborn Exam Reporting
Hint: Appropriate ICD-9 codes will help a robust claim When your internal medicine spe... Read more
E/M Coding:
PFSH Missing PFSH Documentation Might Cost More Than $70 Per Encounter
Hint: Omitting history captured in previous visits will mean loss of revenue. When you... Read more
ICD-10 Update:
Diabetes Mellitus: Segregate Your Codes Based on Type
Hint: Use fourth and fifth digit expansion to specify complications. When your interni... Read more
Reader Question:
Medical Necessity Drives E/M Code Choice
Question: Our physician documents office visits very thoroughly. Because he documents in... Read more
Reader Question:
Coding E/M With G0438, G0439
Question: Can we bill an E/M code with a 25 modifier along with annual check-up codes G0... Read more
Reader Question:
Block Scheduling to Balance Late Patient Back-Ups
Question: We’ve had a lot of patients showing up late for their appointments latel... Read more
You Be the Coder:
Reporting Pre-Op Clearance for Surgery
Question: What CPT® code should we submit for pre-op clearance by one of our interna... Read more
Transitional Care Management:
4 Points To Remember When Reporting Transitional Care to Medicare
New rules apply when you follow CMS guidelines instead of CPT® Now that you’... Read more
Well Visits:
Understand Payer Differences Before Coding Pap Smears With Annual Physicals
Heads up: Medicare follows its own guidelines, not CPT® rules. If your physicians ... Read more
E/M Coding:
MDM Determination: Steps You Can Follow
This system will help you correctly calculate each piece of the MDM puzzle. The Office... Read more
Neck Pain: From 723.1 to M54.2
Good news: Official descriptor remains same. Internal medicine physicians often see pa... Read more
Reader Question:
CDL Physicals: Special In-House Code Might Be Best
Question: One of our physicians wants to bill an E/M code for a commercial driver’... Read more
Reader Question:
Verify Anatomic Locations Before Submitting Multiple Lines of 20600
Question:  Our physician treated a patient who has osteoarthritis in her hands by i... Read more
Reader Question:
Switching Order of Diagnoses on Claim Can Be OK
Question: Our physician documented gingivitis as a contributing factor in a patient&rsqu... Read more
Reader Question:
Verify MD/NP Collaboration Agreement Before Locum Tenens Time Starts
Question: One of the physicians in our practice will be traveling for two months and has... Read more
Reader Question:
Include Retained FB Code With Toe Blister, If Applicable
Question: I’m coding a case of treatment for an ischemic blister of the right grea... Read more
You Be the Coder:
Reporting 11042 With 10120
Question:Is it acceptable to code 11042 and 10120 together? If so, do I need to include ... Read more
CCI 19.1:
Injection Administration Coding Edits: New Bundling Policies
Start reporting vaccine administration with office consultation. The latest update fro... Read more
Office Visits:
Recognize 3 Opportunities to Bill Services With Preventive Care
Tip: Check whether the payer also requires modifier 25. Preventive wellness visits are... Read more
Incident-To Billing:
Follow These 3 Steps for Better Incident-To Claims
Don’t forget to check your state’s laws for NPP scope of services. Having... Read more
Viral Infection Diagnosis: Extra Details Required to Avoid 'Unspecified' Code
Code 079.99 makes an easy switch, but payers might not reimburse. When your physician ... Read more
Reader Question:
Bill 92504 Alone, Not With 69210
Question: The physician cleared cerumen impaction from the patient’s left ear and ... Read more
Reader Question:
G0402 or G0403: Replacement Code for Deleted Code G0366
Question:  A 65-year-old patient who just enrolled in Medicare came to our office f... Read more
Reader Question:
Q2038, G0008: Acceptable Fluzone Pairing for Medicare Patients
Question: Medicare denies our claims for flu vaccines with claim status codes of 254 and... Read more
Reader Question:
692.6 for Poison Ivy Diagnosis
Question: I’m having trouble finding a diagnosis code for 96372 when the physician... Read more
Reader Question:
Code 90714 for All TD Vaccines in U.S.
Question: I know that, as of the first of the year, code 90718 has been deleted.  I... Read more
You Be the Coder:
Diagnosing is Important in Initial Vs. Follow-Up Fracture Visit
Question: Our physician treated a patient for a fracture of the second metatarsal. A fol... Read more
Preventive Services:
Separate Problem Can Be Billed During a Well Check Visit
Watch for significant and separately reportable service that could boost pay. When a p... Read more
4 J Code Options Help You Identify Strep Throat Diagnoses
Wait for lab results before assigning the final code. ICD-9 coding: When using the ICD... Read more
Waiving Co-pays: Beware of The Fallouts
Tip: Get your own verification of financial hardship. Every physician wants to collect... Read more
Reader Question:
Penalties Could Be On Your Way for Illegible Documentation
Question:  My physician’s handwriting really is difficult to read sometimes, ... Read more
Reader Question:
Watch Details While Deciding Between Levels 4 and 5 E/M
Question: We have enough details for an encounter to reach these levels: HPI &... Read more
Reader Question:
Removal: No Incision Means No 10120
Question: My physician documented that a tick was embedded in the patient’s abdome... Read more
Reader Question:
Look at 917.2 for Toe Blister Diagnosis
Question: What is the correct diagnosis for an ischemic blister of the right great toe? ... Read more
Reader Question:
Choose V13.3 for Atypical Nevus Diagnosis
Question: I can’t seem to find a clear diagnosis code for personal history of atyp... Read more
Reader Question:
Do Not Bill 92504 With 69210
Question: The physician cleared cerumen impaction from the patient’s left ear and ... Read more
You Be the Coder:
Billing Same-Day Physician/Nurse Practitioner Services
Question: Our nurse practitioner (NP) is working with our internal medicine physician in... Read more
BMD Coding:
Bone Density or DEXA Scan Coding: Tips to Help You Out
Check your LCDs to see if coverage is once every 2 years. The restrictions Medicare se... Read more
New CMS Guidelines To Be Followed To Keep Record Amendments Updated
Heads up: Single-line corrections are fine. No practice – or physician – i... Read more
BMI Coding: Becoming More Specific Under ICD-10
Most ICD-9 codes have straight crosswalk for ICD-10. Obesity in adults and children co... Read more
Reader Question:
Use V65.40 or V65.49 for A Visit to Discuss Lab Tests
Question: A patient would like to schedule an appointment with her physician to review l... Read more
Reader Question:
No Separate Simple Repair Work Coding with CPT® 17110
Question: Our physician performed an excision of two warts (one from the elbow and one f... Read more
Reader Question:
Begin With 95004-95071 for Allergy Testing
Question:  Our physician’s documentation regarding an allergy test is as foll... Read more
Reader Question:
'Health Coach' Services: Preventive Codes To Be Applicable?
Question: I am looking for CPT® or HCPCS codes for health coach services that would ... Read more
Reader Question:
Second Cast Placement: Submit 29405 and Q4038
Question: A patient was put in a cast after surgery, then came to our clinic the very ne... Read more
Reader Question:
Report Both COPD and Chronic Bronchitis, but Not With Separate Codes
Question: Is it appropriate to code 491.0 with 496 when the patient has chronic bronchit... Read more
Reader Question:
No CC or Prescribed Service Could Mean Preventive Counseling
Question: A patient met with our physician to discuss his need for a scooter. He denied ... Read more
You Be the Coder:
Decide E/M Level Even Without Patient History
Question: Our physician saw patient in the office, but couldn’t get all necessary ... Read more
CPT® 2013:
Learn All About Transitional Care Management (TCM) Codes of 2013
Tip: Watch individual days, not just calendar months. CPT® 2013 introduced two new... Read more
CCI 19.0:
Immunization Coding Affected By Latest CCI Changes
Tip: Pay special attention to influenza vaccines. The latest Correct Coding Initiative... Read more
Otalgia Coding in 2014: Watch For Fifth Digits
ICD-10 will introduce 4 new options. Otalgia is one of the most common complaints in a... Read more
Reader question:
Signature Variations Are Acceptable, If You Maintain Signature Log
Question: We’re having trouble making sure our providers meet signature requiremen... Read more
Reader question:
Report 255.0 for Hypercortisolemia
Question: One of our providers ordered labs with hypercortisolemia as the supporting dia... Read more
Reader question:
E/M Without Vitals: OK To Bill When Documentation Is Good
Question: A daughter brought her mom to our office. The mother was seen by the doctor, b... Read more
Reader question:
+99354 Applicable to Office Visit After Hospital Stay
Question: What is the best way to code for an extended office visit following an acute h... Read more
Reader question:
No Patient History? E/M Level Can Be Decided Based On Other 2 Components
Question: Our physician saw patient in the office, but couldn’t get all necessary ... Read more
You Be the Coder:
Routine Screening and Diagnostic Test: Choose Code Based on Purpose of Test
Question: A patient came in for a bone density scan, which was positive for osteopenia. ... Read more
CPT® 2013:
Learn To Use New Care Coordination Codes
Your chance to report services across multiple specialties for a single patient. CPT&... Read more
Understand Your Electronic Prescription System
Get started now to avoid further pay hits in 2014. Incentives for using electronic pre... Read more
K Codes: Extract More Details For Acute Appendicitis
Hint: Start your search based on the presence or absence of peritoneal involvement. Ab... Read more
News Flash:
Modifiers 24 and 27: New Resources to Bypass CCI Edits Bundling
Plus: You can also override bundles with modifiers LM and RI Coders learned years ago ... Read more
Reader Question:
Consider Each Additional Service While Billing With HCPCS Code G0402
Question: I’m trying to understand what we can bill to Medicare during a patient&r... Read more
Reader Question:
Check Payer Guidelines for Submitting Modifiers
Question: One of my third-party payers is denying L4360 because they are asking for &quo... Read more
Reader Question:
Differentiate Between Multiple Diagnosis and Symptoms
Question: Can I code tonsillitis, pharyngitis, and upper respiratory infection together?... Read more
You Be the Coder:
Choose Proper Modifier for Non-Surgical Service within Global Period
Question: A patient came to our office for a minor skin surgery procedure. He was back f... Read more
Modifiers 24 And 57 Will Allow You to Bypass CCI Edits in 2013
Plus: You can also override bundles with modifiers LM and RI We’ve all heard the ol... Read more
News You Can Use:
Internal Medicine Specialists Should Prepare for Transition Codes, PCIP Pay
Here’s Your Rundown From the 2013 AMA Symposium. The American Medical Associatio... Read more
E/M Coding:
5 Simple Tips to Boost Your E/M Bottom Line
Heads up: Dig past ‘follow-up’ for acceptable chief complaint. E/M coding ... Read more
Mononucleosis: Prepare for Infection, Complication Details
Coding under ICD-10 will depend on the level of detail providers note. When your inte... Read more
Reader Question:
Modifier 50 Not Applicable to 69205
Question: The physician administered anesthesia before removing a bead from each of a ch... Read more
Reader Question:
Check These Code Families for 'Case Management' Scenarios
Question: Services such as phone calls to patients, filling out forms, and coordinating ... Read more
Reader Question:
Never Submit 99211 With 96372
Question: One of our patients purchases her medicine through her prescription program an... Read more
Reader Question:
Use Various ECG Service Codes for Professional and Technical Components, Not Modifiers
Question: Our office owns an EKG/ECG device. How should we bill for tests performed in o... Read more
Reader Question:
Headache Doesn't Always Point to 346.x, Check the Actual Diagnosis modify erase
Question: A co-worker says we can submit "headache" and "migraine" o... Read more
You Be the Coder:
Follow-Up Visit Coding for 10060
Question: A patient saw our physician because of an abscess, and returned for a follow-u... Read more