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Outpatient Facility Coding Alert

ICD-10-CM Updates:
Get Busy Learning This Brand-New Set of ICD-10-CM Codes
No specialty is safe when it comes to ICD-10-CM 2020. The 2020 edition of ICD-10-CM is ju... Read more
Compliance:
Begin Prep Now for New PAMA Rules and Regulations on ADIS Orders
See what it takes to streamline the process between ordering and furnishing providers. Th... Read more
CPT® Coding:
Work Out 3 Unique Cataract Coding Cases
See how well you understand cataract bundling rules. Cataract services can be nuanced and... Read more
You Be the Coder:
Append Appropriate Modifier for OR Complication Treatments
Question: Our physician performed a cystoscopy, a right retrograde pyelogram, and a r... Read more
Reader Question:
Think Outside the Joint for ALL Reconstructions
Question: What CPT® codes will I report for an anterior cruciate ligament (ACL) repair al... Read more
Reader Question:
Use This Modifier for Transgender Screening Mammograms
Question: How do I code for a transgender patient receiving a screening mammogram? We... Read more
Reader Question:
Discern Between US Codes for Intraoperative Services
Question: Should I report 76536 for ultrasound (US) guidance during a total thyroidectomy?... Read more
ICD-10-CM Coding:
ICD-10 Challenge: Work Out This Tricky MRI Report
Hint: Break down the impression into individual components. If you've coded for an indepe... Read more
Guidelines:
Stay on Top of 92502 Guidelines and Policies With This Guide
Use all sets of authoritative resources at your disposal. There are some instances where ... Read more
CPT® Coding:
Learn the Fundamentals of 38531 Coding With 2 Helpful Tips
Prevent unexpected denials by keeping an eye out for bundled services. When 2019 arrived,... Read more
You Be the Coder:
Refer Back to NCCI Edits for Marker Placement With 38505
Question: Can I code for clip placement with an axillary lymph node biopsy? Also, the surg... Read more
Reader Question:
Know Which Dxs Correspond to ABI, Flow Velocity
Question: On a complete bilateral duplex scan of the lower-extremity arteries, I am confus... Read more
Reader Question:
Stick to ICD-10-CM Index for Orbital Erosion of the Skull Diagnosis
Question: What diagnosis code would you report for orbital erosion? Alabama Subscriber A... Read more
Reader Question:
Implement X{EPSU} Payer Rules into Practice Guidelines
Question: Which payers accept the X{EPSU} modifiers? I've heard that you should only repor... Read more
CPT® Coding:
Abide By These Key Cerebral Angiography Coding Rules
Channel guidelines from a variety of different sources. Diagnostic cerebral angiograms ar... Read more
MIPS:
Report MIPS Radiation Codes, Avoid Negative Payment Adjustments
Give your provider the best shot at a positive payment adjustment. Merit-based Incentive ... Read more
E/M Coding:
Watch Out for E/M Pitfalls with Pre-Colonoscopy Screenings
Know when, when not to include an E/M code. Physicians performing colonoscopies in an out... Read more
Reader Question:
Make Proper Distinctions Between Myringoplasty, Tympanoplasty
Question: What's the difference between a tympanoplasty and a myringoplasty? I was under t... Read more
Reader Question:
Bank on This Criteria for 31267 Reporting
Question: I'm coding a maxillary antrostomy. The doctor documents a small amount of tissue... Read more
Reader Question:
Take Indication, Impression into Account When Choosing Dx
Question: I'm working on a chest X-ray with an indicating diagnosis of chest pain and... Read more
You Be the Coder:
Think Twice Before Reporting 66982 for Capsular Cataract Staining
Question: Can I report complicated cataract code 66982 if the surgeon uses trypa... Read more
Case Studies:
Properly Account for Bundling, Laterality, Modifiers in This Surgical Example
When in doubt, report modifier 59 over X{EPSU}. If you're working on a detailed surgical ... Read more
ICD-10-CM:
Boost Your Aftercare, Follow-Up Dx Coding Skills With 2 Examples
Proper code sequencing is only half the battle. The inexperienced coder might use terms l... Read more
CPT® Coding:
Break Down the Nuances of This EGD, Colonoscopy Example
Note when the surgery changes from diagnostic scope to surgical endoscopy. When you're ta... Read more
You Be the Coder:
Know What to Report for Septal Spur Excision
Question: I'm working on a functional endoscopic sinus surgery (FESS) involving a left max... Read more
Reader Question:
Report Single Code for COPD, Bronchiectasis Dx Combo
Question: What is the ICD-10-CM code to report for chronic obstructive pulmonary disease (... Read more
Reader Question:
Avoid Denials, Check Code’s LCDs, ICD-10-CM Crosswalk
Question: We received a denial for code 92511 for due to an incorrect diagnosis code. The ... Read more
CPT® Case Studies:
Use Op Reports, I.D. Fundamentals of Cystourethroscopy Procedures
Use these three operative reports to drive the point home. Every surgical specialty has i... Read more
CPT® Coding:
Code X-Ray-Guided Tube, Catheter Placement According to NCCI Policy
Use key points on reporting initial and secondary X-rays for line and tube placements. Co... Read more
Modifiers:
Enhance Your Assistant Surgeon Modifier Reporting With This Guide
Plus, know how to report PA, NP, and CNS-assisted surgeries. Coding some operative report... Read more
Reader Question:
Go Unlisted With Femoral Hernia Repairs
Question: What CPT® codes should I use to report a laparoscopic bilateral inguinal hernia... Read more
Reader Question:
Bundle Catheter Placement into TUIP Code
Question: The surgeon performs a cystoscopy with transurethral incision of the prostate (T... Read more
Reader Question:
Consider 1 or 2 Oblique Views on Hip X-Rays
Question: I'm working on a unilateral right hip with pelvis X-ray. The provider has docume... Read more
You Be the Coder:
Don’t Leave Reimbursement on the Table With Incomplete Op Reports
Question: My physician performed a 38500, but did not document the closure. I inquired and... Read more
CPT® Coding:
Keep Your UPPP, Pharyngoplasty Coding in Check With These Examples
Learn what to look out for in the documentation. There are plenty of variables to conside... Read more
ICD-10-CM Guidelines:
Bust This Rheumatic Heart Valve Disease Coding Myth
See what pitfalls to avoid when coding heart valve conditions. The world of procedural an... Read more
NCCI Updates:
Acclimate Yourself With These 2019 Integumentary, Cardiovascular Updates
Avoid unnecessary denials by staying on top of some important new hospital and physician e... Read more
You Be the Coder:
Consider Peripheral, Major Veins When Choosing Between 36561, 36571
Question: What is the CPT® code for a left cephalic port-a-catheter placement for a 50-ye... Read more
Reader Question:
Break Down Coding Dynamics for Multi-Sinus Balloon Dilation
Question: How do I code a bilateral frontal sinus balloon dilation and a left sphenoi... Read more
Reader Question:
Check Bilateral Surgery Indicator Before Billing Bilaterally
Question: Can I use modifier 50 when submitting code 17110 if lesions were removed fr... Read more
Reader Question:
Know What Qualifies as Incidental, Separately Billable Intraoperative Appendectomy
Question: While performing an open gallbladder removal, the surgeon noted localized perito... Read more
Modifiers:
Get Familiar With Modifier JW Use in OPPS Settings
See how guidelines differ in outpatient facility settings. When billing and reporting for... Read more
Guidelines:
Adhere to Rules on Single-View Chest, Abdomen X-Ray Coding Cases
Learn how to navigate between parenthetical notes and other authoritative sources. Someti... Read more
CPT® Coding:
Case Study: Know When to Code Hernia Repair With Colon Resection
Learn the rules for separate services. From a coder's perspective, some of the more chall... Read more
Reader Question:
Consider this C Code for MRI Breast With Contrast
Question: How should I report a magnetic resonance imaging (MRI) scan of the breast with c... Read more
Reader Question:
Make These Considerations When Choosing Vulvar Excision Code
Question: The doctor removed a 10 cm vulvar mass from a patient. The mass was external and... Read more
Reader Question:
Consider Modifier 79 for Unrelated Procedure Within Global Period
Question: The provider performed a debridement endoscopy (31237) at a one-month check-up v... Read more
Reader Question:
Report C9749 for Latera Implant in OPPS Setting
Question: I have a doctor that performed a “placement of bilateral Latera® implants for... Read more
You Be the Coder:
Check for Specific Criteria on Duplex Scan Reports
Question: On a scrotal ultrasound (US) with duplex scan, the provider docum... Read more
CPT® Case Study:
Break Down Each Step of This Oropharyngeal Resection Procedure
Use all the resources at your disposal to reach the correct coding choice. The process of... Read more
CPT® Guidelines:
Avoid These Pitfalls on 2019 Breast MRI, CAD Combo Coding
Plus, don't let this semantic error send you into a coding tailspin. By this time of year... Read more
ICD-10-CM Coding:
Report External Cause Codes Accurately and Confidently With These Tips
Add clarity and context to your primary diagnoses with external cause codes. Although not... Read more
Reader Question:
Consider CT Shoulder Arthrography, CT Upper Extremity 1 in the Same
Question: What's the CPT® code for a computed tomography (CT) arthrography of the shoulde... Read more
Reader Question:
Check Medicare Criteria for AAA US Screenings
Question: What criteria need to be met in order for a Medicare patient to qualify for an a... Read more
Reader Question:
Note Circumstances of Postop Pain Before Determining Dx Code
Question: A patient is seen by the physician two days following an ethmoidectomy. The pati... Read more
Reader Question:
Know How to Sequence Complication, Condition Codes Properly
Question: How should I code a diagnosis of chronic nasal bleeding following sinus surgery?... Read more
You Be the Coder:
When in Doubt, Use Clinical Responsibility as a Reference
Question: My physician is suggesting that we report code 30117 for the removal of a nasoph... Read more