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Primary Care Coding Alert

2002 Diagnosis Codes Are More Specific Describing Asthma, Womens Conditions
Family practice coding professionals will rely on a number of important new and revise... Read more
CPT 2002 Has Few Changes That Affect FPs
Family physicians will find few changes when new CPT 2002 codes are implemented Jan. 1, 20... Read more
Time Is of the Essence in ADD Evaluation
A few weeks after students return to school in the fall and again after the winter holid... Read more
FPs Inundated With Complaints of Anthrax Exposure
With the ongoing reports of biological terrorism saturating the media, many family p... Read more
To Bill or Not To Bill:
Telephone Code Refresher
While FPs spend a lot of time on the telephone with patients, most do not bill telepho... Read more
Reader Question:
After-Hours Codes
Question: A physician was treating a newborn who was jaundiced. He received the lab result... Read more
Reader Question:
Anxious Patient on Medication
Question: A patient presents with complaints of anxiety. Because the patient takes Imipram... Read more
Reader Question:
Biopsy Versus Excision
Question: If a physician removes a lesion from the face for biopsy and sends it for pathol... Read more
You Be the Coder:
Coding the Get-Acquainted Visit
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
2-D Approach Simplifies Workers Comp Claims
Family practice coders can make workers' compensation reporting easier by remembering th... Read more
Bone Up on Fracture Care Coding
Coding fracture care is a lot like working a puzzle: Coders must identify various piec... Read more
Reduce Denials on Follow-Ups Via the V Codes
Family practice coders are often confused whether they should use V codes to bill follow... Read more
Reader Question:
New Versus Established Patient
Question: One of our patients was seen by a physician who had seen her two years ago at a ... Read more
Reader Question:
Diagnosis Coding
Question: Should we assign a diagnosis code based on the symptoms that a patient present... Read more
Reader Question:
Diagnostic Pap Smear
Question: How should we bill Medicare for obtaining a diagnostic Pap smear? The patient ... Read more
You Be the Coder:
TB Skin Tests
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Dont Miss a Beat:
Pay Attention When Reporting Similar Cardiac Monitoring Codes
Family physicians may use one of several monitoring techniques to evaluate patients ... Read more
Documentation Drives Proper Wound-Repair Coding
Minor and intermediate wound repair is a staple of many family practices: An 8-year-old bo... Read more
E/M Guideline Revisions Suspended
Eagerly awaited modifications to E/M documentation guidelines have been postponed while ... Read more
Conference Targets Coding, Compliance
The National Pediatric and Ob-Gyn Coding and Compliance Conference: 2001 will be held in N... Read more
Reader Question:
Additional Time With Disabled Patients
Question: Our practice sees two patients who are hearing- and speech-impaired. Are there c... Read more
Reader Question:
Pelvic Exam Without Pap Smear
Question: A Medicare patient who recently had a Pap was seen in our office because of vagi... Read more
Reader Question:
Refusal To Sign ABN
Question: Recently, a Medicare patient refused to sign the advance beneficiary notice (A... Read more
You Be the Coder:
Place of Service
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Follow-up Care for Newborns Means Additional Codes Reported and Reimbursement Received
According to the American Academy of Family Physicians (AAFP), more than 60 percen... Read more
Successful Diabetes Coding Requires a Fifth Digit
Most FPs report that many of their patients suffer from diabetes, which is not surpris... Read more
Get Paid for Back-to-School Hearing and Vision Screening
For many students in the fall, "back to school" also means back to the doct... Read more
Reader Question:
Coding Rechecks
Question: When treating a child with an ear infection, our FP asks the family to schedule ... Read more
Reader Question:
New Physicians Joining the Group
 Question: Recently, we added two new physicians to our practice. Should we code all ... Read more
Reader Question:
Payment for Supplies
Question: Can our practice recoup the cost of supplies for services or minor procedures pe... Read more
You Be the Coder:
Diagnosed Pregnancy at Annual Checkup
Test your coding knowledge.  Determine how you would code this situation before ... Read more
You Be the Coder:
Pulse Oximetry Denials
Question: Why are claims for pulse oximetry nearly always denied?Iowa Subscriber  An... Read more
Six Factors Affect Reimbursement for Wart Removal
No fewer than six distinct factors impact coding for wart removal, and each eleme... Read more
Standardized Forms Can Facilitate Proper Coding
Few family practice coders would argue: the more they know about what takes plac... Read more
HCFA Name Change
The Health Care Financing Administration (HCFA), which administers Medicare and Medicaid... Read more
Reporting Noncovered Medicare Services
This spring, CMS deleted HCPCS modifier -GX (service not covered by Medicare). This modi... Read more
Automatic Denial of Pre-Op V Codes Banned
CMS's directive prohibiting local carriers from automatically denying claims containing ... Read more
Reader Question:
Multivisit Coding Complications
Question: A patient dropped a 25-pound bag of salt on her right foot. She went to the urge... Read more
Reader Question:
Meningitis Vaccine
Question: We frequently provide meningitis vaccines to college-age students who may be a... Read more
Reader Question:
Use E Code To Explain
Question: We received a denial for a claim describing services provided to a patient w... Read more
You Be the Coder:
After-Hours Code
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Dont Let Confusing Nebulizer Definitions Hurt Your Reimbursement
Family practice coders struggle with how to report several nebulizer encounter codes  and... Read more
Get Paid for Problems Treated During Preventive Exams
Preventive service is a classic example of an area where good medicine doesn t necessaril... Read more
Correct Coding Scenarios Using 94640, 94664, 94665
Example #1: A 13-year-old boy comes into the office for an unscheduled visit after soccer... Read more
Reader Question:
Hematoma Drainage
Question: Which code do I use when the doctor says he did an incision and drainage (I&am... Read more
Reader Question:
Initiation of Observation
Question: When should I begin timing for eight-hour observations? Does this service begin ... Read more
Reader Question:
Delayed Development
Question: We recently had a mother bring in her 4-year-old son because she was concerned a... Read more
Reader Question:
Overnight Pulse Oximetry
Question: Can I use 94762 to report overnight pulse oximetry?West Virginia Subscriber Answ... Read more
Reader Question:
HPI by Ancillary Staff
Question: I was at a seminar recently and heard a speaker say that details gathered at th... Read more
Reader Question:
Multiple Procedures Modifier
Question: When I add modifier -51 to a claim, does it matter what procedure codes I append... Read more
Reader Question:
I&D with E/M
Question: I am not sure which codes to assign for the following procedure. Is there enough... Read more
Reader Question:
Newborn Circumcision
Question: Which diagnosis code should I report for a newborns circumcision? We had been us... Read more
You Be the Coder:
Interpreting X-rays
Test your coding knowledge. Determine how you would code this situation before looking at ... Read more
Dont Miss a Beat When Coding ECG Interpretations
When family physicians (FPs) order electrocardiograms (ECG), correct coding depends on wh... Read more
Get Paid for FOBTs Obtained During an Office Visit
Whether a practice can report diagnostic guaiac tests performed during a digital rectal ... Read more
Coders May Count Organ Systems in Both HPI and ROS
Because documentation for E/M services is so closely scrutinized, family practice coders a... Read more
Reader Question:
Infant Blood Draw
Question: One of our physicians made three attempts (arterial, femoral and brachial) to dr... Read more
Reader Question:
Prolonged Services
Question:Our physician recently spent 70 minutes providing a level-three established patie... Read more
Reader Question:
Suture Removal
Question: How would we code for suture removal when our physician didnt do the original re... Read more
Reader Question:
Discharge to Nursing Home
Question: How do I code a Medicare patient being transferred from the hospital to the nurs... Read more
Reader Question:
Pre-op Vasectomy Consults
Question: A patient comes in with his wife for a vasectomy consultation with our physician... Read more
Reader Question:
Fracture Care
Question: On occasion, our physicians are called to the emergency department (ED) to see a... Read more
You Be the Coder:
Genital Wart Removal
Reviewed on May 22, 2015 Test your coding knowledge. Determine how you would code this... Read more
Diagnoses and Physician Qualifications Are Vital For Concurrent Care Reimbursement
Family physicians (FPs) reporting services concurrently with other specialists should foll... Read more
RVU File Contains Essential Coding Information for Family Practices
Many coding and billing professionals view HCFAs national relative value units (RVU) file ... Read more
Low-level E/M May Generate Higher Level of Revenue
Proper use of low-level office visit codes (99201 and 99211) can provide an important stre... Read more
2001 National Physician Fee Schedule Relative Value File
CPT Codes and descriptions only are copyright 2000 American Medical Association. All Rig... Read more
Sample 99211 Policy (B)
Policy: Use of CPT code 99211Purpose: To clarify the use of 99211, thereby ensuring consi... Read more
Sample 99211 Policy (A)
Policy Name: Coding and Documenting 99211 Office VisitsPolicy Number: 101Effective Date o... Read more
Reader Question:
Observation Discharge
Question: How do I bill the following scenario using the new hospital observation codes? A... Read more
Reader Question:
IUD Removal
"Question: One of our patients came in complaining of cramping and bleeding in between her... Read more
Reader Question:
Unna Boot
Question: Could you please tell me which diagnosis codes are most appropriate to assign wh... Read more
Reader Question:
Hydrocele Excision
Question: I am coding the excision of a hydrocele of the spermatic cord. I understand that... Read more
You Be the Coder:
PMDD = Premenstrual Syndrome
Question: The advertisements on television lately advise patients to see their physicians ... Read more
New HCPCS Codes Render Payment for Home Health Certification
HCFA introduced two temporary (HCPCS) codes in 2001, giving family physicians (FP) an aven... Read more
Accurate Diagnosis Coding is Key to Reporting Hypertension Services
Many family practices report that diagnosis coding for hypertension can be problematic b... Read more
How to Code ED Visits Properly to Assure Timely Payment
Family physicians (FPs) are often called when a patient is seen in the emergency departmen... Read more
Reader Question:
Varying Rates
Question: Can a practice have different charges for patient types, i.e., Medicaid, Medicar... Read more
Reader Question:
Wound Exploration
Question: What code for superficial wound exploration do I use in the following situatio... Read more
Reader Question:
Fecal Disimpaction
Question: Is there a specific code our practice can assign for fecal disimpaction? We have... Read more
Reader Question:
Question: Recently weve had a lot of claims denied with patients we have diagnosed as depr... Read more
You Be the Coder:
Specimen Transfer
Question: Can you explain the proper use of CPT code 99000? Our practice does not pay for ... Read more
Increase Revenue Ethically by Reporting Same-day Joint Injections and E/M Services
The typical treatment for conditions like tendinitis, osteoarthritis, rheumatoid arthritis... Read more
Gain Accurate Reimbursement by Distinguishing Between Consultations and Referrals
Correct use of consultation as opposed to referral can have significant impact on physicia... Read more
HCFA Suspends a Large Portion of the CCI 6.3 Edits
In an unusual move, HCFA has announced the suspension of national Correct Coding Initiativ... Read more
Reader Question:
Cerumen Removal
Question: Is it appropriate to charge for an evaluation and management (E/M) code in addit... Read more
Reader Question:
Use of Modifier -57
Question: How do I correctly assign modifier -57? It seems to be very similar to modifier ... Read more
You Be the Coder:
Coding E/M Based on Time
Question: If a physician spends 50 minutes with an established patient and documents that... Read more
Two New Coding Options Dispel Confusion When Reporting Care Plan Oversight Services
Understanding and justifying the use of care plan oversight codes (99374-99380) has always... Read more
Coding Crisis:
Mini-mental Exams Are Included in E/M Service
Family physicians and coding professionals are frustrated with the confusion surrounding p... Read more
Oversight Guidelines
According to CPT, the specific guidelines family physicians need to keep in mind when logg... Read more
Reimbursement for Rape Exams Rests on Diagnosis
Coders who work for family practices where rape or sexual abuse exams are performed unders... Read more
Care Plan Oversight Log Sheet
To view this log sheet please open the PDF file. ... Read more
Reader Question:
Followup Coding
Question: One of our patients with hypertension came in for a four-month followup exam. He... Read more
Reader Question:
Medical Testimony Coding
Question: An attorney representing one of our patients recently requested that our physici... Read more
Reader Question:
Parental Consults
Question: A parent schedules an appointment to show the physician reports on tests conduct... Read more
Reader Question:
Factor Time With Wound Care
Question: How should we bill for a visit that involves simple wound care when no debrideme... Read more
You Be the Coder:
Hemocult Coding
Question: If a physician performs a rectal exam and completes one hemocult card while in t... Read more
Understand Pulmonary Function Coding to Boost Payment for Spirometry
Many family practice coders describe significant confusion regarding how to properly repor... Read more
HCFA Changes Eliminate Reimbursement Policy Conflict
As most family practice coders anticipated, Medicare revised its payment policy for sever... Read more
Pulmonary Function Codes
Additional CPT 2001 codes for pulmonary function. 94010 spirometry, including graphic r... Read more
Reader Question:
Regular Portacatheter Cleaning
Question: We have a patient whose portacatheter is cleaned monthly with saline followed by... Read more
Reader Question:
Injection Therapy
Question: A patient recently seen in our practice was suffering from tendonitis (i.e., 726... Read more
Reader Question:
Workers' Compensation Claims
Question: We had a patient come in for a job-related injury, but also had a cold. Can this... Read more
Reader Question:
Urine Collection
Question: How do we code urine collection for drug screens?New York Subscriber Answer: Us... Read more
Reader Question:
Ear Piercing
Question: How do I code when a clinical staff member performs ear piercings?Ann Cutler Elk... Read more
You Be the Coder:
Allergy Shot With Office Visit
Question: A patient came to our office for a level-three outpatient visit and requested an... Read more