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Primary Care Coding Alert

You Can Unbundle Medicare's X-Ray Codes
Use modifier -59 for separate sides It's official: You should code a finger or a ... Read more
Immunization Alert:
How to Code Just-Released FluMist
Get ready for flu vaccines with this combo Wondering what to do about the new intranasal ... Read more
Pediatric Coding Corner:
3 Tips for Improving Your Lactation Counseling Pay
You can bill more than 99211 for this service You could be losing out when your office pr... Read more
Think NCCI 9.3 Won't Affect Your Hospital Billing?
Medicare adds pharmacologic management edits If you report 90862, you'll need to know whi... Read more
Avoid Workers' Comp Underpayments With E Codes
3 steps will improve your pay If you don't assign E codes when you file workers' comp... Read more
Reader Question:
Know When to Bill an E/M With 29580
Question: After evaluating an established patient's varicose leg ulcer, the family physici... Read more
Reader Question:
Don't Report TB Administration Separately
Question: Should I bill for an injection administration in addition to a tuberculosis (TB)... Read more
Reader Question:
Recoup Communication Difficulties
Question: A new patient who is unable to communicate clearly and to explain her medical pr... Read more
Reader Question:
Surgical Package Includes Local Anesthetics
Question: Would you clarify when I should report J3490 for Marcaine?North Carolina Subscri... Read more
Reader Question:
Patient's Status Drives Component E/M Coding
Question: During an office visit, my family physician performed an expanded problem-focuse... Read more
Reader Question:
You May Charge G0101 and Q0091
Question: My family physician performs a breast and pelvic exam on a Medicare patient and ... Read more
You Be the Coder:
CPO Coding
Question: During the final weeks of a patient's life, hospice caregivers call a family phy... Read more
Do You Know These 93000 Requirements?
Experts reveal 4 secrets of component-ECG coding Family physicians (FPs) don't al... Read more
Boost Your Diagnostic Element With 3 Proven Strategies
Get inside your FP's head to code E/M services appropriatelyWant an easy way to more accur... Read more
Don't Miss Out on E/M Charges With Wart Removal
Are you having trouble deciding when to charge 99201-99215 with 17000-17111? Coding expe... Read more
Pediatric Coding Corner:
4 Field-Tested Tips for Improving Newborn Exam Payment
When your FP evaluates a newborn after a hospital discharge, consider the visit a problem-... Read more
5 Steps Get You Paid When Using Modifier -22
If you're submitting claims for unusual procedural services without first determinin... Read more
Take the Sting Out of Coding for Allergy Reactions
You could be losing out when your family practitioner (FP) treats bee-venom-triggered anap... Read more
Avoid Counseling Underpayments With 3 Simple Coding Rules
You can boost your E/M levels and generate more reimbursement for your practice by trackin... Read more
We'll Show You How to Bill ECGs Correctly
A flow chart points you to the right codeAnswer two questions regarding your family physic... Read more
Reader Question:
Put Surgical Clearance Diagnoses in Order
Question: To cover preoperative consultations, Medicare requires V72.81-V72.84 for the pri... Read more
Reader Question:
Discover Code for Thumb Radiology
Question: The Coder's Desk Reference says that CPT 73140 is for digits 2-5 excluding the t... Read more
Reader Question:
Best Way to Code Ear-Wick Placement
Question: Which code should I assign for inserting a wick in a child's ear?Georgia Subscri... Read more
Reader Question:
Consult or Inpatient E/M Depends on Care
Question: Our family physician (FP) decides to admit an established patient to the hospita... Read more
Reader Question:
Use V Codes for Travel Exam
Question: Prior to traveling to China to adopt a baby, an established patient presents for... Read more
Reader Question:
Check Time Constraints of After-Hours Codes
Question: Our office has posted hours of 7 a.m. to 11 p.m. When may we use 99050 and 99052... Read more
Reader Question:
99211 Requires a Service
Question: When a patient drops off a urine sample and doesn't see a nurse, may I report 99... Read more
Reader Question:
Opt for -22 Over an Unlisted-Procedure Code
Question: Our physician asks us to report procedures that take extra time and effort wit... Read more
Reader Question:
Identify Separate E/M From 46600
Question: When my family physician (FP) performs an anoscopy during an office visit, shoul... Read more
Reader Question:
Body Regions Involved Determines OMT Coding
Question: My family physician's (FP) chart states: "OMT to lumbar, sacral, leg and pelvic ... Read more
Reader Question:
Who Specified What
Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I... Read more
Reader Question:
Code 90782 Multiple Times
Question: When using 90782 for injection administration, can I use this multiple times wit... Read more
You Be the Coder:
Worker Needs Occupational Vision Screening
Question: A 35-year-old firefighter comes in for his annual exam and also requires a visua... Read more
Reporting 600.0 for BPH? Not for Long
You will finally have a code to specify whether a patient's prostate enlargement involves ... Read more
FP ICD-9 Code Changes:
A Clip-N-Save Short List
Save yourself the hassle of sorting through the entire 2003 ICD-9 manual with this handy l... Read more
69210 for Irrigation, Right? Wrong
If your family physician (FP) isn't using instrumentation to remove cerumen, you might hav... Read more
Quick Chart Reveals 4 Clever Ways to Code Ear-Wax Removal
Need some direction on coding cerumen-removal methods? If so, coding experts, Medicare pol... Read more
Pediatric Coding Corner:
A Simple Rule Avoids a VFC Coding Pitfall
Despite vaccine program variations, one constant exists: You should always code for the va... Read more
Reader Quesiton:
Straighten Out a Two-Day Admission
Question: After seeing a female patient in his office, family physician (FP) A admits the ... Read more
Reader Question:
Rule Out Unconfirmed Diagnosis
Question: If lab or imaging data do not support a particular diagnosis, should I report th... Read more
Reader Question:
Tackle Time-Consuming PAP Forms
Question: My medical assistant (MA) spends a lot of time completing the paperwork required... Read more
Reader Question:
Psychiatrist's Intent Determines E/M Code
Question: Our family physicians (FP) treat many patients for anxiety or depression. We use... Read more
Reader Question:
Know What the Fourth Digit Means in 401.x
Question: When should I use a diagnosis of malignant hypertension? For example, if a patie... Read more
You Be the Coder:
Determine 99381-99397-52 Applicability
Question: When my family physician (FP) performs a sports exam and performs a brief histor... Read more
Which New NCCI Cast Bundle Will Trigger a Denial? Hint:
Its a Combo You Shouldnt Report Anyway
If you're wondering about reporting a fracture treatment and cast code for the same anat... Read more
ICD-9 2004 Top Family Practice Changes Are Coming Soon
If coding urgent urination has stumped you, starting Oct. 1 you may be able to use 788.63 ... Read more
Clip and Save This Related-Fracture Care Chart To Get 100 Percent of Your FPs Services
Don't lose out on entitled revenue when your family physician (FP) treats fractures or r... Read more
How a Simple Pre-Op Exam Code Can Save You $200 Per Week
When your family physician (FP) examines his own patient for surgical clearance, dont miss... Read more
Pediatric Coding Corner:
Test Your Prolonged Service Skills With an Asthma Scenario
If you want to charge 99354 when your family physician (FP) treats asthmatic reactions, th... Read more
YouBe the Coder:
Recoup Same-Day E/M and Discharge Services
Question: My family physician (FP) attends to a badly burned boy in the hospital and disch... Read more
Reader Question:
Get the Lowdown on Discussing 95250 Results
Question: When a patient returns for the report after a 72-hour glucose monitoring (95250)... Read more
Reader Question:
NCCI Determines Applicable Wound Modifier
Question: In the June 2003 Family Practice Coding Alert article on lacerations, you sugges... Read more
Reader Question:
Skill Separates 36410 From 36415
Question: What is the difference between venipuncture codes 36410 and 36415?Florida Subscr... Read more
Reader Question:
Take the Pain Out of J2000 Denials
Question: How should I code for a joint aspiration injection of lidocaine? Should I bill f... Read more
What No Ones Telling You About ADD/ADHD Exam Coverage
Don't let conflicting information on using 90801 and 90862 versus 99214-99215 for ADD/... Read more
3 Immunotherapy Requirements Most Coders Miss
If you're billing incorrectly for 95165, you're not alone a recent survey found that 40... Read more
Are You Coding 99303, 99238/9? Heres When Its OK to Do So
Many family physician (FP) coders are eager to capture the extra $69.17 for a hospital d... Read more
Reader Questions:
Consider E/M Significance When Weighing Denials
Question: Payers always deny starred procedures when billed with an E/M code and modi... Read more
Reader Questions:
Sniff Out Sensitivity Test Limitations
Question: When my family physician (FP) performs allergy testing (86003, 95004, 95024, 950... Read more
Reader Questions:
Tally History Elements
Question: May I count the organ systems in both the HPI and the ROS?California Subscribe... Read more
Reader Questions:
Determine CPE Charge Based on 99397-G0102
Question: When we perform a digital rectal exam on the same date of service as a prevent... Read more
You Be the Coder:
In-Office Wound Closure Requires More Care
Question: A patient presents with a wrist laceration through multiple muscle layers and ve... Read more
Dont Book That Package Until You Check Out These Divided Pregnancy Care Coding Tips
When your family physician (FP) shares maternity care outside a group-... Read more
Are You Sewing Up Scrapes Correctly?:
A 4-Step Test Will Ensure Flawless Coding
With long summer days right around the corner, fitness fanatics long cooped up insid... Read more
Reader Question :
Stop Ticking Services Away
Question: My family physician (FP) removed an embedded tick from a patient's upper arm... Read more
Reader Question :
Nail Foot-Care Payment
Question: A Medicare diabetic patient presents for nail trimming of onychonosus nails.... Read more
Reader Question :
Compare PFSH to Disease Diagnosis
Question: When should I use a diagnosis of family history of malignant neoplasm rather... Read more
Reader Question :
Measure Your Supply Code Knowledge
Question: My family physician administered 2 milliliters (mL) of Decadron with 1 mL = ... Read more
Reader Question :
Ignoring New TPI Rules Is Painful
Question: Insurers keep denying trigger point injection (TPI) claims with 20550. For i... Read more
Reader Question :
Use ICD-9 to Explain Unusual Lactation
Question: How should I code hyperprolactinemia due to psychological medications? Would... Read more
You Be the Coder:
To Interpret and to Read Is What Matters
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Break Free of Fracture Coding Problems
Capitalizing on reimbursement for treating simple fractures in the primary-care sett... Read more
Take a Reading on 99211 & PPD
Faced with numerous endorsements that you can report a nurse visit for interpreting tu... Read more
Birth and Blood Are Under Fire From NCCI
The latest version of the National Correct Coding Initiative (NCCI) targets obstetric ... Read more
Reader Question:
Inject a Reason
Question: A patient presents with elevated blood sugar. A family physician (FP) admini... Read more
Reader Question:
Judge ROS Versus PFSH
Question: A patient presents complaining of a swollen and sore wrist with symptoms las... Read more
Reader Question:
A Dime a MinuteApplies in the Office
Question: How should I code for Coumadin management when our physician does the evalua... Read more
Reader Question:
Stop Stressing Over ECGs
Question: My family physician performed an electrocardiogram (ECG) prior to giving the... Read more
Reader Question:
Compare Rest Home to Home Visit Criteria
Question: A family physician makes home visits to home-bound elderly patients who live... Read more
Reader Question:
Screen Carriers for G0107 Specifics
Question: Which diagnosis code does Medicare accept for an occult blood test perfo... Read more
You Be the Coder:
Destroy Lesion Excision Confusion
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Delve Into Lesion Excisions With 5 Tips
Faced with a host of new 2003 directives, family physician coders who already cite l... Read more
Lesion 101:
Uncover Excision Basics
Some family physician (FP) coders may look at a report containing excision and start... Read more
Mind Your Ss,Qs and Gs When Billing Well Visits,Paps
When billing for a preventive medicine service, gynecological examination and Pap smea... Read more
Reader Question:
Dont Hold Your Breath Over O2
Question: Should we bill for oxygen administration and the oxygen? South Carolina Sub... Read more
Reader Question:
Know the Ins and Xs of 99245 and 90801
Question: An ob-gyn referred a patient to my family physician for a psychiatric evalua... Read more
Reader Question:
Swab It to the Lab
Question: Should we bill insurance carriers for nasal swabs? We perform them in the of... Read more
Reader Question:
Wave -QW
Question: When we perform waived lab tests, such as strep screens and accuchecks, shou... Read more
Reader Question:
Who Specified What
Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I select between th... Read more
Reader Question:
Cut the Fat
Question: Which CPT code(s) should I use for a patient who requires regular choleste... Read more
You Be the Coder:
Stick to Injection Specifics
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Break Down Nebulizer Session to Capture Allowable Services and Procedures
Although CPT 2003 clarified the nebulizer training codes, famil... Read more
FPs Receive Double Whammy:
Fee Schedule for 2003 Slashes RVU Reimbursement, Amount
Medicare not only cut relative value unit (RVU) reimbursement fo... Read more
Dont Let the Interim Fee Schedule Filing Rules Drive You Crazy
Juggling two fee schedules for one calendar year could drive the most patient fa... Read more
CMS Rejects New Hepatitis B Codes, Accepts Old Versions
Just when you thought you grasped the CPT 2003 changes, CMS reverses its decisio... Read more
The 2003 Fee Schedules Bottom Line:
CMS Cuts E/M Reimbursement Levels
... Read more
Reader Question:
Dont Charge Extra for Bilateral 69210
Question: For 69210, should we charge one price regardless of whether the physic... Read more
Reader Question:
On-Call Requires Patient-Specific Attendance
Question: How do the new on-call codes apply? Insurers will likely not pay for t... Read more
You Be the Coder:
To Append an Attempt or Not?
Test your coding knowledge.Determine how you would code this situation before look... Read more
Medicare Is Not so Stingy When FPs Share Treatment with EDs
Like most coders, you probably assume that a family physician and an emergency physi... Read more
Consultation versus ED Service Codes:
Mark the Motive
Confusion over when to bill for a consultation and when to bill emergency department (... Read more
CCI 9.0:
Small but Significant Changes
The Correct Coding Initiative (CCI) latest edits, version 9.0, offer few changes for f... Read more
New NPP Rules Affect Hospital,Not Office,E/Ms
Question: I've heard that CMS issued a memorandum regarding new NPP guidelines. Wi... Read more
Reader Question:
Use E/M Codes for Removal of Sutures Placed by Different Doctor
Question: How should I report suture removal without anesthesia in the office when o... Read more
Reader Question:
Use Consult Codes for Some Pre-Op Visits
Question: A Medicare patient of ours is going in for surgery, and the surgeon requeste... Read more
You Be the Coder:
After-Hours Coding
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
You Be the Coder:
Use Alternatives for Unclear Bowel Diagnosis
Question: A patient says she has had chronic bowel problems for the last 10 years, wit... Read more
Ring In the New Year With CPT 2003
The New Year brings new and revised codes that will significantly affect family ... Read more
Post-Op Payment:
Use a Different Diagnosis Code
When your practice provides postoperative care, the key to proper reimbursem... Read more
Reader Questions:
Sports Physical Not Problem-Oriented
Question: Our practice has so much trouble getting reimbursed for sports physica... Read more
Reader Question:
Follow Medicare Fecal-Occult Requirements
Question: Does Medicare cover fecal-occult stool samples for Medicare patients who... Read more
Reader Question:
Pay Attention to Lesion Global
Question: When destroying multiple lesions using cryosurgery, my doctors want to b... Read more
Reader Question:
Watch Out for Mental-Health Codes
Question: A mother brought her toddler in with a chief complaint of sleeping pro... Read more
Reader Question:
Peak Flow Not Separate
Question: I never know when to charge for peak flow separately or when it's included... Read more
You Be the Coder:
Use Place of Service With Nursing Home Consult Code
Test your coding knowledge. Determine how you would code this situation before l... Read more