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Primary Care Coding Alert

Halt Knee-Related Injection Rejections With 3 Critical Details
Code 20610 might always need a modifier for Medicare pay If denials for trigger point a... Read more
Clean Up Maternity Confirmatory Visit Claims With Quick Quiz
Don't miss out on E/M fees by initiating the maternity record too soon When your FP sim... Read more
Pediatric Coding Corner:
Protect Time-Based Pay in 2 Easy, But Critical, Steps
Omitting this detail could cut a 99214 to a 99213 If time-selected E/M documentation do... Read more
Reader Questions:
9924X Allowed Source Depends on Guideline
Question: May a provider bill insurance for a consultation that a school nurse or teache... Read more
Reader Questions:
Look for Site-Specific I&D Code
Question: Our physician assistant (PA) did an incision and drainage (I&D) (10060) fo... Read more
Reader Questions:
2 Hospital Visits: 1 E/M or 2?
Question: A private payer representative informed my doctors that they can bill for more... Read more
Reader Questions:
Consider MMSE Part of E/M
Question: An FP saw a 72-year-old woman because she had been feeling light-headed and di... Read more
Reader Questions:
Consider 90465, 90471 Mutually Exclusive Codes
Question: Regarding the counseling code for vaccines administered to patients less than ... Read more
You Be the Coder:
Align 'Well' Cervical Pap Diagnoses
Question: An FP performs a preventive medicine service and collects a Pap smear for cerv... Read more
Use Inside Info to Prevent HPI Rule Hunt
In CMS's eyes, this element is your FP's duty Although support staff might want to ligh... Read more
Risk Audit by Coding Same-Date E/M, Critical Care
Heed this warning: Medicare mentions -discretionary reviews- on 99291 claims You-ll nee... Read more
Clean Up 99291 Claims by Keeping Up With Transmittals
Medicare now excludes critical care and an ED E/M on same date CMS has released a flurr... Read more
Pediatric Coding Corner:
Using 2 ICD-9 Tips to Get Paid for 95930 and E/M
Careful: Sometimes a well-check diagnosis isn't the way to go You-ll get paid the first... Read more
Reader Questions:
Include Anesthesia in 1 Circ Type
Question: When an FP performs a neonatal circumcision without anesthesia, a consultant s... Read more
Reader Questions:
Code Differently for 'Alterations' and 'Blackouts'
Question: A 25-year-old new patient reports to the FP for his initial visit. He says tha... Read more
Reader Questions:
ICD-9 Code Choice Depends on Apnea's Cause
Question: The physician performs a level-two E/M on a new patient with sleep issues. The... Read more
Reader Questions:
Freeze at 327.XX ICD-9 Section for Sleep Paralysis
Question: An established patient reports to the FP reporting that shortly after waking u... Read more
Reader Questions:
If Physician Makes No Incision, Opt for E/M
Question: A patient presents to the FP with shards of glass from a shattered light bulb ... Read more
You Be the Coder:
Complex or Simple Nosebleed Treatment?
Question: An established patient reports to the FP with a bleeding left nostril. She tel... Read more
Heed New Transmittal When Compiling Critical Care Time or Face Denials
Medicare release clears up family counseling, concurrent care rules If you can spot cr... Read more
Protect Incident-to Pay With This Added Phrase
Hassle-free option: NPP can report the service directly without having to satisfy criter... Read more
ICD-9 2009 Update:
Prepare to Expand Fever Diagnosis so Fall Claims Will Sail Through With Ease
Your 780.6 entry soon will require four more lines To report a fever of unknown origin ... Read more
Reader Questions:
Use Modifier 51 on Some Surgery Encounters
Question: A patient reports to the FP with two cuts on his right forearm: a deep 6-cm la... Read more
Reader Questions:
Get Your MIA CPT Codes Here
Question: I read that the CPT Codes 2008 manual doesn't contain three new vaccine codes... Read more
Reader Questions:
It's Not too Late to Participate in PQRI
Question: Our family medicine practice did not begin the Physician Quality Reporting Ini... Read more
Reader Questions:
Choose Code After Checking for Preservatives
Question: The FP's physician assistant (PA) administered a preservative-free intramuscul... Read more
Reader Questions:
Patient Actions Guide Insulin OD Code Choice
Question: Encounter notes indicate that a patient with uncontrolled type II diabetes had... Read more
You Be the Coder:
How to Code Admit to Hospitalist
Question: An FP sees an established patient in the office for high fever and dehydration... Read more
Revert to 'Crossed-Out' for Your Inhalation Solution Drugs
Albuterol, levalbuterol pay depends on returning to more specific J codes Although you ... Read more
On the Cutting Edge:
Use 2 Questions to Pin Down J7611-J7614 Inhalation Coding
You can crosswalk brands, deleted code with this flowchart A year and a half has passed... Read more
ICD-9 2009 Update:
Use New Codes for Diabetes Caused by Another Problem
Changes also make blood-in-urine, pressure-ulcer coding more specific You can head off ... Read more
ICD-9 2009 Update:
Focus on Headache Details to Master Diagnosis Subsets
These terms help you sort through post-traumatic, cluster, tension categories Although ... Read more
Reader Questions:
Apply Universal New-Patient Definition
Question: A physician in our group provides an E/M service to a hospital inpatient. If t... Read more
Reader Questions:
How to Report Hearing Loss Unfounded
Question: A 12-year-old patient comes to us after failing a school hearing screen but pa... Read more
Reader Questions:
E/M Not Possible When Session Is for Training Only
Question: An established patient with acute bronchitis reports to the FP's office for a ... Read more
Reader Questions:
Wait for Cards Before Reporting Take-Home FOBT
Question: An established patient receives a level-two E/M service from the FP, who then ... Read more
You Be the Coder:
E/M or Nosebleed?
Question: An established patient reports to the FP with a nosebleed that he could not st... Read more
Update Your IVIG Codes Today to Avoid a Pile of Denials
Medicare still pays for immune globulin shots -- under new guidelines If you haven't no... Read more
Follow These Coding Do's on Inhalation Service Claims
Code 94664 describes 4 devices, but that's not a complete list Stop missing opportuniti... Read more
Pediatric Coding Corner:
Avoid Undercoding ADD/ADHD Sessions by Using This Continuum
Ethically boost assessment visits when you find this documentation You can capture the ... Read more
Reader Questions:
Consider Flu Nasal-Wash Options
Question: Is there an appropriate "collection code" to report for performing the flu nas... Read more
Reader Questions:
You'll Code Differently for Blood Draws, Lab
Question: We saw a patient for a blood draw and sent it to an outside lab for testing. T... Read more
Reader Questions:
Differentiate Between Different COPD Diagnoses
Question: The FP performs a level-four E/M for an established patient. The notes indicat... Read more
Reader Questions:
Leg Pain at Well Check Means 2 Codes
Question: An established 2-year-old patient presented for a well child checkup. The pati... Read more
Reader Questions:
Zoom In on Fluorescein Use
Question: Our FP performed a fluorescein staining for detecting a corneal abrasion. When... Read more
You Be the Coder:
 Reporting E/M-Urinalysis Claims
Question: The FP performs a level-two E/M for a new patient. The results of the evaluati... Read more
CCI 14.1 Update:
Break Bundles to Prevent Payment Loss on 90760, 90772
New edits put focus on separate, significant E/Ms The next time a patient requires hydr... Read more
CCI 14.1 Update:
Code Nebulizer Treatment Only With 94640 or 94644
Prepare for edits to strapping, nebulizer services -- and more Find out when and how t... Read more
Pediatric Coding Corner:
Use This Guide to Net All 'Bright Futures' Services
Are you forgetting to code any -extras- during well checks? If you-re not clear on the ... Read more
Reader Questions:
Squirmy Child Stops Screen
Question: We tried to do an audiogram with a 7-year-old patient, but we were unable to o... Read more
Reader Questions:
Learn 2008 Conversion Factor -- for Now
Question: What is the conversion factor for 2008? North Carolina Subscriber Answer: Th... Read more
Reader Questions:
Photoscreening Gets Category I Code
Question: I-m questioning our practice's use of 92015 for photoscreening. The procedure ... Read more
Reader Questions:
Beware Bundles on 99477 Claims
Question: What services are included in the new neonatal initial hospital intensive care... Read more
You Be the Coder:
Coding Multi-Day Hospital Stays
Question: An FP admits a patient to observation on Feb. 22. The physician writes orders ... Read more
Expert Advice:
Count Hours to Arrive at Proper Observation Code Choice
8-hour mark is crucial for Medicare patients When your FP performs observation services... Read more
Pediatric Coding Corner:
Test Results Tell You Whether to Report Lead Poisoning Dx
Better way: A high-risk V code can remedy payment woes You-re going to have to use an e... Read more
Reader Questions:
Percentages Provide Clues on Obesity Dx
Question: What distinguishes "obesity" from "morbid obesity"? North Carolina Subscriber... Read more
Reader Questions:
Is Parents-Only Conference Billable?
Question: An established patient's parents came in without their teenage son to discuss ... Read more
Reader Questions:
Get the Lowdown on 'Missing' CPT 2008 Codes
Question: I read that the CPT 2008 manual doesn't contain three new vaccine codes. Would... Read more
Reader Questions:
Stick With 075 for EBV
Question: Should I code Epstein-Barr with new 2008 code 058.89 (Other human herpesvirus ... Read more
Reader Questions:
Use Notes to ID Fracture Treatment Type
Question: The FP performs closed treatment on a patient's ulnar shaft fracture. There ar... Read more
Reader Questions:
Prepare for 'UHC Meets CCI'
Question: I-ve heard that I-m going to have to start changing some of the codes that I b... Read more
You Be The Coder:
Be Precise With Jaw-Injury Diagnoses
Question: The FP treated a patient who had been in a minor motorcycle accident (the pati... Read more
Gain $8 per Visit by Recognizing All 69210 Coding Opportunities
Careful: That cerumen removal encounter might be an E/M When your FP removes cerumen, z... Read more
Pediatric Coding Corner:
Know the Facts Before Buying SureSight
Report SureSight services with 99173, not 92015 If you-re considering replacing technic... Read more
Reader Questions:
Beware the Burn Coding Bundles
Question: A patient came in with first- and second-degree burns on her hand. The physici... Read more
Reader Questions:
Draw Complete ROS Picture With System Reviews
Question: There are three review of systems (ROS) levels: problem-pertinent, extended an... Read more
Reader Questions:
Omit Laceration Repair Code on Bandage Fixes
Question: An established patient who had an accident during a bicycle race reports to th... Read more
Reader Questions:
Use This Bladder Aspiration Code in 2008
Question: The FP performs a suprapubic aspiration to obtain a clean urine specimen from ... Read more
Reader Questions:
Leave Modifier 51 Off Vaccination Claims
Question: Can you settle a dispute our office is having? Do we need to use modifier 51 w... Read more
Reader Questions:
Keep Coding Even if Payment Doesn't Come
Question: When an insurance carrier does not pay for a code, should we still report it? ... Read more
You Be The Coder:
Multiple Laceration Repairs
Question: An established patient reports to the FP with a facial laceration just below t... Read more
Use These Tips to Avoid an E/M Denial With 95115, 95117
Medicare starts paying for same-day E/M service and allergy injection When the FP perfo... Read more
CPT Update:
Use 99477 to Capture Care Beyond 99223
Newborn care continuum now has a middle tier You can confidently use a new tool in your... Read more
Gain $173 for Increased Newborn Care Work
4 vignettes pin down when to report 99477 Initial newborn care codes pay from a high of... Read more
Reader Questions:
Knock Out Sedation Denials With New Policy
Question: When our physician provides moderate sedation in addition to a procedure, some... Read more
Reader Questions:
Look to Type I Codes First for Diabetic Ketoacidosis
Question: A new patient with diabetes reports to the FP for an initial evaluation. The p... Read more
Reader Questions:
Location Matters When Coding Ultrasound Service
Question: Our FP took a biopsy using ultrasound to guide needle placement in the office ... Read more
Reader Questions:
Code Well Portion, Asthma Treatment Separately
Question: After receiving a preventive medicine service, an established patient has an a... Read more
Reader Questions:
Include I&D in Excision
Question: A patient with a simple pilonidal cyst reports to the ED. The physician decide... Read more
You Be The Coder:
Coding Hydration in 2008
Answer: You could have reported the hydration with 90760 (Intravenous infusion, hydratio... Read more
Mind Your G's and Q's, or Medicare Might Deny Well-Woman Exams
Use separate codes for breast/pelvic exam and Pap smear When your FP provides a well-wo... Read more
Use This E/M Guide to Stay Out of Auditor's Crosshairs
Study the claim element-by-element to determine correct history level You don't have to... Read more
Reader Questions:
Code Sub Physician's Work With Proper Modifier
Question: One of our FPs is taking December and January off (an extended holiday). We ha... Read more
Reader Questions:
Report Biopsy Code Per Lesion
Question: A new patient reports to the FP for an initial E/M. During the course of a lev... Read more
Reader Questions:
When Should You Charge for PPD Readings?
Question: We charge for a PPD placement but historically have not coded for reading the ... Read more
Reader Questions:
Exceed Inherent E/M Before Coding It Separately
Question: One of our nurse practitioners (NPs) recently saw a 65-year-old established pa... Read more
Reader Questions:
Fifth Digit Can Be Vital for Claim Acceptance
Question: A patient with extrinsic asthma reports to the hospital in the throes of a sev... Read more
You Be The Coder:
Reporting Diabetic Manifestations
Question: An established patient with type II uncontrolled diabetes reports to the FP fo... Read more
CPT Update:
Revised Nursing Codes Put Time on Your Side
CPT 2008 reworks definitions for 99304-99310 Good news for coders: CPT has revised the ... Read more
CPT Update:
Check Panel Type Before Choosing Test Code
Metabolic panels now broken into different types This winter you-ll need to discern the... Read more
CPT Update:
Let Nurses Conduct Your Team Conferences
New codes coming for ADHD school meetings, vent management and more Don't have time to ... Read more
Reader Questions:
Remember T Modifiers on Toenail Trims
Question: An established patient complaining of pain in toes on both feet reports to the... Read more
Reader Questions:
E Code Helps Explain Insulin Overdose
Question: An established patient with uncontrolled type II diabetes who is on insulin an... Read more
Reader Questions:
TB Test Should Not Include Injection Code
Question: When a patient reports to the physician for a tuberculosis (TB) skin test, can... Read more
Reader Questions:
Fifth Digit Can Be Vital for Claim Acceptance
Question: A patient with extrinsic asthma reports to the hospital in the throes of a sev... Read more
You Be The Coder:
Observing Global Surgical Periods
Question: An established patient had an accident while on vacation, and another physicia... Read more
Get Ready to Say 'Hello' to New Telephone Call Codes for 2008
Smoking cessation counseling to get CPT codes Has the imprecise matching of simple, int... Read more
Use 'E Visits' to Save Time, Fatten Bottom Line
Caution: Don't discuss sensitive medical matters via unencrypted e-mails When your FP p... Read more
Pediatric Coding Corner:
Avoid Losing Out on Vaccine Dollars With These Tips
Remember: Dose code differs for children under 3 If your practice is losing money on fl... Read more
Reader Question:
6 New Vaccine Codes Coming Next Year
Question: Will there be any new vaccine codes for coders in 2008? Tennessee Subscriber ... Read more
Reader Question:
Report Entire 1st Visit With New Patient Codes
Question: Could you clarify how to code a new patient visit during which the patient com... Read more
Reader Question:
Can You Use V Codes as Primary Diagnoses?
Question: When the FP performs diabetes screenings for our patients, which ICD-9 code sh... Read more
Reader Question:
Medicare to Allow More Moderate Sedation Pay
Question: What are Medicare's payment policies for the new moderate (conscious) sedation... Read more
Reader Question:
Include V Code on Toy-Related Lead Screenings
Question: What V code should we use for lead screenings that parents request for their c... Read more
You Be The Coder:
Coding a Catch-Up Shot Session
Question: At an 18-month preventive medicine service, the FP noted that the toddler had ... Read more