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Primary Care Coding Alert

Influenza Vaccine Update:
Beef Up Your Influenza Coding Arsenal This Flu Season With 90630
Heads up: You will begin to receive payments for the code in April 2016. Although the ... Read more
Clip and Save:
Get Proficient With Influenza Coding with These Handy Tips
Don’t let the myriad of choices vex you. As flu season drags on, you will need t... Read more
NGS Update:
Don't Panic If You're Facing Denials for Routine Foot Care and Nail Debridement
Watch out for scenarios where Medicare is denying payments for preoperative tests, too. ... Read more
Benefit From These Expert Tips for Successful ICD-10 Implementation
Communication between coders and providers is vital for success. With all the drama su... Read more
Reader Question:
Know When to Choose Complicated Abscess Drainage
Question: Our physician reviewed a 56-year-old male patient with complaints of pain and ... Read more
Reader Question:
Using CMS Software Won't Help Search ICD-10 Codes Automatically
Question: I have heard that Medicare has created free billing software that will let us ... Read more
You Be the Coder:
Know if You Need an Anesthesia Modifier with Procedural Code
Question: We had a young patient who came into our office for an ingrown toenail (11750)... Read more
ICD-10 Update:
Don't Fret If You're Getting Denials for Immunization Encounters in October
Good news: You now stand better chance for winning appeals for denied claims. If you h... Read more
Start Off a Fresh Phase of ICD-10 Training After Implementation Date
Coders, clinicians must come together to solidify office’s ICD-10 coding. With a... Read more
Benefit From Grace Period To Aid ICD-10 Implementation in Your Practice
Be ready to use ICD-10 or claims won’t fly. Amid the ocean of information CMS ha... Read more
Reader Question:
Choose Site Specific Codes for Abscess Drainage When Available
Question: Our FP recently performed incision and drainage of a finger abscess. Shou... Read more
Reader Question:
Report Wedge Excision Only Once For One Toenail
Question: Our FP recently performed removal of the inflamed tissue adjacent to the ... Read more
You Be the Coder:
Base Debridement Reporting on Area of Wound
Question: Our FP recently treated a patient with multiple extensive wounds requirin... Read more
CPT® 2016 Update:
Get a Heads Up On What to Expect For Family Medicine in CPT® 2016
Stay tuned for reimbursement answers. September is here, and with it comes the annual ... Read more
Influenza Coding:
Ensure Flu Vaccine Coding Success with These Four Expert Tips
From immunizations to diagnoses, get the lowdown on flu patients. It’s that time... Read more
ICD-10 Update:
Watch for Simple One-to-One Transition for Sebaceous Cyst in ICD-10
Don’t report the same diagnosis code for pilar cysts and trichilemmal cysts. If ... Read more
Reader Question:
Reaching Out to E/M Always? Think Again
Question: Can I charge for a 99213 and a 17250 on the same day at the same visit if... Read more
Reader Question:
Location of Cast Guides Removal or Bivalving Code Choice
Question: I need help with this one: Presenting complaint: Patient states that he... Read more
You Be the Coder:
Reporting Reconstruction with Nail Plate Avulsion? Here's What You Need to Know
  Question: Our FP reconstructed the nail bed on a patient’s left grea... Read more
Preventive Care:
Learn The Ins and Outs of G0446 For Successful CVD Therapy Claims
Hint: Check CCI when service is performed with other same day services. If your FP per... Read more
Allergy Immunotherapy:
Get Your Allergy Coding on Track Using This Expert Advice
Hint: Use size of the vial as the guiding factor to number of units to be billed. Do y... Read more
ICD-10 Update:
Look Out For One-to-One Transition for Allergic Rhinitis in ICD-10
You can now report vasomotor rhinitis with a specific diagnosis code. When reporting a... Read more
Reader Questions:
Watch Reporting Options For Immobilization of Thumb
Question: Our FP recently saw a patient with gamekeeper’s thumb. The operativ... Read more
Reader Questions:
Reporting Multiple Paring Codes? Think Again
Question: Our FP recently removed some hyperkeratotic lesions that a patient had on... Read more
You Be the Coder:
Differentiate Between Simple and Complicated For FBR
Question: Our FP recently removed a glass splinter from a patient’s foot. Whe... Read more
Behavioral Counseling:
Know The In and Out of G0445 For HIBC Reporting Success
Hint: Don’t forget to report appropriate diagnosis codes to support medical necess... Read more
Payer Pointers:
Wash Off Some Coding Misconceptions Using This NGS Advice
Look out for guidance with MDM, X{EPSU}, PQRS, and more. If you are not knowing on how... Read more
ICD-10 Update:
Get More Specificity to Infectious Mononucleosis Reporting in ICD-10
Zip from a single code in ICD-9 to 16 highly specific ICD-10 codes. When you begin usi... Read more
Reader Questions:
Use PFSH Elements to Determine Level of E/M
Question: I have a claim in front of me that is giving me pause, because I cannot d... Read more
Reader Questions:
Selecting E/M Code Based on Time Not Dependent on Procedural Code
Question: Is it alright to use time to select an E/M code even if the other service... Read more
You Be the Coder:
Stick to Integumentary Codes For Wart Removal From Buccal Sulcus
Question: Our FP recently removed ten lesions of verucca vulgaris from the buccal s... Read more
Preventive Services:
Ace ECG With Preventive Services Reporting With These 2 Scenarios
Hint: Identify level of ECG service performed to nail the right code. When your FP per... Read more
CPT® Coding Strategies:
Understand The Bilateral Clause With 69210 For Cerumen Removal Claims
Hint: Check payer preference prior to using modifier 50. When reporting for claims for... Read more
ICD-10 Update:
Lock Into 4 Code Choices For Impacted Cerumen in ICD-10
Hint: Check documentation to know if the condition is unilateral or bilateral. If your FP... Read more
Reader Questions:
Watch Requirements For Reporting Blister Drainage With an I&D Code
Question: Our clinician recently performed drainage of fluid that was collected in ... Read more
Reader Questions:
Know if College Physicals Are a Covered Service
Question: Our FP performs school and college physicals on a regular basis. I did no... Read more
You Be the Coder:
Include Foot Care Evaluation For LOPS With Other E/M Services
Question: Recently, I tried billing G0245 with an E/M code for a diabetic patient t... Read more
CPT® Coding Strategies:
Know The Difference Between Simple vs. Complicated Pilonidal I&D or Lose $90
Check for instances when you can report an additional E/M. When your FP performs incis... Read more
Case Study:
Perfect Your Smoking Cessation Reporting Using These 3 Scenarios
Consider between using HCPCS codes and CPT® codes appropriately. You may think tha... Read more
ICD-10 Update:
Rejoice With More Specific Options for Reporting Pilonidal Cyst and Sinus in ICD-10
Hint: Watch for presence of abscess as you did in ICD-9. When your FP diagnoses a pati... Read more
Reader Questions:
Clear Confusion About Same Day Office and Hospital Visits
Question:  We have several patients that we see in the office and then they are adm... Read more
Reader Questions:
Base Laceration Repair Code Selection on Payer Preference
Question: If our FP used a tissue adhesive instead of placing a suture, can this pr... Read more
You Be the Coder:
Exploration But Foreign Body Not Found? Here's What to do
Question: Our FP recently saw a patient who came in complaining of some discomfort in hi... Read more
Preventive Medicine:
Ensure AWV Coding Success With These Useful Pointers
Hint: Use appropriate modifiers when reporting other same day services. When your FP p... Read more
CPT® Coding Strategies:
Discern Between Biopsy and Excision For Apt Skin Lesion Removal Reporting
Hint: Watch for site-specific biopsy codes to report in lieu of skin biopsy. When your... Read more
ICD-10 Update:
Click on B35.1 For Onychomycosis Reporting in ICD-10
Hint: Watch for other conditions of the nail for which you can use the same code. If y... Read more
Reader Questions:
E/M Code With Vaccine Codes For New Patients? Not Always
Question:  Our FP recently administered varicella vaccine to a new 23-year-old pati... Read more
Reader Questions:
Billing Incident-to Patients as New Patients? Think Again
Question: If one of our FPs referred a patient to one of our NPs for primary care, ... Read more
You Be the Coder:
Provide Documentation Supporting Medical Necessity of Callus Removal
Question: Our FP recently excised a callous on a patient’s foot with a scalpel. Wh... Read more
CPT® Coding Strategies:
Failure To Properly ID Complicated I&D Could Leave You Short $90
Watch for instances when you can report an additional E/M. When your clinician perform... Read more
Preventive Counseling:
Get Proficient With Preventive Medicine Counseling With These 3 Scenarios
Hint: Counseling codes cannot be used for patients with existing illness. When your FP... Read more
ICD-10 Update:
Use One-to-One Transition Code For Chronic Laryngitis in ICD-10
Hint: Don’t forget to report exposure to tobacco or infectious agents separately. ... Read more
Reader Questions:
Use Abnormal Results to Report Diagnosis That Prompted Biopsy
Question: If an abnormal pap smear prompted our clinician to undertake a cervical b... Read more
You Be the Coder:
Get Clear About Reporting E/M With Physical Examinations
Question: Our FP recently saw a patient for his routine physical examination. The patient ... Read more
Add G0472 For HCV Screening to Your Preventive Services Arsenal
Hint: Repeated screening is allowed annually for high risk patients. When your FP scre... Read more
Tackle These TPI Reporting Myths That Might Hurt Your Claims
Warning: Watch for bundling edits when reporting other codes with TPI. When you are re... Read more
ICD-10 Update:
Pave the Way for More Reporting Choices for IBS With K58
Hint: You use the same diagnosis code for spastic colon. When your clinician diagnoses... Read more
Reader Question:
Looking for Coverage For Two Annual Physicals? Think Again
Question: A patient came to our FP for a school physical as he was required by admi... Read more
Reader Question:
Use Appropriate HCPCS Codes For Home Health Care
Question: Our FP recently contacted a home health care agency to plan and provide h... Read more
You Be the Coder:
Watch For Chances to Report E/M With Flu Vaccinations
Question: If our clinician administered a flu vaccination to a patient, is it possi... Read more
Medicare Immunizations:
Ensure Reporting Success For Pneumococcal Vaccination With This Expert Advice
Use different administration codes for Medicare patients. When your FP provides a pneu... Read more
Preventive Counseling:
Tune Into New HCPCS Code For Obesity Group Counseling in 2015
Hint: Use appropriate ICD-9 or ICD-10 codes to support the medical necessity. When you... Read more
ICD-10 Update:
Switch to One-to-One 'N' Series Crossover Options For UTI
Don’t forget to additionally report causative organism for proper reporting. If ... Read more
Reader Question:
Use Days of Treatment as Basis to Select Anticoagulant Management Code
Question: We have a patient that comes into the office and requires anticoagulant m... Read more
Reader Question:
Know If HRA Should be Separately Billed With E/M
Question: A patient of one of our providers came in for an annual wellness visit an... Read more
You Be the Coder:
Routinely Reporting E/M With 11721? Think Again
Question: If our FP performs a procedure like the debridement of nails, is it neces... Read more
Preventive Medicine:
Get Proficient With Preventive Visit Reporting Using This Expert Advice
Watch out for scenarios to report a problem visit on the same calendar date. When repo... Read more
Tackle These HPV Administration Myths To Avoid Losing Valuable Reimbursement
Find out what you should report when the patient decides against immunization. You mig... Read more
ICD-10 Update:
Get Specific For Reporting Additional Complications of Herpes Zoster
Otitis externa is reported with a more generalized code choice. When reporting a diagn... Read more
Reader Question:
Don't Report Hemostasis Separately With Excision Code
Question: Our physician recently removed a cyst in the pre-auricular area. The cyst... Read more
You Be the Coder:
Watch CCI For Same Day Injection and Cerumen Removal
Question: Our FP recently performed cerumen removal and provided an injection to the ... Read more