CPT Coding

  • Payers get the upper hand because they are huge companies that can funnel resources into figuring out how not to reimburse you. Their most recent shell game is prior authorization. “When I started out [prior authorization] never came up,” says Kevin de Regnier, an osteopath who   Read more..
    Posted on 15 Sep, 2017
    3 Ways to Outsmart Prior Authorization Ploys
  • Incorporate new POS code for telehealth services.
    According to a recent report by Zion Market Research, the global telehealth market will increase to as much as 12 million toward the end of 2022, a sign of the growing acceptance of remote medical services. Change Request (CR) 9726 updates recently replaced the place of   Read more..
    Posted on 3 Apr, 2017
    Telehealth Coding System: Changing Rules & Guidelines
  • 2017 CPT® Coding Updates: Make Room for Key Laryngoplasty & Flexible Laryngoscopy Changes
    Remove “fiberoptic” from laryngoscopy codes.  CPT® 2017 packs some important changes general surgery coders don’t want to overlook. Effective Jan. 1, 2017, you’ll have a new specific code — 31573 — to use when your surgeons performs a flexible laryngoscopy with therapeutic injection. The new code   Read more..
    Posted on 20 Dec, 2016
    2017 CPT® Coding Updates: Make Room for Key Laryngoplasty & Flexible Laryngoscopy Changes
  • Remember this modifier when coding for FBR and a separate E/M.
    When a patient reports to the practice for a foreign body removal (FBR), there might be an opportunity to report an FBR code along with a separate evaluation and management (E/M) code. The rub is finding that info in the encounter notes, and knowing when it   Read more..
    Posted on 8 Feb, 2016
    Check for E/M on FBR Encounters
  • With these services correct coding is all about the wound type.
    When the physician performs multiple skin debridements for the same patient, you’ll need to know what separates a “surface” debridement from a deeper one, as it is the most important factor when coding these services. The basics: Most physician practices will perform two types of debridement   Read more..
    Posted on 21 Jan, 2016
    Ignore Anatomy in Favor of Depth on Multiple Debridements
  • Remember: Include healthy tissue provider excises in final tally.
    When faced with a lesion excision claim, you’ll need to follow a couple of specific guidelines to carve out all your deserved reimbursement. The basics: Obtain the proper excision measurements — and properly ID the pathology of the lesion — and you’ll be on your way   Read more..
    Posted on 15 Jan, 2016
    Want to Max Out Lesion Coding Returns? Measure Specimens Pre-Path
  • Calendar days pace observation service coding.
    The rules for observation coding are typically pretty straightforward. Pick 99218-99220 for the first day when the patient is in observation for multiple days; pick 99234-9236 if the observation lasts more than eight hours on a single day. Monkey wrench: Are you prepared, however, for an   Read more..
    Posted on 4 Jan, 2016
    When Clock Strikes Midnight, Switch Up Observation Coding
  • Payers require specific criteria for 10120.
    A patient steps on a splinter from a holiday tree, or some other foreign body (FB), and your physician performs a foreign body removal (FBR). You should choose an FBR code for the service, right? Well … maybe: The service might not qualify for the CPT®   Read more..
    Posted on 30 Dec, 2015
    Are You Sure About that ‘Simple’ FBR? It Could Be an E/M
  • Higher-level E/Ms possible with complete ROS.
    When your physician provides an evaluation and management (E/M) service, a vital part of the history component is the review of systems (ROS). In short: There are three levels of ROS, and your level of ROS coding will need to be spot on if you’re to   Read more..
    Posted on 17 Dec, 2015
    Key on Components for Accurate ROS Count
  • CMS sets RVUs for 99497, 99498.
    If your physician treats a lot of elderly patients, you probably have experience with advance care planning (ACP): treatments options, life expectancy, etc. In 2015, CPT® introduced ACP codes 99497 (Advance care planning including the explanation and discussion of advance directives such as standard forms [with   Read more..
    Posted on 27 Nov, 2015
    Want to Get Paid for ACP? Medicare Ruling Means You Could in 2016

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