Month: September 2017

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7 Things to Consider When Retiring from Practice

Physicians Practice – September 27, 2017 by Karen Zupko Preparing for retirement can be challenging for any busy professional. But for physicians, the challenge goes beyond office closure procedures and financial details. Of course you’ll contact the state medical society, board of medicine, and Drug Enforcement Agency to verify rules about how long to keep...

Billing Medicare Patient Admittance
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Billing Medicare Patient Admittance

September 21, 2017 Question: I was consulted to see a Medicare patient in the emergency room (ER) by the Emergency Department physician.  When I arrived, the patient was still in the ER but had been admitted to the hospitalist and was waiting for a bed. Answer: Since the patient is Medicare and has been formally...

Sentinel Node Mapping in Mastectomies
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Sentinel Node Mapping in Mastectomies

September 21, 2017 Question: Sentinel node mapping was performed and documented in both axillas. Is code +38900 reported once or twice? Answer: Sentinel node mapping may be reported bilaterally with a 50 modifier.  Claim form reporting in a single line format (38900-50) or on two lines (38900, and 38900-50) will be dependent on the payor....

Endoscopic Sphenopalatine Artery Ligation
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Endoscopic Sphenopalatine Artery Ligation

September 21, 2017 Question: I did an endoscopic ligation of the left sphenopalatine artery for recurrent epistaxis in a patient with Coumadin-induced coagulopathy. I don’t see a CPT code for this procedure – can I use 30920? Answer: No, you’ll need to use an unlisted code such as 30999. Your comparison code can be 30920...

Scribe Question
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Scribe Question

September 21, 2017 Question: In my office, we use a PA as a scribe for new patient office visits for our doctors. We have an electronic medical record and the scribe signs in under her own name when she begins notating for the doctor. What is the correct way to notate in the medical record...

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Coding Debridement for an Ulcer

September 21, 2017 Question: I debrided and ulcer. How do I know if I use 97965 or 11042? Answer: Code 97597 is described by CPT as a debridement (e.g., high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (e.g., fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical...

Coding Pulsed Radiofrequency
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Coding Pulsed Radiofrequency

September 21, 2017 Question: How is pulsed radiofrequency coded? Answer: Pulsed radiofrequency stuns the nerve but does not destroy it. Therefore, the existing radiofrequency codes are not appropriate for pulsed radiofrequency. An unlisted code is reported. *This response is based on the best information available as of 09/21/17.

Absorbable Implant
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Absorbable Implant

September 21, 2017 Question: I billed 30465 for an injection of a bioabsorbable implant into the lateral nasal wall to repair nasal vestibular stenosis. The insurance company is denying this for “coding issue” and “wrong place of service”. How can I appeal? Answer: CPT 30465 says “Repair of nasal vestibular stenosis (eg, spreader grafting, lateral...

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Six Steps for Conducting an Internal Evaluation & Management Audit

Six Steps for Conducting an Internal Evaluation & Management Audit Healio Orthopedics • Orthopedics Today – September 2017 by Sarah Wiskerchen, MBA, CPC Evaluation and management coding patterns are under the microscope. CMS is monitoring evaluation and management code usage by specialty, state and nationally. The Recovery Audit Program of CMS aims to identify and correct...

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