Month: February 2018

KX Modifiers
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KX Modifiers

February 15, 2018 Question: Are you using the KX modifier correctly on PT/OT claims? Answer: One Medicare carrier has concerns that the KX modifier if not being used appropriately. National Government Services (NGS) shared the following concern in their January Newsletter released 1/25/18. Bottom line is that clients serviced by this carrier are receiving claims...

Bilateral L4-L5 Transforaminal Epidural Injection
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Bilateral L4-L5 Transforaminal Epidural Injection

February 15, 2018 Question: How is a bilateral L4-L5 transforaminal epidural injected coded? Answer: You would report 64483-50 (Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level). Some payors want you to report the service as 64483-single level 1 side and 64483-50-for the other side or...

Repairs with Mohs Surgery
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Repairs with Mohs Surgery

February 15, 2018 Question: I know that simple repairs are included with lesion excisions, but what about Mohs surgery? Answer: Although simple repairs are included (bundled) into almost all integumentary codes, no repair is bundled into Mohs per the NCCI and CPT. The CPT guidelines for Mohs state that if a repair is performed, you...

Malignant Skin Lesion Re-Excision
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Malignant Skin Lesion Re-Excision

February 15, 2018 Question: We excised a skin lesion and the margins came back positive so I had to re-excise. I did the re-excision and now the path report came back as negative for cancer. How do I code this? Answer: Good question! You will use the malignancy diagnosis code as well as CPT code...

EVAR Coding 2018
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EVAR Coding 2018

February 15, 2018 Question: I know EVAR has bundled some components as of 2018. What’s now included in the new codes? Answer: In addition to the components that were already Included in EVAR, the new 2018 EVAR main body codes now also include: Nonselective catheterization, unilateral or bilateral (36200). All intraprocedural imaging (eg, angiography, rotational...

Coding An Incomplete Colonoscopy
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Coding An Incomplete Colonoscopy

February 15, 2018 Question: In a diagnostic colonoscopy, if the prep is incomplete and the scope cannot be advanced past the splenic flexure, do I report a diagnostic colonoscopy (45378) with a modifier? Answer: No. CPT says if the scope cannot advance past the splenic flexure, report a diagnostic sigmoidoscopy, code 45330. *This response is...

Debridement of the External Auditory Canal
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Debridement of the External Auditory Canal

  February 15, 2018 Question: I can’t find a CPT code for debridement of the EAC such as for Swimmer’s ear. Help! Answer: Actually there isn’t one! Typically the debridement is performed with a microscope so you may report 92504 (binocular microscopy) with your E/M code assuming your documentation supports it. Do not use a...

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Risks Associated with Critical Care Coding

Risks Associated with Critical Care Coding ICD10 Monitor – January 2018 by Deborah Grider, CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP Questions abound when reporting critical care services. Reporting Adult Critical care can be complicated. It is not only the coding but the rules and that go along with critical care.  Many questions come up...

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Arthroscopy Coding for Major Joints – Knee

Arthroscopy Coding for Major Joints – Knee AAOS Now – February 2018 By: Michael R. Marks, MD, MBA When the American Medical Association (AMA) published the first edition of Current Procedural Terminology (CPT) to standardize surgical procedure terminology and reporting, modern arthroscopy was in its infancy and no CPT code described it. As the number...

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