Month: August 2018

Contract Termination Provisions – Physician Contract Basics
Post

Contract Termination Provisions – Physician Contract Basics

August 15, 2018 Never have I witnessed delight or a light-hearted attitude when the time comes to bounce a partner.  Quite the contrary, there is often significant consternation when making the final decision. The practice has invested time and effort in recruitment, financial guarantees, marketing support, staff – the list goes on. So, physician termination...

Post

What is Defined as “Operating Room”

August 9, 2018 Question: What is considered an operating/procedure room when billing complications with a modifier 78? Does an office procedure room count? Answer: According to Medicare, the treatment of complications is separately billable only when performed an approved operative suite which includes an OR, ASC, endoscopy or angiography suite. *This response is based on...

Shave or Excision?
Post

Shave or Excision?

August 9, 2018 Question: If I do a shave of a lesion and it comes back from pathology as a malignant lesion, can I bill it as a malignant lesion excision instead of a shave? Answer: No.  According to CPT, a shave is the sharp removal by transverse incision or horizontal slicing to remove epidermal...

Coding Catherization’s with Interventions
Post

Coding Catherization’s with Interventions

August 9, 2018 Question: Are there any peripheral interventions that still allow separate coding of catheterization in addition to the intervention? Answer: Yes, there are. Code that allow separate reporting of catheterization include: Non- lower extremely, stenting, angioplasty, for example visceral and upper extremity Venous stenting and angioplasty Embolization Thrombolysis and thrombectomy Diagnostic angiograms and...

Post

Modifier 50 with 30930?

August 9, 2018 Question: Can I bill 30930 with a modifier 50?  My physician and I are confused if it’s appropriate or not.  We’ve heard conflicting information. Answer: No.  A CPT Assistant from November 2017 overturned advice they published in July 2016.  The advice in the CPT Assistant, July 2016 stated modifier 50 (bilateral procedures)...

Post

Bone Marrow Aspirate

August 9, 2018 Question: Our surgeon aspirated bone marrow for a subtalar fusion. We are unsure how to report this. Are you able to help? Answer: Yes, with the guideline changes surrounding CPT code 38220 and the new code 20939, CPT instructs to report 20999 for bone marrow aspirate for other musculoskeletal fusions (non-spine). (For...

Post

Diagnosis Code for a Scar Contracture

August 9, 2018 Question: What ICD-10-CM diagnosis code do I report for a patient seen for a release of scar contracture of the flexor surface of the left elbow after healing of a third degree burn? Answer: You would report L90.5 (scar conditions and fibrosis of the skin) and T22.322S (Burn of third degree of...

Post

Microscope with Carotid Endarterectomy

August 9, 2018 Question: Can we code the microscope (69990) with 35301, carotid endarterectomy?  Answer: CPT does not list 35301 as inclusive of the microscope (+69990); therefore, the microscope can be coded assuming documentation criteria is met.  That said, Medicare considers the microscope bundled into 35301 and will not reimburse it.  Other payors may or...

Post

Documenting the Initial Pain Assessment

August 9, 2018 Question: What needs to be documented for the initial assessment for a pain management patient to support medical necessity for interventional pain management procedures? Answer: To support medical necessity, documentation should include the site of pain, along with the severity of pain (pain scale 0-10.  It is important to also document the...

4 Reasons to Pay More Attention to the Appointment Schedule
Post

4 Reasons to Pay More Attention to the Appointment Schedule

August 1, 2018 The appointment schedule is often overlooked as a cause of negative online reviews and inefficient operations. Sure, improving it can be time-consuming and messy. But improve it you must. Here are four reasons why: 1. Your online reputation. Check Yelp or any of the other rating and review sites and you’ll find...

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches