Month: September 2018

Contractual Indemnification - DANGER
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Contractual Indemnification – DANGER

September 12, 2018 Indemnity provisions are used to shift risk from one party to another. The intent of an indemnification provision in an agreement is to impose on one party the responsibility to pay the liability, damages, costs, expenses, and attorney fees for the other party to the agreement, under the circumstances set forth in...

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AMA Releases 2019 CPT® Code Set

AMA Releases 2019 CPT® Code Set ICD10 Monitor – September 2018 by Deborah Grider, CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP New code changes number 335. The new current procedural terminology (CPT®) codes have been released with 335 code changes in 2019.  There were many code revisions with guideline, description and instructional note changes.   Let’s look...

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Cosmetic Rhinoplasty and a Functional Septoplasty

September 6, 2018 Question: If I do a cosmetic rhinoplasty and a functional septoplasty on a patient, should I document both procedures on the same operative note? Or should I document a separate operative note for each procedure? Answer: Good question!  In KZA’s experience, it is best to document one operative note for all procedures...

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Coding a Colotomy

September 6, 2018 Question: How is this scenario coded?  A segment of the colon is opened to remove a foreign body and then closed. No resection and no perforation. Answer: The scenario you describe is a colotomy; making an incision in the colon through which the colon is explored for biopsy or foreign body removal...

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Modifier 56

September 6, 2018 Question: Why would we receive a Medicare denial when reporting a major surgical procedure with a modifier 56? We only did the pre-procedure work and made the decision for surgery. Answer: Medicare does not recognize modifier 56 (pre-operative care only); instead report the E&M for the decision for surgery.  Append modifier 57 if...

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Diagnosis Coding for Hydrocephalus

September 6, 2018 Question: What is the ICD-10-CM code for hydrocephalus following an intraventricular hemorrhage? Answer: That depends on how it is documented by the physician.  The code could be G91.0 (Communicating hydrocephalus) or G91.4 (Hydrocephalus in diseases classified elsewhere) or G91.8 (Other hydrocephalus). *This response is based on the best information available as of 09/06/18.

Post-Tonsillectomy Bleed
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Post-Tonsillectomy Bleed

September 6, 2018 Question: I am being told that treating a post-tonsillectomy bleed in the ED with local anesthesia and silver nitrate will not be paid.  Is it true that the only code that would be reimbursed is bringing the patient back to the OR? Answer: Medicare says that the tonsillectomy’s 90-day postoperative period includes...

Wrist Lesion
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Wrist Lesion

September 6, 2018 Question: Please help settle this.  A 0.8 cm benign lesion was excised from a patient’s wrist.  I say that it should be coded under 11421 for benign excision of lesion on the hand.  My colleague says it should be coded under 11401 for benign excision of lesion on the arm.  Who is...

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Dialysis Circuit Imaging – Part 2

September 6, 2018 Question: Is dialysis circuit imaging, (36901) always bundled with any dialysis circuit intervention? If not, when can it be reported? Answer: Dialysis circuit imaging, (36901), is bundled with any peripheral intervention (36902- 36906).  However, it may be reported if only central segment interventions (+36907 and +36908) and/or an embolization (+36909) is reported....

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Code Submission Order on Claims

September 6, 2018 Question: When we are submitting multiple procedures on a claim, should we submit the CPT codes in the order the procedures were performed, or the most serious findings first, or does it matter? Answer: You should submit codes in descending relative value unit (RVU) order.  If you don’t have software that gives...

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