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APCs Insider
This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations. Topics include the outpatient code editor (OCE), complex coding issues, beneficiary co-payment discounting, and cross-department APCs tracking.
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Issue 52, December 30, 2011
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Q/A: Who must approve change in patient status for condition code 44?
Q: Our question pertains to condition code 44. At our hospital, a patient’s physician must... -
Tip: Correctly structure an E/M audit
After completing a risk analysis, a facility or practice should develop an audit structure that... -
Pay-per-view: Unscramble the complexities of ABNs
Just because a physician considers a service or procedure medically necessary doesn't mean... -
Trivia
The first Tournament of Roses Parade® stepped off on January 1 of which year?
Issue 51, December 23, 2011
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Happy Holidays from HCPro
Dear colleagues, On behalf of HCPro, Inc., and APCs Weekly Monitor, I want to wish you a joyful... -
Q/A: Ensure that physician orders are complete
Q: Our facility recently was audited and cited for our inadequate myocardial perfusion stress test... -
Tip: Know when limits on liability apply
A facility must provide patients an ABN when limits on liability (LOL) apply. LOL specifically... -
Pay-per-view: Review guideline changes as well as CPT code updates
Coders know they should review CPT® code changes very year, but they shouldn’t overlook... -
Trivia
Alvin, Simon, and Theodore won three Grammy Awards for “The Chipmunk Song” in 1958...
Issue 50, December 16, 2011
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Q/A: Billing chest x-ray and venipuncture separately from critical care
Q: Our MAC audited some of our critical care accounts and denied charges for chest x-ray and... -
Tip: Learn structures of anterior segment of the eyeball
The anterior segment of the eye includes the internal structures and anatomy that encompass... -
Pay-per-view: Report condition code 51 for nondiagnostic services unrelated to inpatient stay
Consider this scenario: A 42-year-old female patient presents to the ED with ankle pain after... -
Trivia
Normal 0 false false false EN-US X-NONE X-NONE...
Issue 49, December 9, 2011
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Q&A: Reporting discontinued radiology procedures
Q: Our radiologist attempted to perform a barium enema with air contrast. However, the radiologist... -
Tip: Use OIG?s strategy for tracking device credits
Special billing rules apply when facilities receive devices for free or at a reduced cost. The OIG... -
Pay-per-view: Unscramble the complexities of ABNs
Just because a physician considers a service or procedure medically necessary doesn't mean... -
Trivia
In the “Twelve Days of Christmas” carol, how many geese does my true love give to...
Issue 48, December 2, 2011
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Q/A: Appropriate reporting of CPT code 95810
Q: Our hospital performs a lot of sleep testing, especially CPT® code 95810 (Polysomnography... -
Tip: Look for added specificity when coding E. coli
E. coli food poisoning is a potentially deadly event. The specific strain or serotype of E. coli... -
Pay-per-view: Report condition code 51 for nondiagnostic services unrelated to inpatient stay
Consider this scenario: A 42-year-old female patient presents to the ED with ankle pain after... -
Trivia
In the movie “The Polar Express”, what does the boy chose as the first Christmas gift?
Issue 47, November 18, 2011
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Q/A: Publication date for NCCI guideline updates
Q: I have been searching for the National Correct Coding Initiative (NCCI) guidelines update. I... -
Tip: Ensure accurate billing of no-cost devices
When a replacement device is provided at no cost, coders or another hospital staff member must... -
Pay-per-view: ICD-10 anatomy refresher: Heart
The heart is the center of the circulatory system, and it pumps blood throughout the body. It moves... -
Trivia
When did the Pilgrims celebrate the first Thanksgiving?
Issue 46, November 11, 2011
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Q/A: Reporting hydration with phlebotomy
Q: We provide IV fluids to our patients who undergo therapeutic phlebotomy procedures to replace... -
Tip: Differentiate between packaged, bundled services
Packaging is different from bundling—bundling is a coding concept, whereas packaging is a... -
Pay-per-view: CMS adds new radiopharmaceutical, modifier
CMS reclassified HCPCS code C9406 (iodine I-123 ioflupane, diagnostic, per study dose, up to 5... -
Trivia
Who was the first artist named Entertainer of the Year by the Country Music Association?
Issue 45, November 4, 2011
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Q/A: New HCPCS device codes in OPPS update
Q: Does the October 2011 OPPS quarterly update include any newly created HCPCS device codes?
Issue 44, October 28, 2011
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Q/A: May we create a protocol for complete pulmonary function test?
Q: Some physicians send patients to our hospital outpatient department with an order for... -
Tip: Assign correct new glaucoma codes
As part of the final regular update to ICD-9-CM before the transition to ICD-10-CM October 1, 2013... -
Tip: Learn the anatomy of a vertebral body
Each vertebra includes a vertebral body that surrounds the spinal cord to protect its front... -
Pay-per-view: This Month's Coding Q&A
Q: Is a status order valid if a physician writes it after writing a discharge order, but while the... -
Pay-per-view: Correctly bill for free, reduced-cost devices
Most devices are considered integral to the procedure being performed, which means that without the... -
Tell us what your facility does
Dear Healthcare Professional: JustCoding wants to know how you charge inpatients for ancillary... -
Trivia
Which Best Picture Oscar winner took its title from a line in another Best Picture Oscar winner? -
Trivia
Count Dracula may suffer from alliumphobia, a fear of which of the following:
Issue 43, October 21, 2011
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Q/A: Reporting allografts with 153xx code series
Q: Physicians at our facility use allografts (e.g., GRAFTJACKET™) in surgical procedures such... -
Tip: Get to know the spinal column
Knowledge of spinal anatomy provides the foundation necessary to assign codes both before and after... -
Pay-per-view: Final regular ICD-9-CM code update continues trend of increased specificity
Beginning October 1, coders will have 17 additional V codes to report personal history of various... -
Trivia
Which Peanuts character dresses as a ghost in It’s the Great Pumpkin, Charlie Brown?
Issue 42, October 14, 2011
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Q/A: Payment when reporting CPT code 97602
Q: Members of our hospital outpatient wound care department recently listened to our FI/MAC’s... -
Tip: Review, remember revised code descriptions
The Centers for Disease Control and Prevention revised the code descriptions for 41 ICD-9-CM... -
Pay-per-view: ICD-10-CM anatomy refresher focuses on the spine
The spine is only one part of the musculoskeletal system, but its interwoven bones, nerves, and... -
Trivia
The New York Yankees hold the Major League Baseball record for World Series Championships with 27...
Issue 41, October 7, 2011
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Q/A: Charging for wound care supplies
Q. We would like to charge for the wound and ostomy supplies used in our hospital outpatient wound... -
Tip: Learn the new ICD-9-CM lung disease codes
The CDC added 15 new codes in the 516.- series for diagnosis of lung diseases as part of the final... -
Pay-per-view: Proposed IPPS-based payment cap raises concerns
CMS' plan to cap payment for cardiac resynchronization therapy (CRT) based on Medicare severity... -
Trivia
How long did Daniel Defoe’s character Robinson Caruso spend marooned on a desert island?
Issue 40, September 30, 2011
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Q/A: Billing for routinely ordered post-op observation
Q. A physician at our facility routinely orders observation services following surgery. The... -
Tip: Remember to add fifth digit when coding malignant neoplasms of the skin
The CDC significantly expanded code series 173.x (other malignant neoplasms of the skin) by adding... -
Pay-per-view: APC Panel debates requiring codes for packaged services
Should CMS require hospitals to report HCPCS codes for all packaged services that have HCPCS codes... -
Trivia
Which Caribbean country is the largest in area?
Issue 39, September 23, 2011
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Q/A: Reporting irradiation of blood products
Q: How should we report the irradiation of blood products? We have been reporting the P code for... -
Tip: Know what factors can affect financial risk
Financial risks can include anything that pertains to the revenue cycle or financial reporting. For... -
Pay-per-view: Final regular ICD-9-CM code update continues trend of increased specificity
Beginning October 1, coders will have 17 additional V codes to report personal history of various... -
Trivia
How many U.S. Presidents were born British subjects?
Issue 38, September 16, 2011
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Q/A: Understand requirements for separately reporting CBC with manual differential
Q: Our MAC recently conducted a focused review based on CERT results concerning complete blood... -
Tip: Note these physician supervision changes
CMS finalized several changes to physician supervision requirements for hospitals for CY 2011. -
Pay-per-view: Keep an eye on three-day payment window clarification
HIM staff in hospitals might not pay attention to the Medicare Physician Fee Schedule (MPFS... -
Trivia
Which state of the contiguous 48 states is farthest north?
Issue 37, September 9, 2011
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Q/A: Understand proper use of modifier-58
Q: A patient underwent an excision of large infected mass in our hospital outpatient surgery... -
Tip: Review revised drug reimbursements to ensure compliance
As part of the July OPPS update, CMS provided a long list of drugs that had incorrect reimbursement... -
Pay-per-view: CMS to revise conversion factor, physician supervision
CMS proposed no changes to E/M visit coding guidelines, nor did it discuss drug administration in... -
Trivia
Who is Batman’s alter ego?
Issue 36, September 2, 2011
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Q/A: May chiropractors order services for Medicare patients?
Q: We recently learned that CMS now allows chiropractors to order services and refer Medicare... -
Tip: Know when to carve out services from observation time
Coders may report outpatient therapeutic services and observation services on the same claim... -
Pay-per-view: CMS proposes new APCs for combination CT codes
Providers complained and CMS listened, at least a little. As part of the 2012 OPPS proposed rule... -
Trivia
Which of the following can be used as an ingredient for dynamite?
Issue 35, August 26, 2011
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Q/A: Know important dates for outpatient updates
Q: Fall is sneaking up on us as we near the end of summer. What are most the important tasks that... -
Tip: Create useful, meaningful audit report package
Upon completion of an audit, package it in a manner that provides meaningful, easy-to-follow... -
Special report: Payment cap based on MS-DRG debated during APC Panel meeting
CMS’ plan to cap payment for cardiac resynchronization therapy (CRT) based on Medicare... -
Trivia
The Teapot Dome Scandal occurred during which U.S. president’s administration?
Issue 33, August 19, 2011
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Q/A: Billing for Provenge
Q: Our facility’s billing office tells us that our FI/MAC is not reimbursing us for drug... -
Tip: Use caution with E/M templates, checklists
When used appropriately, templates are good tools for any practice. Templates help promote the... -
Special report: APC Panel debates requiring HCPCS drug codes for packaged services
Should CMS require hospitals to report HCPCS codes for packaged services? This topic generated... -
Trivia
Where is the Prado Museum located?
Issue 32, August 12, 2011
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Q/A: New code for image-guided minimally invasive lumbar decompression
Q: Has CMS provided any updates regarding image-guided minimally invasive lumbar decompression... -
Special report: News from the Advisory Panel on Ambulatory Payment Classification Groups Meeting
Editor’s note: Kimberly Anderwood Hoy, JD, CPC, Director of Medicare and compliance at HCPro... -
Tip: Know the documentation essentials for E/M coding
A thorough understanding of E/M coding begins with documentation. If it’s not documented, it... -
Trivia
Which of the original 13 colonies was the last to ratify the U.S. Constitution?
Issue 31, August 5, 2011
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Q/A: Note new HCPCS codes for outpatient procedures
Q: Did CMS add any new HCPCS codes for hospital outpatient procedures effective July 1? -
Tip: Count observation hours correctly
Report observation services with HCPCS code G0378 (observation services, per hour) under revenue... -
Pay-per-view: CMS clarifies modifier -PT use, adds new codes to I/OCE
CMS continues to clarify the use of modifier -PT (colorectal screening test converted to diagnostic... -
Trivia
Who is the main character in George Orwell’s 1984?
Issue 30, July 29, 2011
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Q/A: Remember these dates for smooth transition to ICD-10
Q: What’s the newest timeline for the transition to ICD-10-CM? We know the important role... -
Tip: Don't bill these bundled procedures with hysteroscopic procedures
When using a hysteroscope, physicians inflate the uterus with gas or fluid to obtain a better view... -
Pay-per-view: CMS revises counting for observation hours in OPPS update
As part of the July quarterly update to OPPS, which became effective July 1, CMS introduced a new... -
Trivia
Which of the Great Lakes is entirely within the United States?
Issue 29, July 22, 2011
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Q/A: Billing outpatients for dialysis in inpatient unit
Q: Our facility has an inpatient dialysis unit, but it is not an outpatient dialysis center. On... -
Tip: Start training physicians for ICD-10-CM now
Even though the transition to ICD-10-CM seems a long way off, start acquainting physicians with the... -
Pay-per-view: Correctly count observation time for outpatients
Counting time for observation isn't always straightforward under OPPS. Coders and billers need to... -
Trivia
How many countries border China?
Issue 28, July 15, 2011
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Q/A: Charging for PICC line insertion radiologic guidance
Q: We have been told that we may not charge for radiology chest one view or two views (CPT®... -
Tip: Learn new ICD-10-CM documentation requirements for pathologic fractures
A pathologic fracture is a broken bone caused by disease. ICD-10-CM expands code selection for this... -
Pay-per-view: Decision tree helps guide appropriate use of modifier -59
Dr. Cooper attempts to repair a rotator cuff tear using an arthroscopic approach, but she is unable... -
Trivia
Lava Hot Springs is located in which U.S. state?
Issue 27, July 8, 2011
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Q/A: Payment for partial hospitalization services
Q: Is CMS proposing any changes to the APCs for partial hospitalization programs (PHPs)? -
Tip: Ask these questions before appending modifier -59
Coders can use a decision tree to ensure they append modifier -59 (distinct procedural service... -
Pay-Per-View: ICD-10-CM prep: Determine documentation trouble spots
Each facility faces different challenges as it prepares for the transition to ICD-10-CM based on... -
Trivia
Sir Arthur Conan Doyle killed off Sherlock Holmes in which of the following tales?
Issue 26, July 1, 2011
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Correct use of modifier -AY for ESRD
Q: Our MAC started recouping payments on claims for lab tests such as a complete blood count... -
Tip: Identify appropriate situations to use modifier -59
Coders use modifier -59 (distinct procedural service) to identify instances in which overriding an... -
Pay-per-view: Review documentation for correct hysteroscopy coding
A hysteroscopy is not the same as a hysterectomy. The two words sound similar but refer to two very... -
Trivia
What is the National Prohibition Act informally called after the chairman of the House Judiciary...
Issue 25, June 24, 2011
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Reporting splints with CPT and L codes
Q: An insurance company that follows APC guidelines recently denied a large number of our claims... -
Tip: Report drugs with HCPCS code, revenue code 636
Many facilities report packaged drugs under revenue code 250 (pharmacy) regardless of whether an... -
Pay-per-view: Decision tree helps guide appropriate use of modifier -59
Dr. Cooper attempts to repair a rotator cuff tear using an arthroscopic approach, but she is unable... -
Trivia
How many strings does a modern harp have?
Issue 24, June 17, 2011
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Q/A: Reporting multiple outpatient visits that occur the same day
Q: Some of our outpatient claims contain multiple charges reported with revenue code 0761... -
Tip: Find errors before the bill drops
Examine your facility's process for sending a claim out the door. Does it drop as soon as it is... -
Pay-per-view: Good documentation starts with physician education
If your ICD-10-CM/PCS readiness plan consists of hoping that CMS will reschedule the go-live date... -
Trivia
Who is the patron saint of the blind?
Issue 23, June 3, 2011
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Q/A: Copays for preventive services
Q: How does healthcare reform affect copayments for preventive services? -
Q/A: Billing for ED services when medical necessity is lacking
Q. When medically necessity for ancillary tests (i.e. laboratory, x-rays) performed in our ED is... -
Tip: Share payer policies among departments
Instead of playing the blame game when a payer returns a claim, try resolving problems by... -
Tip: Tackle denials with teamwork
What happens when your facility receives a denial? Does your billing staff just write it off, or do... -
Pay-per-view: Evaluate charge setting for combination codes
Combination codes are becoming more common as the AMA continues to combine codes for procedures... -
Pay-per-view: Medical necessity is key to the E/M visit level
Medical necessity governs provision of all healthcare services, regardless of reimbursement source... -
Trivia
Which of the following was the first national park established in the Unites States? -
Trivia
Who was the first Tudor monarch of England?
Issue 22, May 27, 2011
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Q/A: How does CMS calculate outlier payments?
Q: Our business office staff members were discussing outlier payments, particularly the... -
Tip: Stay up-to-date with conditionally bilateral code changes
Each quarter, CMS releases updates to the Integrated Outpatient Code Editor (I/OCE), with revisions... -
Pay-per-view: OPPS vs. CPT: Coding injections and infusions
Coders already know that CMS doesn't always follow the language in the CPT® manual. -
Trivia
What is the second-longest river in the world?
Issue 21, May 20, 2011
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Q/A: Assigning HCPCS code for H1N1 vaccine
Q: In our hospital outpatient setting, we are providing H1N1 immunizations and we understand that... -
Tip: Look at historical charges when prices for combination codes
Facilities should consider how they will charge for new combination codes-not just those for... -
Pay-per-view: Coders and billers: It’s time to start talking
A payer sends a claim back to your facility. Who's at fault? Is it the biller? The coder? Or maybe... -
Trivia
What was The Beatles' first number 1 hit on the Billboard hot 100?
Issue 19, May 13, 2011
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Q/A: Single vial used for multiple patients
Q: Our pharmacists say they are allowed to use a single vial for more than one patient, as long as... -
Tip: Look for documented details of wound characteristics
Documentation for wounds should include specific details regarding the wound(s). -
Pay-per-view: Catch errors with second-quarter NCCI edits
Coders may have seen some new edits show up for cardiac catheterization procedures in April, but... -
Trivia
What is the term for a word that imitates the sound it represents?
Issue 18, May 6, 2011
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Q/A: Coding for free radiopharmaceuticals
Q: Medicare is rejecting our outpatient claims because we are not reporting a radiopharmaceutical... -
Tip: Differential between modifiers -33 and -PT
On the surface, modifier -33 (preventive service) and modifier -PT (colorectal cancer screening... -
Pay-per-view: Dig into the details of wound care documentation
Documentation is central to accurate coding and reimbursement. It justifies treatment, supports the... -
Trivia
The violet is the state flower of which U.S. state?
Issue 17, April 29, 2011
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Q/A: Using modifier -59 with EKGs and cardiac catheterization
Q. We have an ongoing debate about modifier -59 (distinct procedural service). Some physicians... -
Tip: Assign modifiers correctly for multiple E/M visits with procedures
In some cases, you may need to append more than one modifier to explain what happened with a... -
Pay-per-view: I/OCE edits: Look for bilateral status changes, new modifier
As part of the April update to the I/OCE, CMS added 34 codes to the list of conditions that are... -
Trivia
Which play did President Lincoln attend at Ford's Theater April 14, 1865?
Issue 16, April 22, 2011
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Q/A: Replacement for HCPCS code Q1003
Q: We learned that HCPCS Q1003(new technology, intraocular lens, category 3 [reduced spherical... -
Tip: Consider intent of visit when appending modifier -25
Coders need to look at the intent of the visit when determining whether to append modifier -25... -
Pay-per-view: OPPS vs. CPT: Coding injections and infusions
Coders already know that CMS doesn't always follow the language in the CPT® Manual. -
Trivia
Which US state is known as the “Beehive State”?
Issue 15, April 15, 2011
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Q/A: Reimbursement for composite CPT codes
Q: We’ve been reporting the new combination CPT® code for a CT of the abdomen and pelvis... -
Q/A: Reimbursement for composite CPT codes
Q: We’ve been reporting the new combination CPT® code for a CT of the abdomen and pelvis... -
Q/A: Reimbursement for composite CPT codes
Q: We’ve been reporting the new combination CPT® code for a CT of the abdomen and pelvis... -
Q/A: Reimbursement for composite CPT codes
Q: We’ve been reporting the new combination CPT® code for a CT of the abdomen and pelvis... -
Tip: Ensure record supports use of modifier -25
As part of the standard of care, a physician or nurse will record a patient's vital signs and... -
Pay-per-view: Multiple same-day outpatient hospital visits: Modifier -27
It's a classic example: Ragweed season is in full swing. An asthma patient presents to your ED two... -
Trivia
What was the original name of Truth or Consequences, New Mexico?
Issue 14, April 8, 2011
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Q/A: Revenue codes for drug charges
Q: Some of our drug charges with HCPCS J-codes are rolled into revenue code 250 (pharmacy) on the... -
Tip: Prepare for coding challenges with seventh character in ICD-10-CM
Current ICD-9-CM codes are three to five characters in length. Valid ICD-10-CM codes range from... -
Pay-per-view: Significant, separately identifiable E/M: Modifier -25
Assigning the most appropriate E/M level can be a challenge since no national guidelines exist and... -
Trivia
Which instrument measures wind speed?
Issue 13, April 1, 2011
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Q/A: Medicare drug reimbursement updates
Q: How often does Medicare update the reimbursement for drugs and biologicals? We have provided the... -
Tip: Review your records for use of modifier -25
A self-audit is one way to ensure that coders are correctly charging for a separate E/M visit and... -
Coming soon to an ED near you: ICD-10-CM codes
The transition to ICD-10-CM/PCS will be here sooner than you think, so now is the time to start... -
Trivia
Which classical composer was born on April Fools Day?
Issue 12, March 25, 2011
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Q/A: Ambiguous orders
Q: Our physician writes an order to “admit to 2 West” and intends this to be an... -
Tip: Selecting codes and counting time for injections and infusions
Coders still follow the hierarchy when selecting codes, and the AMA added only one new code for... -
Pay-per-view: Brush up on hemorrhoid coding: Know types, treatments
Hemorrhoids are the great unmentionable in our list of ailments. Some people never suffer from... -
Trivia
Who wrote the book, The Secret Garden?
Issue 11, March 18, 2011
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Q/A: Billing for x-rays ordered by a chiropractor
Q. A local chiropractor frequently sends patients to our hospital outpatient radiology department... -
Tip: Get to know the new modifiers
CMS added 13 modifiers as part of its I/OCE edit update. -
Pay-per-view: Brush up on hemorrhoid coding: Know types, treatments
Hemorrhoids are the great unmentionable in our list of ailments. Some people never suffer from... -
Trivia
The Ides of March falls on which date?
Issue 10, March 11, 2011
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Q/A: Wound care and NCCI edits
Q: We are almost to the second quarter of 2011. Medicare often updates the Integrated Outpatient... -
Tip: Accounting for charges with new CPT codes
The AMA has issued some new “all-inclusive” and combination CPT® codes for several... -
Pay-per-view: Resolve continuing questions about injection and infusion coding
Not much has changed with injection and infusion coding in recent years. After all, coders still... -
Trivia
Which U.S. river traditionally is dyed green on St. Patrick’s Day?
Issue 9, March 4, 2011
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Q/A: NCCI edits and wound care management
Q: We have been coding active wound care management based on the new 2011 narrative updates and... -
Tip: Keep up with pain management code changes
The AMA continues to revise codes for the extracranial nerves, peripheral nerves, and autonomic... -
Pay-per-view: I/OCE edits: CMS switches around packaged, separately payable drugs, changes some APC status indicators
CMS changed the packaging status of several drugs and reduced the number of HCPCS codes available... -
Trivia
Which actor provides the voice of Buzz Lightyear, space ranger, in the Toy Story movies?
Issue 8, February 25, 2011
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Q/A: Critical care and NCCI edits
Q: A note in the 2011 CPT® update states that facilities may now bill separately for services... -
Tip: Count time correctly under new CPT guidelines
The AMA included a new subhead (Time) and guidelines for reporting time in the 2011 CPT®... -
Pay-per-view: Wound care coding revisions part of CPT surgery changes
The AMA added 62 new CPT® codes in the surgery section and revised 55 other codes. The 2011... -
Trivia
Mount Magazine is the highest point in which U.S. state?
Issue 7, February 18, 2011
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Q/A: Automatic denials with modifier -GZ
Q: Our MAC denied line items with modifier -GZ (Item or service expected to be denied as not... -
Tip: Learn the guidelines for new cardiac catheterization codes
Some of the biggest changes to the CPT® codes for 2011 appear in the cardiac catheterization... -
Pay-per-view: 2011 CPT® changes feature new time guidelines, subsequent observation care codes
Coders will have 212 new CPT® codes for 2011 as a result of the AMA’s CPT update. In... -
Trivia
The Spanish-built fortified city of Intramuros lies within the metropolitan area of which...
Issue 6, February 11, 2011
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Q/A: Reporting drug administration services that cross days
Q: We noticed that the 2011 CPT® Manual under the main section Introduction includes a... -
Tip: Learn the different rules for different territories for revascularization codes
Different rules govern each territory for the revascularization codes, so be sure to review them... -
Pay-per-view: Wound care coding revisions part of CPT surgery changes
The AMA added 62 new CPT® codes in the surgery section and revised 55 other codes. The 2011... -
Trivia
Of the many pictures that have won Oscars® in every category in which they were nominated...
Issue 5, February 4, 2011
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Q/A: HCPCS code G0431 and multiple quantities
Q: We had been receiving line item denials for HCPCS code G0431 when we reported multiple... -
Tip: Proper use of new subsequent observation codes
The AMA added new CPT® codes 99224–99226 for subsequent hospital observation for 2011... -
Pay-per-view: AMA changes cardiac catheterization, revascularization coding
Some of the biggest changes to CPT® codes this year appear in the cardiac catheterization and... -
Trivia
Which actor has the most Oscar® nominations for his performances?
Issue 4, January 28, 2011
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Q/A: Reporting platelet rich plasma injection on Medicare claims
Q: The 2011 CPT® Manual includes code 0232T for injection(s), platelet rich plasma, any tissue... -
Tip: Report drug administration codes properly
Medicare recognizes the 2011 CPT® Manual’s drug administration codes, and hospitals... -
Pay-per-view: 2011 CPT changes feature new time guidelines, subsequent observation care codes
Coders will have 212 new CPT® codes for 2011 as a result of the AMA’s CPT update. In... -
Trivia
Which U.S. President was nicknamed “Old Tippecanoe”? -
Participate in our hospital-based outpatient wound care coding survey
Participate in our hospital-based outpatient wound care coding survey.
Issue 3, January 21, 2011
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Q/A: Correct use of modifier -PT
Q: We’ve seen very little information about the new modifier –PT, which denotes a... -
Tip: ED physicians can provide supervision if immediately available
Over the years, many HIM staff have assumed that ED physicians in the hospital could provide the... -
Pay-per-view: Critical care coding changing, cancer center payment isn’t
As part of the 2011 OPPS final rule, CMS finalized changes to critical care coding and shelved a... -
Trivia
Who wrote the lyrics for the Broadway musical, “A Chorus Line”?
Issue 2, January 14, 2011
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Q/A: Additional OPPS changes for 2011
Q: We have read the final OPPS 2011 rules. However, between publication of the rule and the... -
Tip: Understand what immediately available means for supervision requirements
CMS’ decision to remove the words “in the hospital” from physician supervision... -
Pay-per-view: CMS finalizes list of 16 extended-duration services
As part of the 2011 OPPS final rule, CMS identified a limited set of services as “nonsurgical... -
Trivia
The geographic center of the continental United States is located in which state?
Issue 1, January 7, 2011
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Q/A: Changes to HBO therapy billing
Q: Did CMS provide any new updates for hyperbaric oxygen (HBO) therapy services for 2011? -
Tip: Meeting the new physician supervision requirements
CMS’ decision to back away from the boundary requirement for physician supervision provides... -
Pay-per-view: CMS expands suspension of physician supervision rules
The changes CMS made to the supervision requirements will delay but not eliminate the problems... -
Trivia
How many hearts does an octopus have?
