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When to Use 'Uncertain Behavior Diagnosis Code'?

09th June 2011
You may be in for a great loss if you always use diagnosis code 238.2 while reporting 11100 for a biopsy procedure your surgeon performs. The best way to know when to use the 'uncertain behavior' diagnosis code is understanding what that code descriptor r... Read >
Author: James Smith

Unlisted procedure coding? Here's how you should tread

24th May 2011
Always remember this: You should never select a CPT code that merely approximates the service provided. Even though this rule is important for compliant coding, it leaves you with the tough job of submitting a claim minus a procedure-specific code. Here's... Read >
Author: erin

Pathology Coding: do not Double Dip for Microdissection

21st March 2011
Just-in CPT code 88363 is not the only code that describes prep work that a pathologist might carry out prior to molecular testing. Code 88363 describes the work when a pathologist retrieves a signed-out case to choose proper tissue for molecular anal... Read >
Author: Erin Lang Masercola

Rectal exam with anesthesia? Consider 45990

16th March 2011
In a particular coding scenario, the surgeon used a bivalve, suctioned the old blood from where a hemorrhoid had necrosed and fallen off; however the large vessel underneath was continuing to bleed (all carried out under anesthesia). Subsequent to this he... Read >
Author: Erin Lang Masercola

Do and Don't of Unlisted Procedure Coding

24th November 2010
Keep this CPT instruction in mind: "Don't choose a CPT code that merely approximates the service provided." This rule is key for compliant coding, however it leaves you with tough job of submitting a claim without a procedure-specific code. Here are some ... Read >
Author: James Smith

Tips to Help you Capture Percutaneous, Kyphoplasty, Vertebroplasty Payment

24th July 2010
If you do not know the difference between kyphoplasty and vertebroplasty, you and practice are in for denials and lost reimbursement. Kyphoplasty is similar to vertebroplasty, however the two are not identical and you should not code them in the same way.... Read >
Author: James Smith

CPT Assistant: Which code for autism screenings?

18th July 2010
Autism is a disorder of development, which is not easy to detect in very young children. But children who get early intervention have improved long-term prognoses. Keeping this in mind, the Modified - Checklist for Autism in Toddlers (M-CHAT) was made to ... Read >
Author: James Smith

Urology coding: Stay on top of CCI 16 edits

23rd February 2010
These days, a urology coder's hands are already full trying to walk through the maze of all 2010 CPT changes. To make things worse for her, the latest CCI (correct coding initiative) edits version 16.0 ties her hands on some code pairings, including the n... Read >
Author: Celena

CPT Code for Hernia: Take the Mess Out

04th June 2009
Recurrent hernia repair usually requires mesh removal, unless the physician can document extraordinary effort. It's a common procedure, but you can only bill separately for the procedure in a minority of cases. Make sure you know what they are. 1. Cla... Read >
Author: Nancy

CPT Code for Excision: Pathology as the Main Issue

04th June 2009
Excision is defined as full-thickness (through the dermis) removal of a lesion, including margins, and includes simple (non-layered) closure when performed. Report each benign (or malignant) lesion excised separately. Selection of the CPT code for excisio... Read >
Author: Nancy
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