Some of you have read CodingIntel’s article on coding for screening colonoscopy. The questions we get about that article are almost all related to diagnosis coding. The CPT®/HCPCS coding and the modifiers don’t raise many questions, but clinicians, coders, and patients frequently ask about correct diagnosis coding and sequencing of those codes. We posed these […]
Dear Resident, Do you Understand Relative Value Units (RVUs)?
Measuring physician productivity with work Relative Value Units (RVUs) News flash! Physicians are more interested in medicine than coding. No doctor undertook the rigors of medical school in order to be an expert coder. But, when residency ends, some physicians will find themselves looking at employment contracts in which their compensation will be determined in […]
Can you Screen for an Existing Condition? | Diagnosis Coding for Lab Services
Sometimes, the hardest thing about coding for preventive services isn’t the visit at all. It’s the labs. Patients come in for an annual physical and believe that all of the lab work done that day or in preparation for that day will be covered as part of their preventive service. And we know what that […]
HCC Diagnosis Coding: Can you Add a Code from the Past Medical History?
This post describes rules for office/outpatient coding, not facility/DRG rules. Recently a fellow coder wrote to me about risk adjusted diagnosis coding. She was responding to an article that I wrote in which I stated the conditions listed in the past medical history should not be included on the claim form by the coder. I […]
7 Sure Fire Ways to Owe the Government $4 million in Fines and Repayments | Coding Compliance
Most practices aren’t looking to pay the government any money in fines and repayment because of coding errors. Two recent OIG settlements described two practices that did just that. Most practices want to avoid this, of course, but some groups seem determined to achieve that outcome. In reviewing both of the settlements, there are some […]
CPT® and CMS Rules for Critical Care | What’s the Difference?
CMS and CPT count critical care time differently. For Medicare patients, the full 30 minutes of 99292 must be met in order to use the code, not the midpoint (15 minutes) of the code. For Medicare patients: Use 99291 from 30 minutes until 103 minutes. Add on code 99292 only if the time meets 104 […]
Pessary Billing and Coding
Coding for Pessary Services Primary care practices, gynecology and urology practices often prescribe and provide pessaries. Â A pessary is used to treat pelvic organ prolapse and for urinary incontinence. It provides support for the vaginal walls, uterus, bladder or rectum. A physician or non-physician practitioner (NPP) must first see the patient, take a history, examine […]
Can I Get Paid for…My Nurse Doing Ear Lavage
The nurse flushed the patient’s ear so I could examine the TM. Free or Fee? Find out more about billing for ear lavage done by nursing staff in this brief video. Back to list Relevant Search Terms: 69209, 69210, cerumen, removal, irrigation, ​
Can I Get Paid for…Emergency Services in the Office
The patient called for an urgent visit that disrupted your regularly scheduled office hours. Can you get paid at a higher level for providing emergency services in the office? Back to list Relevant Search Terms: 99050, 99058, 99059, add on, codes
Can I Get Paid for…Signing the Home Health Certification Form
An Overview of Home Health Certification CPT® CMS pays a small fee for the planning, certification, supervision and re-certification of home health services. Don’t do the work and forget to get paid. Find out more about getting paid to sign the home health certification form in this brief video from CodingIntel dedicated to home health […]
Can I Get Paid for…Nurse Visits
Nurse visits – when can you bill for them, and when are the services of the nurse just part of the cost of doing business? Back to list Relevant Search Terms: 99211, incident to, nurse visits
Can I Get Paid for…Travel Counseling
So your patient is going to the Galapagos, and wants your advice. Can you get paid for travel counseling? This short video has the answer. Back to list Relevant Search Terms: 99401,99404, immunizations, preventive medicine
Can I Get Paid for…a Problem Oriented Visit and Wellness Visit on the Same Day
Patients who come into the office for a physical or wellness visit often have a problem they want to discuss, or chronic conditions that need to be assessed and managed. Whether the patient is receiving a preventive medicine service or a Medicare wellness visit, the decision is the same. Report both services when the practitioner […]
Coding for Screening Colonoscopy
Table of Contents An Overview of Colonoscopy Coding Guidelines Screening Age and Non-invasive Coverage Screening Colonoscopy for CRC What is the Difference Between a Screening Test and a Diagnostic Colonoscopy? Two Sets of Procedure Codes are Used for Screening Colonoscopy E/M Service Prior to a Screening Colonoscopy Screening Colonoscopy for Medicare Patients that becomes Diagnostic […]