a Blog on Medical Billing, Coding, Reimbursement and Health Care Office Management

How do you code an OPEN Procedure for Takedown of Colostomy or Open Reversal of Colostomy?

noreply@blogger.com (Misspy) — Tue, 14 Feb 2012 17:35:00 +0000

You will report the procedure using:

44626 Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure) --- OPEN

When Mobilization (take-down) of splenic flexure is also performed; here's your code:

44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)

Always consult your CPT Code book. CPT is a trademark and owned by the American Medical Association.

Please don't forget to visit my helpful website (Providing free source of useful information on medical billing, coding, reimbursement and office management to Physicians, Office Managers, Medical Billers and Medical Coders since 2005!) - www.justmypassion.com

How do you code a Laparoscopic Takedown of Colostomy or Laparoscopic Reversal of Colostomy?

noreply@blogger.com (Misspy) — Tue, 14 Feb 2012 17:05:00 +0000

You will report the procedure using:

44227 Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis

When Mobilization (take-down) of splenic flexure is also performed; here's your code:

44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)

Always consult your CPT Code book. CPT is a trademark and owned by the American Medical Association.

Please don't forget to visit my helpful website (Providing free source of useful information on medical billing, coding, reimbursement and office management to Physicians, Office Managers, Medical Billers and Medical Coders since 2005!) - www.justmypassion.com

CODING CORRECTION from the AMA - Endoscopic Transoral Incisionless Fundoplication (also called TIF) - CODING APPROPRIATELY FOR TIF

noreply@blogger.com (Misspy) — Tue, 14 Feb 2012 14:53:00 +0000

Corrected ((from the CPT assistant June 2011) the CPT for for TIF from an unlisted code 43659 - Unlisted laparoscopy procedure, stomach to 43499 - Unlisted procedure, esophagus.

Bottom line --- you will report your surgeon's TIF procedure using the unlisted code 43499! Unlisted procedure, esophagus.

This correction can be found and explained on the CPT Assistant published in December 2011.

CPT is a trademark and owned by the American Medical Association.

Please visit my professional blog at www.justmypassion.com

CPT 2012 Express Reference Coding Card General Surgery (AMA Express Reference)

noreply@blogger.com (Misspy) — Thu, 09 Feb 2012 19:57:00 +0000

Amazon.com Books: general surgery coding

CPT 2012 Express Reference Coding Card General Surgery (AMA Express Reference)

Paperback:
4 pages

Company: Amer Medical Assn
(2011-11-30)

ISBN: 1603595538

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Coding with Modifiers: A Guide to Correct CPT and HCPCS Modifier Usage

noreply@blogger.com (Misspy) — Sun, 22 Jan 2012 18:33:00 +0000

Amazon.com Books: hcpcs coding

Coding with Modifiers: A Guide to Correct CPT and HCPCS Modifier Usage

The new third edition contains updated CMS, third-party payer and AMA modifier guidelines to assist in coding accurately. This edition contains updated CMS, third party payer, and AMA modifier guidelines to assist in coding accurately and avoiding payment delays. New to this edition: * New teaching tool - Gives instructors the ability to create and administer tests * New clinical examples - Guide readers in determining the correct modifier to use * Additional Test-Your-Knowledge questions - Test your comprehension of the material through more than 190 questions Plus, successful features from prior edition: * Modifiers approved for hospitals and ASCs - Information for professional service and hospital reporting requirements * Coding tips for using specific modifiers - Helps to clear up confusion surrounding modifier usage * Decision Tree Flow Charts - Guides you in choosing the correct modifier to use

Author: American Medical Association, Deborah J. Grider

Paperback:
497 pages

Company: AMA Press
(2007-01)

ISBN: 1579478891

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Amazon.com Books: medical modifiers

CPT and HCPCS 2011 Level II Modifiers Express Reference Coding Card

Author: American Medical Association

Paperback:

Company: Amer Medical Assn
(2010-12-30)

ISBN: 1603592776

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Amazon.com Books: sanders

Betraying Nexus

Jason works for Nexus, a secret vigilante organization. He’s a Mind Bender and can implant thoughts into the minds of others. He's both a prodigy and a rising star.

But when he’s forced to take down an old friend and learns Nexus's darkest secret, he must ask himself what he believes in. And if it’s worth turning against the woman he loves.

Author: Richard Sanders

Kindle Edition:
29 pages
Kindle eBook

Company:
(2011-09-28)

(2011-09-28)

List Price: $0.99

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What are your Place of Service Codes - Nursing Care Facility, Ambulatory Surgery Center, In-Patient Hospital, Independent Laboratory.. etc.

noreply@blogger.com (Misspy) — Sun, 22 Jan 2012 15:54:00 +0000

I can give you the link on my website where you can find the complete list for the Place of Service codes.

Here you go..

http://www.justmypassion.com/placeofservicecodes.html

How and Where to Search for NPI -National Provider Identification Number for Provider and Organization

noreply@blogger.com (Misspy) — Sun, 22 Jan 2012 15:50:00 +0000

So you are entering your patient's demographic information. And it is very important that you also enter your patient's referring physician's NPI number and if the patient was seen other than at the provider's office (eg, outpatient hospital, surgery center or nursing care facilities - you also need to enter their group/organization or institution NPI number.

Here's the useful link where you can search and look up NPI:

https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do

You can look up by PROVIDER or by ORGANIZATION.

I hope this helps.

Please visit my professional website on Medical Billing, Coding, Office Management and Reimbursement at www.justmypassion.com.

Thanks!

Billing and Coding for Skilled Nursing - Nursing Facility Care and Visits (99304-99310)

noreply@blogger.com (Misspy) — Fri, 20 Jan 2012 21:55:00 +0000

Since January 01, 2010 - the consultation codes are no longer recognized by Medicare for Part B payment. We were then instructed to bill instead using the nursing facility care codes (99304 - 99306).

Here are your Nursing Facility care codes. I also had included the Subsequent Nursing Facility Care codes!

99304 Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of low severity. Physicians typically spend 25 minutes at the bedside and on the patient's facility floor or unit.

99305 Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Physicians typically spend 35 minutes at the bedside and on the patient's facility floor or unit.

99306 Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Physicians typically spend 45 minutes at the bedside and on the patient's facility floor or unit.

99307 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Physicians typically spend 10 minutes at the bedside and on the patient's facility floor or unit.

99308 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Physicians typically spend 15 minutes at the bedside and on the patient's facility floor or unit.

99309 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient has developed a significant complication or a significant new problem. Physicians typically spend 25 minutes at the bedside and on the patient's facility floor or unit.

99310 Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Physicians typically spend 35 minutes at the bedside and on the patient's facility floor or unit.

Please always refer to your local carrier's Coverage Determination. You can also read more from Medicare's (www.CMS.gov) website the Pub. 100-04, Medicare Claims Processing Manual, located in Chapter 12 and section 30.6 for more information.

CPT is owned and a trademark of the American Medical Association.

You can visit my website for more useful information on Medical Office Management, Billing and Coding at www.justmypassion.com

ICD-9-CM Professional for Physicians, Vols. 1 & 2 - 2012 Edition (Physician's Icd-9-Cm)

noreply@blogger.com (Misspy) — Thu, 19 Jan 2012 19:34:00 +0000

Amazon.com Books: ingenix

ICD-9-CM Professional for Physicians, Vols. 1 & 2 - 2012 Edition (Physician's Icd-9-Cm)

Now enhanced with a new, bolder font to improve readability, the Ingenix ICD-9-CM Professional for Physicians continues to provide accurate and comprehensive coverage for diagnosis coding and reimbursement.

Features include:

ICD-10 Spotlight. Preview ICD-10 codes with the most frequently reported ICD-9-CM codes to learn as you work.

Highlighted coding instructional and informational notes. Recognize important code usage guidance for specific sections more easily with highlighted notes.

Intuitive color-coded symbols and alerts. Identify critical coding and reimbursement issues quickly with alerts on the same page as the code you need.

AHA s Coding Clinic and official coding guideline tips. Use citations to link to the official coding advice every coder in every health care setting must follow for ICD-9-CM and find official coding tips with the codes.

Additional digit required symbols. Know when an additional fourth or fifth digit is required for code specificity and validity to avoid invalid code submissions (provided in Index and Tabular Section).

V-code symbols.Understand the appropriate use of V-codes that may only be sequenced as first-listed diagnosis for cleaner claim submissions.

Manifestation code alert. Properly use codes that represent manifestations of underlying disease by knowing when two codes are required and by knowing alerts to sequencing rules.

Illustrations and definitions.Gain in-depth understanding of anatomy and disease processes in relation to coding with clinically-oriented definitions and illustrations.

Unspecified and Other specified code alerts. Recognize the codes that should be used with caution to reduce denied claims.

Age and sex edits. Be aware of which codes have restrictions on use based on age or sex of the patient to prevent claim delays and denials.

New and revised code alerts with dated pages. Know which codes and instructions are new or revised, with dates on the page indicating when the change was made.

Synopsis of code changes. Perform accurate, retrospective claim audits by quickly identifying new code information for the year.

HIPAA compliance. Avoid delayed or denied claims and costly fines for violations.

Author: Ingenix

Perfect Paperback:
300 pages

Company: Ingenix
(2011-09-16)

ISBN: 1601514875

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Amazon.com OfficeProducts: HIPAA

Saunders Manufacturing Products - Clipboard, w/ Writing Plate, 1/2" Cap, 8-1/2"x12", Aluminum - Sold as 1 EA - Clipboard with hinged cover doubles as a writing surface and a protective cover. Privacy feature on clipboard aids in HIPAA compliance. Antimicrobial additive effectively reduces the formation of bacteria and fungi. High-tension clip holds a stack of forms up to 1/2" thick. Clip is serrated and nickel-plated. Side flange on the left helps align and protect forms. Lacquer finish is stain

Saunders Manufacturing Products - Clipboard, w/ Writing Plate, 1/2" Cap, 8-1/2"x12", Aluminum - Sold as 1 EA

Clipboard with hinged cover doubles as a writing surface and a protective cover. Privacy feature on clipboard aids in HIPAA compliance. Antimicrobial additive effectively reduces the formation of bacteria and fungi. High-tension clip holds a stack of forms up to 1/2" thick. Clip is serrated and nickel-plated. Side flange on the left helps align and protect forms. Lacquer finish is stain-resistant and weather-resistant. Clipboard is made of aluminum with 60 percent post-consumer material.

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Office Product:
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Amazon.com Books: medical billing and coding

CPC® Coding Exam Review 2011: The Certification Step, 1e (CPC Coding Exam Review: Certification Step)

With the expert insight of leading coding educator Carol J. Buck, this complete exam review highlights the content you'll need to master to pass the AAPC CPC® certification exam and take your coding career to the next step. CPC® Coding Exam Review 2011 features an easy-to-follow outline format that guides you through the anatomy and terminology for each organ system; reimbursement concepts; an overview of CPT, ICD-9-CM, and HCPCS coding; and more. Two full practice exams and a final exam modeled on the actual CPC® exam simulate the examination experience and help you build the confidence to succeed.

Comprehensive CPC® coverage highlights essential information for passing the AAPC CPC® exam, accompanied by detailed figures, for the most efficient exam review.

Concise outline format gives you quick and easy access to content and helps you make the most of your study time.

Bound-in companion CD includes a Pre-Exam and a Post- Exam that provide answers and rationales to help you target areas of weakness and reinforce your understanding of coding concepts.

A Final Exam located in the text simulates the actual CPC exam format and gives you a better understanding of how the content will be presented.
A companion Evolve Resources website enhances your review with study tips, web links, and links to related products.

Author: Carol J. Buck MS CPC CPC-H CCS-P

Paperback:
584 pages

Company: Saunders
(2010-12-08)

ISBN: 1437716571

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Understanding Health Insurance: A Guide to Billing and Reimbursement

noreply@blogger.com (Misspy) — Wed, 18 Jan 2012 18:34:00 +0000

Amazon.com Books: insurance claims billing and reimbursement

Understanding Health Insurance: A Guide to Billing and Reimbursement

Understanding Health Insurance: A Guide to Billing and Reimbursement, 8th Edition is a comprehensive source for teaching the subject of health insurance and reimbursement. The book contains chapters on introductory information on the health insurance field, managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Each chapter contains exercises to illustrate content and reinforce learning. Numerous opportunities are provided throughout the book for manual completion of CMS-1500 claims. A CD-ROM at the back of the book allows for electronic data entry of CMS-1500 claim form information. End of chapter review questions in objective format (e.g., multiple choice) test learners on their understanding of book content. Appendices I and II provide case studies that are also included on the Student Practice CD-ROM. Additional appendices provide instruction in dental claims processing and completion of the UB-92 (claim used for inpatient and outpatient hospital claims). The accompanying workbook provides application based assignments for each chapter, additional content review (multiple choice questions), and additional case studies for practice in completing CMS-1500 claims. This edition of the book contains the most up to date information regarding health insurance claims processing and coding and reimbursement issues.

Author: Jo Ann C.(Jo Ann C. Rowell) Rowell, Michelle A. Green

Paperback:
720 pages

Company: Delmar Cengage Learning
(2005-08-25)

ISBN: 1401895956

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Amazon.com Books: medical insurance billing and reimbursement

Understanding Hospital Billing and Coding, 2e

A comprehensive, approachable guide to hospital insurance billing and coding, Understanding Hospital Billing and Coding, 2nd Edition covers everything hospital billers need to know, from patient admission to accounts receivable management and HIPAA. It builds on your knowledge so that you can make a successful transition from the physician/outpatient environment to the hospital setting. Written by coding expert Debra P. Ferenc, this book covers the hospital regulatory setting, the structure and functions of hospital departments, patient accounts and data flow, the billing process, coding, claim forms, reimbursement, accounts receivable management, HIPAA requirements, and much more.

Over 300 illustrations and graphics bring important concepts to life.

Practice hospital cases let you apply concepts to real-life scenarios.

A department-by-department overview of hospital structure shows how hospitals really work.

Detailed chapter objectives highlight what you are expected to learn.

Key terms, acronyms, and abbreviations with definitions are included in each chapter.

Key Points boxes reinforce key concepts.

Test Your Knowledge exercises reinforce lessons as you progress through the material.Comprehensive presentation of the UB-04 includes section-by-section explanations and a comparison between the CMS-1500 and UB-04.

Detailed explanations of HIPAA, hospital coding, and various payer systems prepare you to enter the field of hospital billing and coding.

Chapter summaries review key concepts.

Review exercises in each chapter reinforce your understanding and improve your retention of important concepts.

Exercises on the companion Evolve website simulate a hospital billing and coding environment and provide another method of learning procedures by drawing from source documents - such as application of registration, Charge Description Master (CDM), and the patient invoice.

Updated Claim Forms chapter covers the UB-04 claim form.

Updated information covers diagnosis and procedural coding, with guidelines and applications.

Updated claim forms and names are used throughout.

Author: Debra P. Ferenc BS CPC CPC-I CPC-H CMSCS PCS FCS

Paperback:
672 pages

Company: Saunders
(2010-07-02)

ISBN: 1437722512

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Understanding Hospital Billing and Coding, 2e

noreply@blogger.com (Misspy) — Tue, 17 Jan 2012 19:31:00 +0000

Amazon.com Books: insurance claims billing and reimbursement

Understanding Hospital Billing and Coding, 2e

Over 300 illustrations and graphics bring important concepts to life.

Practice hospital cases let you apply concepts to real-life scenarios.

A department-by-department overview of hospital structure shows how hospitals really work.

Detailed chapter objectives highlight what you are expected to learn.

Key terms, acronyms, and abbreviations with definitions are included in each chapter.

Key Points boxes reinforce key concepts.

Test Your Knowledge exercises reinforce lessons as you progress through the material.Comprehensive presentation of the UB-04 includes section-by-section explanations and a comparison between the CMS-1500 and UB-04.

Detailed explanations of HIPAA, hospital coding, and various payer systems prepare you to enter the field of hospital billing and coding.

Chapter summaries review key concepts.

Review exercises in each chapter reinforce your understanding and improve your retention of important concepts.

Exercises on the companion Evolve website simulate a hospital billing and coding environment and provide another method of learning procedures by drawing from source documents - such as application of registration, Charge Description Master (CDM), and the patient invoice.

Updated Claim Forms chapter covers the UB-04 claim form.

Updated information covers diagnosis and procedural coding, with guidelines and applications.

Updated claim forms and names are used throughout.

more info...

Amazon.com Books: ICD-10-CM and ICD-10-PCS

2012 ICD-9-CM Coding Theory and Practice with ICD-10, 1e

Learn to code effectively with ICD-9-CM medical coding and gain a thorough introduction to ICD-10-CM/PCS coding all in one text! Whether you're learning to code for the first time or beginning the transition from ICD-9-CM to ICD-10-CM/PCS, 2012 ICD-9-CM Coding Theory and Practice with ICD-10 delivers the fundamental understanding you need to succeed in hospital and physician settings and prepare for the October 2013 ICD-10-CM/PCS implementation. Leading medical coding authorities Karla Lovaasen and Jennifer Schwerdtfeger combine basic coding principles with proven, practical insight and the ICD-9-CM and ICD-10-CM/ICD-10-PCS Official Guidelines for Coding and Reporting (OCGR) to equip you for complete professional success in the changing medical coding field.

Coverage of both ICD-9-CM and ICD-10-CM/PCS coding equips you for coding success today and in your future career.

ICD-9-CM and ICD-10-CM/ICD-10-PCS Official Guidelines for Coding and Reporting (OCGR) provide fast, easy access to the latest codes and examples for proper application.

Integrated medical record coverage familiarizes you with records and documents youÕll encounter on the job.

MS-DRG documentation and reimbursement details guide you through this key component of the coding process.

Line coding exercises and activities challenge you to apply chapter concepts to solve problems.

A&P content in each coding chapter includes full-color illustrations and clarifies important anatomy and physiology concepts.

Disease coverage details commonly encountered conditions related to ICD-9-CM coding.

Updated Coding Clinics references guide you to the latest coding insights from the American Hospital Association (AHA).

Procedure guidelines help you effectively apply ICD-9-CM Volume 3 codes for success in inpatient facility settings.

Drug data familiarizes you with medication names you may encounter in medical records for greater coding accuracy.

Companion Evolve website provides convenient online access to the Official Guidelines for Coding and Reporting (OGCR), medical and surgical root operations definitions, MS-DRG list, and answer keys.

Introduction to ICD-10-PCS chapter prepares you to code in inpatient facility settings after the October 2013 ICD-10-CM/PCS implementation date.

Author: Karla R. Lovaasen RHIA CCS CCS-P

Paperback:
832 pages

Company: Saunders
(2011-08-22)

ISBN: 1455705454

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Be careful with your ICD-9 Code that requires a 5th Digit!

noreply@blogger.com (Misspy) — Mon, 16 Jan 2012 04:07:00 +0000

Error: Claims are being rejected for "diagnosis code requires a 5th digit". See, you don't need this kind of claim rejection. Because of this simple issue, your claims get delayed for payment. So you have to really pay attention with your codes. Open your book - don't just "google" it! Your ICD-9 Code book is the best book to look up and find the right code.

ICD-9 Code:

722.1
    Displacement of thoracic or lumbar intervertebral disc without myelopathy

          722.10 for lumbar
722.11 for thoracic!

Pleas visit my professional blog at www.justmypassion.com. Thanks!

HIPAA Compliance Online Training

noreply@blogger.com (Misspy) — Wed, 11 Jan 2012 16:24:00 +0000

Amazon.com Software: hipaa compliance

HIPAA Compliance Online Training

3 Basic Module Courses:
1. Basics of HIPAA Privacy Rule
2. Patient Rights
3. HIPAA Confidentiality

13 Clinic-Focused Courses for
1. Nephrology
2. Orthopedic
3. Oncology
4. Pediatrics
5. Mental Health Clinics
6. Dental Clinics
7. Skin Clinic
8. Family Care Clinic
9. Cardiology Clinic
10. Pulmonary/Respiratory Clinic
11. Neurology Clinic
12. Gastrointestinal - Genitourinary Clinic
13. Obstetric - Gynecology Clinic

6 Hospital Based Courses:
1. HIPAA - Ancillary Staff
2. HIPAA - Billing and Records Staff
3. HIPAA - Diagnostic Technicians
4. HIPAA - Helpdesk Staff
5. HIPAA - Nursing Staff
6. HIPAA - Volunteers

You get only 1 User License for 12 weeks

THIS IS AN ONLINE TRAINING COURSE. NO CD/DVD WILL BE SHIPPED. WE WILL PROVIDE WITH LOGIN ID/PASSWORD TO LOGIN INTO OUR SYSTEM AND TAKE THE TRAINING COURSE AND GENERATE CERTIFICATE.

DVD-ROM:
DVD-ROM22 Online HIPAA Courses divided into 3 modules, Basic, Clinic Focussed and Hospital based modules, Voice-Over/Narration to help understand the concepts, Quizzes and Certification at the end to ensure compliance, No need for DVDs, CDs, or software installation.

Company: emPower eLearning

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Amazon.com Magazines: CPT

Casting Plant and Technology International

Magazine:
Magazine Subscription

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Amazon.com Books: cpt coding current procedural terminology

Understanding Procedural Coding: A Worktext

UNDERSTANDING PROCEDURAL CODING: A WORKTEXT, Second Edition is a comprehensive, hands-on worktext that will help your students gain confidence in procedural coding. Procedures are illustrated to clarify concepts and practice exercises are provided throughout so your students can test themselves as they progress. Used in conjunction with their CPT and HCPCS Level II manuals, this learning resource will help your students master procedural coding for all medical specialties. UNDERSTANDING PROCEDURAL CODING: A WORKTEXT, Second Edition allows your students to answer questions right in the book, making it both a learning tool and a personalized resource. 30-day free trial of Ingenix's EncoderPro included.

Author: Mary Jo Bowie, Regina M Schaffer

Spiral-bound:
494 pages

Company: Delmar Cengage Learning
(2010-03-22)

ISBN: 1111037469

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Medical Codes - ICD-10-CM, ICD-10-PCS, IDC-10, IDC-9-CM, and DSM-IV codes in one convenient book. Search by category, alphabetical, keyword, combination of keywords, and by code (Mobi Medical).

noreply@blogger.com (Misspy) — Wed, 11 Jan 2012 10:42:00 +0000

Amazon.com KindleStore: ICD-9-CM

Medical Codes - ICD-10-CM, ICD-10-PCS, IDC-10, IDC-9-CM, and DSM-IV codes in one convenient book. Search by category, alphabetical, keyword, combination of keywords, and by code (Mobi Medical).

ICD-10-CM, ICD-10-PCS, IDC-10, IDC-9-CM, and DSM-IV codes in one
convinient book. Search by category, alphabetical, keyword, combination of
keywords, and by code.
The Book Includes:

ICD-10-CM (2010) - International Classification of Diseases, 10th Revision,
Clinical Modification, provided by the Centers for Medicare and Medicaid
Services (CMS) and the National Center for Health Statistics (NCHS), for coding
and reporting in the United States.
ICD-10-PCS - an American Procedure Coding System of medical classification
used for procedural codes, a successor to Volume 3 of ICD-9-CM and a clinical
modification of the original ICD-10.
ICD-10 - International Classification of Diseases, 10th Revision
DSM-IV Codes - Diagnostic and Statistical Manual of Mental Disorders, 4th
Edition
ICD-9-CM Volumes 1 and 2 - Diagnosis Codes, International Classification of
Diseases, Ninth Revision, Clinical Modification
ICD-9-CM Volume 3 - Procedural Codes, International Classification of
Diseases, Ninth Revision, Clinical Modification
Example of Intestinal infectious diseases codes
(001-009)

(001) Cholera
(002) Typhoid and paratyphoid fevers
(003) Other Salmonella infections

(003.0) Salmonella gastroenteritis
(004) Shigellosis

(004.9) Shigellosis, unspec.
(005) Other poisoning (bacterial)

(005.0) Staphylococcal food poisoning
(006) Amoebiasis

(006.0) Acute amoebic dysentery without mention of abscess
(006.1) Chronic intestinal amoebiasis without mention of abscess
(006.2) Amoebic nondysenteric colitis
(006.3) Amoebic liver abscess
(006.4) Amoebic lung abscess
(006.5) Amoebic brain abscess
(006.6) Amoebic skin ulceration
(006.8) Amoebic infection of other sites
(006.9) Amoebiasis, unspecified
(007) Other protozoal intestinal diseases

(007.1) Giardiasis
(007.9) Intestinal protozoa, NOS
(008) Intestinal infections due to other organisms

(008.61) Rotavirus
(008.8) Gastroenteritis, viral
(009) Ill-defined intestinal infections

(009.1) Gastroenteritis, infectious

Author: MobileReference

Kindle Edition:
1171 pages
Kindle eBook

Company: MobileReference
(2008-01-15)

(2008-01-15)

List Price: $19.99

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Anesthesia & Pain Management Coding Alert

noreply@blogger.com (Misspy) — Wed, 11 Jan 2012 01:27:00 +0000

Amazon.com Magazines: Pain Management Coding

Anesthesia & Pain Management Coding Alert

This eight-page monthly newsletter offers anesthesia and pain-specific coding advice to ensure optimal reimbursement from insurance claims.

Magazine:
Magazine Subscription

Company: Coding Institute

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CPT 2012 (Cpt / Current Procedural Terminology (Professional Edition))

noreply@blogger.com (Misspy) — Tue, 10 Jan 2012 19:30:00 +0000

Amazon.com Books: CPT

CPT 2012 (Cpt / Current Procedural Terminology (Professional Edition))

Author: Michelle Abraham, Jay T. Ahlman, Caryn Anderson, Angela J. Boudreau, Judy Connelly

Spiral-bound:
812 pages

Company: American Medical Association Press
(2011-10)

ISBN: 1603595686

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General Surgery Coding 2012: Here are some of the Deleted and New Codes: CPT Code 15170 has been deleted. See new codes 15271 and 15273

noreply@blogger.com (Misspy) — Thu, 05 Jan 2012 18:59:00 +0000

General Surgery Coding 2012: Here are some of the Deleted and New Codes: CPT Code 15170 has been deleted. See new codes 15271 and 15273

Effective January 01, 2012.

DELETED CODE:

15170 - Acellular dermal replacement, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

NEW CODE(S): SEE 15271 and 15273

15271     Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

15272     Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)

15273     Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

15274     Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

CPT is a trademark and owned by the American Medical Association (AMA).

Please don't forget to visit my professional website at www.justmypassion.com

Still Confused with Modifier 25 versus Modifier 57?

noreply@blogger.com (Misspy) — Sat, 26 Nov 2011 17:13:00 +0000

I will make it simple.. assuming you understand the guideslines on these 2 modifiers.

This time, let's base it on Global Days!

If the service or the procedure has 0-10 global days, this procedure is considered as a minor surgical procedure. This is when you will append your modifier 25 with the Evaluation and Management E/M code! You have to make sure the E/M encounter is a significant and separately identifiable, and is unrelated to the decision to perform the minor surgical procedure!

Now, if the procedure has 90 global days, you can append your modifier 57 (Decision for Surgery) when performed on the same day. When the procedure has 90 days global period, it is considered as Major Surgical Procedure!

References: CPT Code Book, CCI Edits, CMS website at www.cms.gov

Please don't forget to visit my helpful medical billing, coding and office management website at: www.justmypassion.com . Helping Medical Providers, Coders, Office Managers and Billers since 2005!

CPT 2012 Updates and Changes- 73542 is now DELETED! 27096 is now inclusive with 73542 when performed.

noreply@blogger.com (Misspy) — Sat, 19 Nov 2011 14:05:00 +0000

Pain Management Practice must update their codes on their superbill/chargeslip for 2012!

Effective January 2012:

DELETED CODE 73542 - Radiologic examination, hip, arthrography, radiological supervision and interpretation

27096 - Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid (NOW INCLUDES the arthrography 73542)

Please refer to your CPT Code Book 2012.
CPT is OWNED and is a TRADEMARK of the American Medical Association (AMA)

Please don't forget to visit my helpful medical billing, coding and office management website at: www.justmypassion.com . Helping Medical Providers, Coders, Office Managers and Billers since 2005!

Do We Have to Collect Copays for Medicare Patients with Secondary Insurance Having Specialty In-network Copay? Please help!

noreply@blogger.com (Misspy) — Thu, 27 Oct 2011 22:03:00 +0000

One of my readers had emailed me this question: So let me answer it (based on my knowledge and my experience).

When Medicare is a Primary Insurance for the patient, the patient's part responsibility (coinsurance/deductible) normally crosses over to its secondary insurance for secondary coverage (if Medicare has the secondary insurance on file).

As you will notice on your Remittance advise, it'll say: "Claim Information forwarded to: (insurance company here)". Meaning, Medicare will forward the information to the secondary insurance. If not, try to find out if there is a secondary insurance for the patient, then you need to send the paper claim (using the HCFA 1500 form for Office/Provider/Professional Claims) to the secondary and attach a copy of the Medicare EOB (explanation of benefits).

After you submit the claim to the secondary insurance, the secondary insurance EOB will then tell you if there is a copay being applied towards the patient being a secondary insurance after Medicare.

You will then obviously collect that copay based on your contract with the secondary insurance company (and this is also based on the patient's contract with his/her secondary insurance). Medicare patients are mostly aware of their responsibility after the secondary insurance picks up.

Bottom line here:

(1) Medicare must process (not deny or reject!) the claim first being the primary;
(2) Secondary insurance must then process the claim with Medicare's claim information;
(3) Then, if there is a copay being applied towards the patient's responsibility -- you have to bill your patient for that copay!

It may be a lot of work, but what I do is that, when I am billing the patient a copay (from the secondary insurance's determination and per the EOB), I would attach a copy of the EOB on the statement. That way, the patient has a copy of the said EOB and he/she will understand why I am billing for his/her copay.

I hope this helps.

Please don't forget to visit my helpful medical billing, coding and office management website at: www.justmypassion.com

What is the meaning of the CMS Medicare Claim Denial Reason Code: CO-16, CO16, CO/16?

noreply@blogger.com (Misspy) — Tue, 11 Oct 2011 14:26:00 +0000

What is the meaning of the CMS Medicare Claim Denial Reason Code: CO-16, CO16, CO/16?

Reason Code Description: Claim/service lacks information which is needed for adjudication

This kind of rejection is very straightforward and is also easy to fix. You can get additional information about its denial by calling your local carrier's IVR (Interruptive Voice Response)

What to do:
1. Check if you have the right Medicare ID number
2. Check if you the procedure code needs a modifier (eg. LT, RT, 50)
3. Check if your diagnosis code requires a a 4th or 5th digit
4. Check if a referring physician on box 17 is required (don't forget its NPI!)
5. Check if your place of service is appropriate for your procedure code (eg. inpatient service is not billable with POS 11 (office based)!)

Please don't forget to always visit my Medical Billing, Coding and Office Management Website at www.justmypassion.com.

Thanks!

Help with CPT Code for laparoscopic repair of diaphragmatic hernia with placement of mesh.

noreply@blogger.com (Misspy) — Tue, 30 Aug 2011 21:49:00 +0000

Help on how to code for laparoscopic repair of diaphragmatic hernia with placement of mesh.

One of my readers emailed me with this question ~
========================================================

Hi, Ms. Pinky,

Thank you for your helpful blog!

Can you please help me on how to code for laparoscopic repair of diaphragmatic hernia with placement of mesh? Thank you!

In 2010, 2 new codes were created for laparoscopic repair of diaphragmatic hernia ((or paraesophageal hernia));

43281 Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh

===> 43282 Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh

ICD9 Crosscodes with 553.3 Diaphragmatic hernia without mention of obstruction or gangrene

For the open repair codes, please check out my website here for more information on Paraesophageal Hiatal Hernia Repair Codes Differs from (transabdominal, thoracotomy and thoracoabdominal incision) approach. With or Without Implantation of Mesh.

Mandatory use of the new ABN (Advanced Beneficiary Notice) FORM CMS-R-131 (03/11) is by November 01, 2011.

noreply@blogger.com (Misspy) — Thu, 18 Aug 2011 11:46:00 +0000

CMS released Mandatory use of the new ABN (Advanced Beneficiary Notice) by November 01, 2011.

REVISED ABN:
FORM CMS-R-131 (03/11) (released date of 03/2011)

The revised Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories), physicians, practitioners, and suppliers in situations where Medicare payment is expected to be denied. The revised ABN replaces the ABN-G (Form CMS-R-131G), ABN-L (Form CMS-R-131L), and NEMB (Form CMS-20007). See the revised ABN manual instructions below for detailed instructions on mandatory and voluntary use of the revised ABN.

This new revised ABN FORM CMS-R-131 (03/11) will replace Form CMS-R-131L (ABN-L), Form CMS-R-131G (ABN-G) and Form CMS-20007 (NEMB). If you are a provider (medical doctors, practitioners including those for suppliers and laboratories) and if your services for Medicare beneficiaries are anticipated to be denied for reimbursement, you need the ABN form to be signed by the beneficiary. This will allow your beneficiary understand and being notified for their responsibility for such services.

Please visit the CMS site HERE for more information on the new ABN form and how to use it.

Coding and Billing for SYNVISC and/or Synvisc ONE (to treat Osteoarthritis)

noreply@blogger.com (Misspy) — Sat, 02 Jul 2011 04:46:00 +0000

Effective 2010, the old code J7322 has been deleted and changed to J7325. This code is used for Synvisc One and also for SYNVISC.

For SYNVISC - bill with 16 units on the "unit field"
For Synvisc One - bill with 48 units on the "unit field".

Remember to bill with the proper injection code 20610. If it is bilateral, your claim may look like this:

20610 - 50 (modifier) - 1 unit
J7325 - LT - 16 units
J7325 - RT - 16 units

ICD 9 Code that meets Medical Necessity:

715.16    Osteoarthritis, localized, primary, lower leg
715.36    Osteoarthritis, localized, unspecified as to primary or secondary, lower leg
715.96    Osteoarthritis, localized, unspecified whether generalized or localized, lower leg
715.26    Osteoarthritis, localized, secondary, lower leg

Make sure you have the NDC Number, I suggest to enter this NDC number on Box 19 of the HCFA 1500 Form.

SYNVSIC       58468-0090-01
Synvisc-One 58468-0090-03

references: CMS, Synvisc, HCPCS Code Books, CPT Code Books (CPT is owned by AMA)

What is Medical Billing and Coding - Modifier AI?

noreply@blogger.com (Misspy) — Mon, 27 Jun 2011 20:39:00 +0000

Let's define what this modifier is (per CMS guidelines):

Modifier “-AI,” defined as “Principal Physician of Record,” shall be used by the admitting or attending physician who oversees the patient’s care, as distinct from other physicians who may be furnishing specialty care. The principal physician of record shall append modifier “-AI” in addition to the initial visit code. All other physicians who perform an initial evaluation on this patient shall bill only the E/M code for the complexity level performed. NOTE: The primary purpose of this modifier is to identify the principal physician of record on the initial hospital and nursing home visit codes. It is not necessary to reject claims that include the “-AI” modifier on codes other than the initial hospital and nursing home visit codes (i.e., subsequent care codes or outpatient codes). Follow-up visits in the facility setting may be billed as subsequent hospital care visits and subsequent nursing facility care visits as is the current policy. In all cases, physicians shall bill the available code that most appropriately describes the level of the services provided.

What it means is that, if your physician or surgeon is the admitting provider, you have to append the Modifier AI for the E/M codes. This new guidelines was made effective as of January 1, 2010 when the Medicare Part B ceased to recognize the consult codes.

Modifier AI is applicable in the nursing facility (99304-99306) and inpatient hospital setting (99221–99223)

Because of this change, these codes may be billed several times in a day by different providers who are involved with the patient's care as for "Initial Encounter/Visit". But there will be only ONE admitting physician. This admitting physician will then append the Modifier AI to indicate as "Principal Physician of Record" or simply, the "admitting physician".

Read More on the guidelines from CMS here.