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These 3 Simple Tips will Make IVR Coding Effortless

17. November 2014

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Correct documentation is the key to resolve aortography challenges When radiological supervision is performed for cardiac catheterization and angiography, each step performs during the procedure must be specifically documented. Read the documentation very carefully to see whether, the physician performed a left heart catheterization (LHC), i.e. LVEDP (left ventricular end diastolic pressures), left ventricle (LV) […]

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Stop Using Modifiers ZA, ZC with Anesthesia Services!

14. November 2014

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Question: I am using modifier ZC with anesthesia services but I’m getting claim denials. What could be the reason for this? Answer: Modifiers ZA, ZC are anesthesia modifiers used for medical insurance before March 1, 2011.  These modifiers along with 14 other modifiers, used by Medical insurance in California, were deleted in 2011.  You need […]

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Two Major Payers Change Modifier 25 Policies

11. November 2014

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One of the Country’s Major Payers will now need a new diagnosis for E/M payment. Modifier 25 (significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) is used very frequently to justify a separate payment for E/M […]

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Correct Use P Modifiers

31. October 2014

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P modifier distinguishes between the different levels of complexity of anesthesia service. Physical status modifiers, also referred to as P modifiers, are unique to anesthesia coding.  Even though not every payer will add to your reimbursement for these modifiers, they are good for tracking purposes and help explain why anesthesia providers might spend longer on […]

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Coding for Lisfranc Injury Repair gets Easier

29. October 2014

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Does your Medicare carrier require modifier 76 instead of 59? Lisfranc fracture-dislocations are multiple fractures and/or dislocations of the Lisfranc joints — the tarsometatarsal joints of the foot. The injuries usually occur at the base of the metatarsal. There are different CPT codes for repair of Lisfranc fracture-dislocation depending on whether the surgery was performed […]

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How to Use Modifier 27 Correctly

21. October 2014

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For Medicare, your MAC will not reimburse if you do not pair Modifier 27 with condition code G0. Using modifiers is often a judgment that you, as a coder, will have to make as you review the details of each case. There may be instances when Modifier 27 may apply to some of your E/M […]

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Get Answers to These Burning Medicare Questions!

6. March 2014

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Medicare guidelines are ever-changing and it’s difficult to interpret because we often hear advice from different sources. Here’re two burning questions along with advice straight from the source. Examine 3-Year Rule Question: Our claim was denied with the error note – “This patient was seen by your group within the last three years” however this […]

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What Obamacare Means to Your Pediatric Practice

24. January 2014

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Now that the Affordable Care Act (ACA) or ObamaCare became effective on January 1, 2014, if you still have questions about what the act means to your day-to-day pediatric operation, read on to get top three facts that will help you see the law’s impact on your daily practice. More Medicaid Patients Patients who cannot […]

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What are HCPCS codes?

5. December 2013

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Coding professionals are also required to use HCPCS (Healthcare Common Procedure Coding System) Codes to describe any service that a medical practitioner may provide to a Medicare patient. These codes are constantly monitored by the Centers for Medicare and Medicaid Services (CMS). The HCPCS is divided into two subsystems, known as level I and level […]

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Confirm the Purpose of Fiducial Markers

26. July 2012

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Question: Our neurosurgeon did laminectomy for thoracic metastasis and removed epidural tumor. He then placed six fiducialmarkers. Is there a code that we can report for our neurosurgeon placing the fiducial markers? Answer: Your question did not describe the purpose of placing the fiducial markes. The placement of fiducials may be part ofanother procedure and […]

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