SuperCoder Blog

The CPT® 2019 code set is adding to your options for remote services. Here’s a rundown of the changes you can expect for certain remote monitoring services as well as EHR consultative time.

Turn to 9945X for Remote Physiologic Monitoring

The new code set will add codes for remote physiologic monitoring (like weight, BP, pulse oximetry):

• Use 99453 for set-up and educating the patient
• Use 99454 to represent each 30 days of device supply with recordings or alerts
• Use 99457 for 20 minutes or more per month spent by the provider or clinical staff on treatment management, including communication with the patient or caregiver.

Tip: …

ICD-10-CM has a lot of codes (more than 150!) for pressure ulcers, and that means your clinicians’ documentation game has got to be on point for your to get the most accurate code for the case. These three steps should help you get the job done.

1. Know Where to Look for Pressure Ulcer Stage Documentation

For pressure ulcers, a nurse is often the one who documents stage. So it’s good news you can base code assignment for pressure ulcer stage on medical record documentation by someone other than the “physician or other qualified healthcare practitioner legally accountable for establishing …

Let’s put data to work to help prevent denials! CGS is one of the Medicare contractors that provides information on top claim denial reasons, and here we’ll take a look at some denial triggers from August 2018 and how you can prevent them.

Check Status Before Reporting Duplicate Service

Reporting the exact same service more than once leads to a duplicate service denial. For August 2018, CGS indicates there were more than 120,000 duplicate service denials for Part B in Kentucky and Ohio.

So how can you avoid this common problem? Here’s what CGS suggests:

• Don’t resubmit a claim until you’…
  

For claims to succeed, you can’t use deleted CPT® codes. There’s no getting around it. So give your claims their best chance in 2019 by making sure these deleted codes don’t land on your claims.

And of course: You need to know the new codes (see blog post overviews Part 1, Part 2, Part 3) and revisions. Some of the deletions are covered there, as well, but it doesn’t hurt to discuss the changes from multiple angles. The codes below …

Because of Hurricane Florence, CMS issued several waivers in North Carolina, South Carolina, and Virginia to help with access to healthcare. Even if you’re not in an affected area, this should be a reminder that disaster prep isn’t just about working in theory. You need to understand it well enough to apply it. Below you’ll find some questions based on the Medicare resources available. You can see if you need to study to ensure you know the rules when an emergency strikes.

It’s ICD-10-CM 2019-eve! A big chunk of the changes effective Oct. 1, 2018, make coding for many eyelid diagnoses more specific, requiring you to specify not only the eye but also the eyelid involved. To be sure you’re ready, here’s one last crash course in eyelid ICD-10-CM coding for 2019. (more…)

Looking for help with delivering up-to-date medical coding data to your healthcare organization? Now is a great time to check out TCI SuperCoder’s Data Files for 2019. While you’re exploring our affordale CPT®, HCPCS, and ICD-10-CM options, don’t miss our files for NCCI, LCDs, and MPFS, too. And that’s just the start.

Contact our data file specialist Abbey at 239-280-4236 or abbeyp@codinginstitute.com to learn more about our ready-to-go files and customization options from the quality-focused experts at TCI.

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If telehealth is on your radar, you’ll want to watch the Medicare Physician Fee Schedule for 2019. The MPFS 2019 proposed rule discusses potential changes to Medicare telehealth services, specifically the addition of G0513 and G0514 to the Medicare telehealth list. Get a closer look at these codes so you’ll better understand them and the criteria for getting on to Medicare’s telehealth services list.

Tip: If you want more information on what’s in the MPFS proposed rule, check out our blog on potential E/M payment changes.

You learned about CPT® 2019 additions in our overview series with Part 1, Part 2, and Part 3. But what about revisions? We covered some of those in relation to additions, but here are some more updates that may affect you when the changes are effective Jan. 1, 2019. (These are highlights, not a complete list, so be sure you use the updated AMA CPT® code set and guidelines for 2019 dates of service!)

Swap Out ‘Family’ for ‘Territory’ for +61641, +61642

The descriptors for +61641 …

Subsequent hospital care E/M codes 99231-99233 have some oddities that can trip you up if you don’t use these codes often (and even if you do). Improve your E/M coding accuracy by keeping these three pointers in mind.

1. Look for 2 of 3 With Interval History Option

The descriptors for 99231, 99232, and 99233 all specify that the code requires you to meet two of three key components required. The key components are interval history, examination, and medical decision making, with levels required varying by code.

Did you catch the “interval” terminology in “interval …