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Urology: Prevent Claim Problems by Applying New BCG Code

8. August 2019

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Urology coders who report BCG had an important code update July 1, 2019. Make sure you’ve made this important code swap and understand the new rules for accurate reporting of this bacteria-based immunotherapy. Replace J9031 With J9030 for BCG One use of Bacillus Calmette-Guérin, more commonly known as BCG, is bladder cancer treatment. The provider […]

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Smash 3 Myths to Upgrade Your Mammography Coding and Coverage Knowledge

18. July 2019

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Mammography is a common service, but radiology coders need to learn some not-so-common rules. Take your know-how to the next level by getting to the truth about these myths. Myth 1: Mammography Is for Women Only Medicare’s National Coverage Determination (NCD) for Mammograms states that “diagnostic mammography is a radiologic procedure furnished to a man […]

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Modifier 51 Hints: Your Go-To Guide for the MPFS Multiple Procedure Column

13. June 2019

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There are nine different Multiple Procedure indicators on the Medicare Physician Fee Schedule (MPFS), meaning there are a lot of payment adjustment possibilities you need to know. Here’s each indicator, an example of a code with that indicator, and a quick look at where modifier 51 comes into play. What Is Modifier 51? The basic […]

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Coding Smarts: Be a Diabetic Neuropathy Vocab Champ

5. June 2019

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Roughly 25 percent of people over 65 in the U.S. have diabetes, and about half of people with diabetes have some form of nerve damage. So there’s a good chance you’ll need to know the terms used for diabetic neuropathy ICD-10-CM codes at some point. Be ready with this quick list of medical definitions. Are […]

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Site, Timing, Trauma: 3 Top Areas to Watch for Osteoporotic Fracture

3. June 2019

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Before you report an ICD-10-CM code for a patient with osteoporosis who has broken a bone, take a moment to make sure you’ve applied these three (and a half) tips for more accurate coding. 1. Take a Break From Coding Site (Unless There’s a Break) Site is not a component of M81.- (Osteoporosis without current […]

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Modifier 25 Scavenger Hunt! Can You Find These Answers?

21. May 2019

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Keeping up with modifier 25 rules can be intimidating, so let’s add a little fun by seeing if you can unearth the answers to these questions at the locations provided. Ready, set, go! 1. Is This a Separate E/M? You may have the descriptor memorized for modifier 25 (Significant, separately identifiable evaluation and management service […]

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Clear Up Coverage Questions for Medicare’s Hepatitis B Screening

17. May 2019

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The percentage of people who have hepatitis B but don’t know it could be as high as 67 percent, and the opioid epidemic is fueling an increase in infections, according to the Department of Health and Human Services (HHS). That’s one reason screening is so important. Medicare’s coverage rules for hepatitis B screening are specific, […]

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5 Things to Know About K57.- for Diverticular Disease of Intestine

10. May 2019

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ICD-10-CM provides more than 20 codes for diverticular disease of the intestine, so you know attention to detail is the key to success! Here are five areas to watch to improve your coding accuracy. 1. Eat Your Wheaties Before You Tackle Documentation ICD-10-CM includes a lot of codes for diverticular disease under K57.-, so you’ve […]

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Bulk Up Your Global Surgical Package Knowledge for Cleaner Claims

6. May 2019

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Let’s take Medicare’s list of services included in global surgery payment up a notch. If you remember each added tip below, you’ll be more likely to avoid reporting both too many and too few codes. Read This Booklet to Dive Deeper The source of the straight-from-Medicare bullet points quoted below is Medicare’s Global Surgery Booklet. […]

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Medicare Helper: Don’t Let DOS Be the Downfall for Your Claims

2. May 2019

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Determining date of service (DOS) can be harder than it seems. Once you dive into the world of professional/technical components, monitoring services, and other non-obvious DOS possibilities, things get complicated fast. You can use the Medicare rules below as a starting point. Apply Different Dates for Radiology Components For many radiology codes, the Medicare Physician […]

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