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Make the CCI Manual Your Go-To Guide for Shoulder Arthroscopy With Debridement

21. March 2019

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Before you code debridement with shoulder arthroscopy, make sure you know what the Medicare Correct Coding Initiative (CCI) manual has to say. You’ll find the highlights here to help you get started. Where to look: You’ll find these instructions in chapter IV, section E, of the Medicare CCI manual. Same Shoulder? Stick to the Basic […]

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3 Can’t-Miss Reasons to Read the Radiology CPT® Coding Guidelines

15. March 2019

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Supervision and interpretation, contrast, and images — these are all terms you need to know for radiology CPT® coding. The 70000 Radiology section guidelines are a good place to start for authoritative information. Helpful: If you use a paper CPT® manual, you are likely to find the Radiology section guidelines directly preceding the first 70000 […]

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Here’s Why the MPFS Should Be at the Top of Your Modifier Checklist

25. February 2019

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When you think of the Medicare Physician Fee Schedule (MPFS), fees might be the first word that comes to mind. But modifiers should be a close second. Here’s how you can use the MPFS to improve your modifier accuracy for Medicare claims. Start here: To read about the MPFS bilateral indicator and modifier 50, read […]

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ICD-10-CM: Don’t Give Up Too Soon When Coding Flank Pain

18. February 2019

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Flank pain is a complaint a lot of general practices and specialties see. Here are some pointers on how to code correctly for this common condition. Find Flank Under Abdominal in the Index The flank is the side area of the torso below the ribs. To code for flank pain, start by looking at the […]

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Do You Know About Medicare Add-On Code Edits? You Should!

11. February 2019

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Pairing an add-on code with an appropriate primary code is a key factor in bringing in that extra add-on reimbursement. The CPT® manual often provides a listing of appropriate primary codes for an add-on code, but not always. In those cases, you may find answers in Medicare’s Add-On Code Edits, our topic for today. Know […]

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Bring in Correct Bilateral Procedure Pay With These Pro Pointers

7. February 2019

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Choosing medical codes and modifiers for bilateral services can be confusing. Here are a few questions you can ask to help ensure accurate coding and reimbursement for physician claims. Does the Code Descriptor Specify Bilateral? “Bilateral surgeries are procedures performed on both sides of the body during the same operative session or on the same […]

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Say Cheese! Medicare Is Paying for Photo and Video Evals in 2019

17. January 2019

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If a picture is worth 1,000 words, how much is evaluating a picture worth? Medicare has taken a stance on that. As of Jan. 1, 2019, Medicare is paying for remote evaluation of pre-recorded patient videos and images reported using G2010. Here’s what we know from the Medicare Physician Fee Schedule Final Rule. Compare Our […]

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Take the Mystery Out of the MPFS Conversion Factor and Calculations

14. January 2019

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In the 2019 Medicare Physician Fee Schedule (MPFS), the conversion factor is 36.0391 compared to 35.9996 in 2018. But that sort of information helps only if you know what a conversion factor is and what to do with it. Here’s a primer you can turn to when you need to brush up on your MPFS […]

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HCPCS 2019: Get to Know New Code G2012 for Virtual Check-In

17. December 2018

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Payment for non-face-to-face communication with patients isn’t the most clear-cut topic. But with new 2019 HCPCS code G2012, you’ve got an intriguing option for virtual check-ins with Medicare patients. Ready to learn more? Dig In to the Long Descriptor for G2012 The first place to learn about the code is the long code descriptor: G2012 […]

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Obstetrics: Take the Confusion Out of Pre-Existing Hypertension ICD-10-CM Coding

13. December 2018

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Hypertension is a common diagnosis, so a lot of specialties have to understand the rules for coding this condition. Obstetrics coders have to go one step further for hypertension and learn the specific rules for coding pre-existing hypertension in pregnancy, which is our focus today. Watch for Documentation of Pre-Existing or Gestational You’ll find the […]

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