Medical Coding and Billing Articles (by Find-A-Code and Friends)

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CPT 10-Year Historical Content - Now Available!


Did You Know? We now offer Historical CPT Content in 2-year, 5-year, or 10-year options! Utilize access to specific CPT historical data for previous years using rules effective at that specific time. If you’ve added UCR fees to your account, you can use Historical CPT Content to view UCR fees from ...

tags  Topic: Auditing    Topic: CPT Coding   

Inadequate Exclusion Screenings Could Put Your Practice at Risk


Exclusion screenings require far more than just checking a name on a federal database at the time you are hiring someone. Far too many providers don’t realize that in order to meet compliance requirements, there is MUCH more involved. There are actually over 40 exclusion screening databases/lists that need to be checked.

tags  Specl: All Specialties    Specl: Chiropractic    Topic: Compliance   

Q/A: How do we Bill Massage Services?


Question: We are adding a massage therapist soon and have some questions about billing their services.

tags  Topic: CPT Coding    Topic: Procedure Coding   

Billing for Telemedicine in Chiropractic


Many large private payers recognize the potential cost savings and improved health outcomes that telemedicine can help achieve, therefore they are often willing to cover it. While there are several considerations, there could be certain circumstances where telemedicine might apply to chiropractic care.

tags  Specl: Chiropractic    Topic: CPT Coding    Topic: E+M Documentation and Coding    Topic: Modifier Coding    Topic: Procedure Coding    Topic: TeleMedicine   

Q/A: Can Chiropractors Bill 99211?


Can chiropractic offices bill code 99211? Technically it can be used by chiropractors, but in most instances, it is discouraged. Considering that 99211 is a low complexity examination for an established patient, this code is not really made for the physician to use. In fact, in 2021, changes are coming for this code...

tags  Specl: Chiropractic    Topic: CPT Coding    Topic: E+M Documentation and Coding   

Non-Surgical Periodontal Treatment


AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.SCALING AND ROOT PLANINGScaling ...

tags  Specl: Dental    Specl: Oral and Maxillofacial Surgery   

Who Knew? There are Three Types of Add-On Codes


Using add-on codes with HCPCS/CPT is not as simple as 123! Although there are three different groups of add-on codes assigned by CMS, these are used to identify code edits. It is easy to see the add-on code with some codes; we can see the instructional notes and phrases such ...

tags  Topic: Claims Processing    Topic: Coding    Topic: CPT Coding    Topic: Procedure Coding   

Denials due to MUE Usage - This May be Why!


CMS assigns Medically Unlikely Edits (MUE's) for HCPCS/CPT codes, although not every code has an MUE. MUE edits are used to limit tests and treatments provided to a Medicare patient for a single date of service or for a single line item on a claim form. It is important to understand MUE's are ...

tags  Payer: CMS|Medicare    Specl: All Specialties    Topic: Appeals    Topic: Auditing    Topic: Coding    Topic: Denial Management    Topic: Modifier Coding    Topic: MUE - Medical Unlikely Edit   

CMS Report on QPP Shows Increasing Involvement


MIPS 2018 participation increased according to the final report issued by CMS on January 6, 2020.

tags  Payer: CMS|Medicare    Topic: Quality Payment Program   

CPT 2020 Changes to Psychiatry Services


As of January 1, 2020, CPT made changes to the health and behavior assessment and intervention codes (96150-96155) and therapeutic interventions that focus on cognitive function (97127). If you code and audit services in this category, you must pay close attention to the changes as they include the removal and ...

tags  Specl: Behavioral Health|Psychiatry|Psychology    Topic: CPT Coding   

Medicare Changes Bilateral Reporting Rules for Certain Supplies


DME suppliers must bill bilateral supplies with modifiers RT and LT on separate claim lines or they are being rejected.

tags  Specl: All Specialties    Topic: HCPCS Coding    Topic: ICD10CM Coding    Topic: Modifier Coding    Topic: Supply Coding   

Time Is Up! Jan 1 2020 Claims Will be Denied Without MBIs


New Medicare Card Transition Ends Next Week: Claim Reject Codes Beginning January 1 If you want to get paid you should be reporting MBIs on all of your Medicare claims. The deadline is here: if you are not using Medicare Beneficiary Identifiers (MBIs) on claims (with a few exceptions) after January 1, ...

tags  Payer: CMS|Medicare    Topic: Billing   

What to look for when auditing moderate sedation codes 99151-99153


What to look for when auditing moderate sedation codes 99151-99153 Physicians performing diagnostic and therapeutic procedures can now separately bill for the provision of moderate sedation services, but there are some interesting wrinkles to be looking for when auditing these services. Starting in 2017, moderate sedation codes 99151-99157 were created to address ...

tags  Topic: CPT Coding   

CMS- Patient Driven Payment Model Effective October 01, 2019


According to CMS, In July 2018, CMS finalized a new case-mix classification model, the Patient-Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. Using the new Patient-Driven ...

tags  Payer: CMS|Medicare    Specl: Skilled Nursing    Topic: Payment Models   

Reporting the Health Effects of Vaping Now and in April 2020


To report vaping related conditions/disorders, use the official CDC guidelines to ensure proper documentation of vaping related health conditions. There is also a new code that will become effective April 1, 2020.

tags  Specl: Allergy|Immunology    Specl: Cardiology|Vascular    Specl: Emergency Medicine    Specl: Home Health|Hospice    Specl: Internal Medicine    Specl: Interventional Radiology    Specl: Oncology|Hematology    Specl: Primary Care|Family Care    Specl: Pulmonology    Topic: Code Updates    Topic: ICD10CM Coding    Topic: Substance Use Disorder   

What did I do today?


What did I do today?   Whether you are auditing inpatient or outpatient documentation, chances are you have come across a situation where the encounters repeat the same story, sometimes day to day, sometimes on every 3-month visit. When EHRs were implemented en masse, a key selling point of almost all of ...

tags  Topic: Auditing    Topic: EHR   

Packaging and Units for Billing Drugs


To determine the dosage, size, doses per package and how many billing units are in each package, refer to the NDC number. Take a look at the following J1071 - Injection, testosterone cypionate, 1mg For example; using NCD # 0009-0085-10 there are 10 doses of 100 mL (100 mg/mL = 1 mL and there are ...

tags  Topic: Auditing    Topic: Billing    Topic: Coding    Topic: HCPCS Coding    Topic: Pharmaceutical   

Coding Auto Accident Injuries


There are several different ICD-10-CM code sections that can be used when coding for auto accident injuries. Injury diagnosis codes in ICD-10-CM are found with leading alpha characters S and T. S codes are injuries related to a single body region. T codes are injuries to multiple or unspecified body regions, poisoning, ...

tags  Topic: ICD10CM Coding   

Look What is New for 2020!


Wait a minute... we are not waiting for 2020, this is too exciting! Same great tools and features, this is just a new look for us! We think you will love it! To start using the new view, simply login to your account and go to My Account. At the bottom of your ...


American Dental Association (ADA) and Delta Dental Plans Association (DDPA) Class Action Lawsuit


The American Dental Association and two individual dentists filed a class-action lawsuit Nov. 26 against the Delta Dental Plans Association, its affiliated national entities, and 39 independent Delta Dental companies, alleging the provider network has engaged in anticompetitive conduct and violated federal antitrust laws. The complaint alleges Delta Dental allocated territories ...

tags  Specl: Dental    Specl: Oral and Maxillofacial Surgery   

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Articles: ICD-10

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