Help: FAQs, tutorials, videos, page index and more
> Home > Info
Viewing:  Nov 18, 2018

Medical Coding and Billing Articles

Recent articles:

Click on the title to see the article summary and a link to the full article.

Diagnosis Coding for Cardiology

|

Diseases of the Circulatory system are found in Chapter 9 and reported with I00 through I99 according to the following sections: Acute rheumatic fever (I00-I02)Chronic rheumatic heart diseases (I05-I09)Hypertensive diseases (I10-I16)Ischemic heart diseases (I20-I25)Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)Other forms of heart disease (I30-I52)Cerebrovascular diseases (I60-I69)Diseases of arteries, ...

Tags:  Specl: Cardiology|Vascular    Topic: ICD10CM Coding   

Read the article →

Muscle Testing and Range of Motion Information

|

Be sure to understand the unique code requirements for Muscle and Range of Motion Testing.

Tags:  Specl: Chiropractic    Specl: Physical Medicine|Physical Therapy    Topic: CPT Coding    Topic: Modifier Coding    Topic: Procedure Coding   

Read the article →

Are you Ready for CMS' 2019 Medicare Physician Fee Schedule Final Rule?

|

The waiting is over, the Final Rule for CMS' 2019 Medicare Physician Fee Schedule (MPFS) is available - all 2,379 pages for those looking for a little light reading. As anticipated, there are some pretty significant changes. Most of us were carefully watching the proposed changes to the Evaluation and ...

Tags:  Topic: E+M Documentation and Coding    Topic: Fees    Topic: HCPCS Coding    Topic: Medicare    Topic: Quality Payment Program    Topic: Reimbursement    Topic: TeleMedicine   

Read the article →

Medi-Cal Coverage Criteria for Hospital Beds and Accessories

|

Medi-Cal coverage of child and adult hospital beds and accessaries. What is covered and what documentation is required.

Tags:  Loc: California    Payer: AMC|Medicaid    Topic: DME    Topic: Documentation    Topic: HCPCS Coding    Topic: Supply Coding   

Read the article →

CMS: Medicare Diabetes Prevention Program Expanded Model

|

CMS announces the Medicare Diabetes prevention program is now a new covered service. Per a recent MLN news release. Medicare Beneficiaries will be notified in 2019 in a Medicare handout. Diabetes affects more than 25 percent of Americans aged 65 or older, and its prevalence is projected to increase approximately...

Tags:  Payer: CMS|Medicare    Topic: Preventive Medicine   

Read the article →

How to Use Modifier Indicators with NCCI Edits (2018-10-31)

|

To verify if clinical circumstances might justify the use of a modifier when billing code pairs, look at the NCCI edits and the modifier indicator.  Medicare may have restrictions on the use of a modifier used to bypass an edit.  This important part of coding can alert a payer or ...

Tags:  Topic: Coding   

Read the article →

Anesthesia and Pain Management

|

Anesthesia and Pain management is under close watch from the OIG according to a report from Anesthesia Business consultants, they stated, "The Health and Human Services Office of Inspector General (HHS OIG) reports in its most recent Semi-annual Report to Congress that in FY 2017 it brought criminal actions against 881 individuals or organizations ...

Tags:  Specl: Anesthesia|Pain Management   

Read the article →

Documentation Requirements for Allergy Testing 10/29/2018

|

Per CMS, First Coast Service Options LCD 33261: Medical record documentation (e.g., history & physical, office/progress notes, procedure report, test results) must include the following information, and be available upon request: A complete medical and immunologic history and appropriate physical exam obtained by face-to-face contact with the patient. The medical necessity for performing ...

Tags:  Specl: Allergy|Immunology    Topic: CPT Coding    Topic: ICD9 Coding   

Read the article →

Common Allergy CPT Codes and MUEs

|

Below is a list of common CPT codes for Allergy and Immunology. Each code is listed with the following information: Medicare Unlikely Edits (MUEs) for both a Non-Facility (NF) and Facility (F) setting. Professional/Technical Component (PC/TC) Indicator. Key Indicator or Procedure Code Status Indicator, which is a Medicare assigned "Indicator" to each code in ...

Tags:  Specl: Allergy|Immunology    Topic: CPT Coding   

Read the article →

Allergy Testing 10/29/2018

|

Allergy testing may be performed due to exaggerated sensitivity or hypersensitivity.  Using findings based on the patient’s complaint and face-to-face exam. Testing may be required to identify and determine a patient's immunologic sensitivity or reaction to certain allergens using certain CPT codes.  According to CMS, LCD 33261, allergy testing can be ...

Tags:  Specl: Allergy|Immunology    Topic: CPT Coding   

Read the article →

We've Always Done It This Way and Other Challenges in Education

|

As coders, auditors, and compliance professionals, we are the provider's advocates in closing the gap between what is medically necessary and what is required for documentation. Sometimes that places us in the role where we need to save our clinicians from themselves, and the patterns they have fallen into...

Tags:  Topic: Auditing    Topic: Documentation    Topic: Practice Management   

Read the article →

Wolters Kluwer Drug Pricing

|

Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average...

Tags: 

Read the article →

Pelvic Floor Dysfunction Treatment Coverage

|

Pelvic floor dysfunction is often the underlying cause of conditions such as pelvic pain; urinary or bowel dysfunction; and/or sexual symptoms. Treatment generally begins with an evaluation and testing (e.g, EMG) followed by a variety of services (e.g., biofeedback, manipulation, pelvic floor electrical stimulation), depending on the findings. Coverage by payers ...

Tags:  Specl: Physical Medicine|Physical Therapy    Topic: CPT Coding    Topic: HCPCS Coding    Topic: ICD10CM Coding    Topic: Procedure Coding    Topic: Supply Coding   

Read the article →

Q/A: What Diagnosis Codes Should I Use for TMJ Headache Massage for Coverage?

|

Question: We have been receiving several DDS referrals to our massage therapists who do intra-oral work. The only problem is that the referral from the DDS lists code R51 for headaches as the only DX code. Since most plans don't cover massage therapy for headaches alone, are there any codes that can distinguish the headaches as ...

Tags:  Specl: Chiropractic    Specl: Physical Medicine|Physical Therapy    Topic: ICD10CM Coding   

Read the article →

Q/A: What Codes do I use for CLIA-Waived Tests?

|

Question: I am a certified DOT medical examiner and have applied to get my CLIA lab (waiver) for urinalysis, finger prick blood tests for A1c, cholesterol and glucose. I realize I cannot diagnose patients with these tests, but I am using them to make decisions in the DOT process and with ...

Tags:  Specl: All Specialties    Specl: Chiropractic    Topic: CPT Coding   

Read the article →

Type of Bill Codes

|

Type of bill codes identifies the type of bill being submitted to a payer. Type of bill codes are four-digit alphanumeric codes that specify different pieces of information on claim form UB-04 or form CMS-1450 and is reported in box 4 on line 1. First Digit = Leading zero. Ignored by CMSSecond ...

Tags:  Payer: CMS|Medicare    Topic: Billing   

Read the article →

Prolonged Services Its Not Just About Time

|

Time, as it applies to E/M codes, has often been viewed as an "if/then" proposition. "If" the documentation shows that a majority of the encounter was based on counseling and/or coordination of care, "then" we choose the highest level of service based on the total time of the encounter. However, a ...

Tags:  Topic: Auditing    Topic: CPT Coding    Topic: E+M Documentation and Coding   

Read the article →

Use My Code Set to Save Priced Procedures

|

Use My Code Set to save priced procedures to refer to commonly used procedures. Once your CCI edits are done and you have your list of Codes, add notes to My Codes. Add all important information to the Code, for viewing again instead of re-working your most commonly used procedures....

Tags:  Topic: Modifier Coding   

Read the article →

Tools and Resources for Life Care Planners

|

Life Care Planners play a vital and underappreciated including understanding the progression of a disease and lifetime clinical treatment options, research, delete (I combined this into the paragraph above) compiled into one easy-to-use resource. a unified providing a single destination for procedure coding coding to find information on...

Tags:  Topic: CPT Coding   

Read the article →

HCC - Acceptable Provider Interpretation for Diagnostic Testing

|

The following table is taken from the Contract-Level Risk Adjustment Data Validation Medical Record Reviewer Guidance dated 2017-09-27 (see References). It is a listing of acceptable provider interpretation of diagnostic testing. Acceptable Examples include: Cardiology and Vascular Surgeons Echocardiogram (including Doppler, Duplex, Color flow of the heart vessels) EKG (electrocardiogram) – Stress test, Cardiac ...

Tags:  Topic: Risk Adjustment   

Read the article →

Articles by Subject: 

Articles by Specialty: 

Articles by Payer: 

Articles by Location: 


Articles by Month

Select year and month:     



If you would like a specific article written on a medical coding and billing topic, please contact us.

Our contact information:

Find A Code, LLC
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Fax: 801-770-4428
Email:

Past Articles

Many of the following articles have been tagged with the tags shown above. These are displayed here again for historical purposes.

The following articles are published here and elsewhere on the Internet. If you would like to publish one of these articles on your website, please contact us and let us know which article you would like to publish and where you will be publishing it.

Articles: ICD-10

Articles: Medical Coding

Articles: Medical Billing

Articles: Medical Billing and Coding (General)


Free 28 Day Trial
No Credit Card Required
Pricing
Starting at $4.95/month
Sign In
Welcome back!