"Acupuncture|Alternative" & "Transition to ICD10" Articles

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February 3rd, 2021

How To Properly Report Prolonged Services Using 99417 or G2212

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published February 3rd, 2021

Prolonged Evaluation & Management codes underwent big changes in 2021, including the creation of a new prolonged code (99417), reportable only with codes 99205 or 99215. While Medicare has agreed to accept the AMA's CPT E/M coding changes, they have formulated an opinion contrary to how CPT calculates time specific ...

April 16th, 2020

Hypertension ICD-10-CM Coding Table, Guidelines, and Tips

By Wyn Staheli, Director of Research & Aimee Wilcox, Director of Content | Published April 16th, 2020

Coding hypertension properly requires knowing all the guidelines. This article summarizes how hypertension is coded using ICD-10-CM and includes tips, definitions and a very helpful coding table summarizing your options.

March 26th, 2020

New Biofeedback Codes to replace 90911 Eff 2020-01-01

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published March 26th, 2020

CMS announced 90912 and 90913 are to be used starting January 2020 in place of 90911. According to CMS MLN, these new codes, designated as “sometimes therapy”, are reported to furnish these services outside a therapy plan of care when appropriate. Codes are permitted to be used by physicians and Non-Physician Practitioners (NPPs), ...

February 19th, 2020

Medicare Begins Covering Acupuncture Services

By Wyn Staheli, Director of Research | Published February 19th, 2020

Medicare is changing their policy regarding coverage of acupuncture, but in order to provide these services, you must follow their rules.

January 30th, 2020

Medicare Announces Coverage of Acupuncture Services

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published January 30th, 2020

On January 21, 2020, a CMS Newsroom press-release read, This new announcement is both exciting and refreshing. Acupuncture, a key component of traditional Chinese medicine and most commonly used to treat pain, is now being officially recognized by Medicare and several other large payers as a covered, alternative treatment option for ...

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October 1st, 2019

Federal Workers Compensation Information

By Wyn Staheli, Director of Research | Published October 1st, 2019

When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program. Division of Federal Employees' Compensation (DFEC) website Division of Federal Employees' Compensation (DFEC) provider ...

September 30th, 2019

New Codes for Dry Needling

By Wyn Staheli, Director of Research | Published September 30th, 2019

Find out what you need to know about the new codes for dry needling, also known as trigger point acupuncture.

August 16th, 2019

Medical ID Theft

By Namas | Published August 16th, 2019 - Last Review/Update August 20th, 2019

Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...

August 9th, 2019

The OIG Work Plan: What Is It and Why Should I Care?

By Namas | Published August 9th, 2019 - Last Review/Update August 14th, 2019

The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...

July 17th, 2019

Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain

By Wyn Staheli, Director of Research | Published July 17th, 2019

Now is the time to comment on a proposal to cover acupuncture for chronic low back pain. This comment period is the part of the HHS response to the opioid crisis. You only have until August 14th to officially comment.

July 12th, 2019

5 Ways to Minimize HIPAA Liabilities

By BC Advantage | Published July 12th, 2019 - Last Review/Update July 30th, 2019

Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...

October 17th, 2018

Wolters Kluwer Drug Pricing

By Find-A-Code | Published October 17th, 2018

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...

October 8th, 2015

DRIP Line ICD-10-CM Did you know... ICD-10-CM/PCS consists of two parts

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 8th, 2015 - Last Review/Update August 9th, 2017

ICD-10-CM – The diagnosis classification system developed by the Centers for Disease Control and Prevention for use in all United States health care treatment settings. Diagnosis coding under this system uses 3–7 alpha and numeric digits and full code titles, but the format is very much the same as ICD-9-CM; ...

August 19th, 2015

Cervical diagnosis Using ICD-10 - July 2013

By | Published August 19th, 2015 - Last Review/Update January 27th, 2017

By Dr. Evan Gwilliam Using a Medicare Local Coverage Determination (LCD), and the General Equivalence Mappings (GEMs) as a starting point, I will attempt in this article to predict which ICD-10-CM codes will be approved for the secondary cervical diagnoses which Medicare uses now. (By the way, I just use the ...

August 10th, 2015

ICD-10 and Dental

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 10th, 2015

Changes are on the horizon for Dentists new diagnosis codes will be changing October 1, 2015. Payers are changing to ICD-10 which will make a great impact on the dental community mainly oral surgeons, dentists who treat temporomandibular disorders, sleep apnea , oral pathologists, facial pain, oral radiologists, pediatric specialists who treat ...

August 10th, 2015

Can Chiropractors Finally Code a "Subluxation" in ICD-10?

By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017

There is a word that has long been held as sacred to the Chiropractic profession. It is the so-called vertebral “subluxation.” Throughout ICD-9, which is the diagnostic code set used on claims for the last thirty years, the term “subluxation” is used to describe a partial dislocation,” which is not how it is defined by many Chiropractors. Medicare ...

August 10th, 2015

ICD-10 External Cause Codes Tell the Whole Story

By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017

Beginning October 1, 2015 all claims for health care services in the United States must use ICD‑10 diagnosis codes. ICD‑9 has been the standard since 1979, but has outlived its usefulness. Because of its structure, ICD‑10 provides better data for research and statistical analysis than ICD‑9. Although there is no national mandate to report ...

August 3rd, 2015

Project Management Skills for ICD-10 Transitation

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 3rd, 2015

Let’s put those to work, the transition from ICD-9 to 10 is a bit more than just code changes to say the least. With all the moving parts you need to focus on more than just learning a new code set. There are several aspects of the transition you need to ...

July 6th, 2015

“If you fail to plan, you are planning to fail!”

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published July 6th, 2015

June 17th, 2015

ICD-10 PCS - Coding System

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published June 17th, 2015

ICD-10-PCS has a seven character alphanumeric code structure. Each character contains up to 34 possible values. Each value represents a specific option for the general character definition (e.g., stomach is one of the values for the body part character). The ten digits 0-9 and the 24 letters A-H,J-N and P-Z ...

May 6th, 2015

ICD-10-CM Abbreviations: NEC, NOS

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published May 6th, 2015 - Last Review/Update August 8th, 2017

The difference between NEC and NOS is very specific and not to be confused as they are two very different abbreviations. NEC - When a specific code is not available for a condition, the Index directs the coder to the “other specified” code in the Tabular List. NEC is used to indicate the ...

February 26th, 2015

CMS: 81 percent of Initial ICD-10 Test Claims Accepted

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 26th, 2015 - Last Review/Update March 2nd, 2016

Of nearly 15,000 test claims received by the Centers for Medicare & Medicaid for the first round of end-to-end ICD-10 testing, 81 percent were accepted, according to statistics revealed by the agency Wednesday. To read the entire article visit FierceHealthIT ...

February 23rd, 2015

What is the difference between ICD-9-CM and ICD-10-CM

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 23rd, 2015

ICD-10-CM uses 3–7 alpha and numeric digits and full code titles, but the format is very much the same as ICD-9-CM (for example, ICD-10-CM has the same hierarchical structure as ICD-9-CM). The 7th character in ICD-10-CM is used in several chapters (for example, the Obstetrics, Injury, Musculoskeletal, and External Cause chapters). ...

February 15th, 2015

New Feature in ICD-10-CM: Combination Codes

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 15th, 2015 - Last Review/Update February 16th, 2016

There are several new features in ICD-10-CM. Watch for these new features such as: Combination Codes Combination Codes For Certain Conditions and Common Associated Symptoms and Manifestations Examples: •K57.21 – Diverticulitis of large intestine with perforation and abscess with bleeding; •E11.341 – Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema; and •I25.110 ...

December 18th, 2014

Coding for ICD-10-CM: More of the Basics MLN Connectsâ„¢ Video

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 18th, 2014 - Last Review/Update March 1st, 2016

In this MLN Connects™ video on Coding for ICD-10-CM: More of the Basics, Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) provide a basic introduction to ICD-10-CM coding. The objective of this video is to enhance viewers’ understanding of ...

November 21st, 2014

Coding for Laser Therapy

By | Published November 21st, 2014 - Last Review/Update January 30th, 2017

The Rule of Coding: Service Codes define "what" you do; diagnosis codes define "why" you're doing it. Billing for laser or any other service must be properly defined and supported by both a service code and a diagnoses code. Coverage for laser, as with any other service, is strictly dependent upon the ...

November 21st, 2014

Understanding TOS Discounts and DMPOs

By | Published November 21st, 2014 - Last Review/Update January 30th, 2017

Time-of-Service (TOS) discounts are a common occurrence in chiropractic. What is often assumed is that if insurance isn't involved, there are no rules that apply. Unfortunately, this is a myth that can become costly to practices and damage provider/patient relationships. So read on to learn the facts about TOS discounting and ...

November 10th, 2014

Drip Line Tip: External Cause and Unspecified codes in ICD-10

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published November 10th, 2014 - Last Review/Update August 9th, 2017

Similar to ICD-9-CM, there is no national requirement for mandatory ICD-10-CM external cause code reporting. Unless you are subject to a State-based external cause code reporting mandate or these codes are required by a particular payer, you are not required to report ICD-10-CM codes found in Chapter 20, External Causes ...

October 17th, 2014

Acupuncture ICD-10 Common Codes

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 17th, 2014 - Last Review/Update January 30th, 2017

The following is a short list of some other handy ICD-10 codes: M76.50 Patellar tendinitis, unspecified kneeM76.51 Patellar tendinitis, right kneeM76.52 Patellar tendinitis, left kneeM05.33 Rheumatoid arthritisM15.9Polyosteoarthritis, unspecified (generalized osteoarthritis NOS)M16.10 Unilateral primary osteoarthritis, unspecified hipM54.40 Lumbago with sciatica, unspecified sideM54.41 Lumbago with sciatica, right sideM54.42 Lumbago with sciatica, left sideM54.6 Pain in the thoracic spineM54.9Dorsalgia, unspecified (backache NOS, back ...

October 16th, 2014

Acupuncture ICD-10-CM Billing

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 16th, 2014 - Last Review/Update January 30th, 2017

If all the criteria are met, pain codes for the most part will be reimbursed by insurance. Keep in mind there are only a limited number of diagnosis codes that are considered medically necessary for treatment to be covered. Low back pain is perhaps one of the most universally accepted diagnoses. General ...

October 16th, 2014

#1 The Alphabetic Index and Tabular List

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 16th, 2014 - Last Review/Update January 30th, 2017

ICD-10-CM is divided into the following: Alphabetic Index: an alphabetical list of terms and their corresponding code consisting of the following parts: Index of Diseases and Injury Index of External Causes of Injury Table of Neoplasms Table of Drugs and Chemicals Tabular List: a list of codes divided into chapters based on body system or condition. See ...

October 16th, 2014

ICD-10 TIP of the MONTH: The Documentation of Procedures

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 16th, 2014 - Last Review/Update January 30th, 2017

To assist you in understanding the key definitions related to documenting procedures in ICD-10, see below for a list of terms to be used in your documentation. Brought to you by Crozer Keystone ICD-10 tip of the month. Examples: Alteration - Modifying the anatomic structure of a body part without affecting ...

October 16th, 2014

Clinical documentation; Supporting good patient care and proper ICD-10 coding - VIDEO

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 16th, 2014 - Last Review/Update January 30th, 2017

Supporting good patient care and proper coding in an ICD-10 environment. Speaker Joe Nichols MD presenting training video on Clinical Documentation: (ICD-10 Webinar). ...

October 10th, 2014

DRIP Line ICD-10-CM Did you know... Coding by the Book

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 10th, 2014 - Last Review/Update January 30th, 2017

InstaCode's speciality books will be one of the best tools to get you started. There are several ways to code from a book. With the ability to search by index and see the commonly used ICD-10-CM codes used for your speciality, you will get a general idea of which codes to ...

October 9th, 2014

Acupuncture and the Treatment of Headaches

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 9th, 2014 - Last Review/Update January 30th, 2017

Acupuncture services are often reimbursed for the treatment of headaches. For examples on headache codes and coding for headaches with ICD-10, visit HealthCMi ...

October 9th, 2014

#2 DRIP Line ICD-10-CM Did you know... What are GEMs?

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 9th, 2014 - Last Review/Update January 30th, 2017

GEMs is a term you will be very familiar with once you start your ICD-10 transition. General Equivalence Mappings (GEMs) for the ICD-10-CM diagnostic codes were created in a joint effort by CMS and The Centers for Disease Control and Prevention (CDC). GEMs can help you to map codes forward, from ICD-9-CM to ...

October 9th, 2014

DRIP Line ICD-10-CM Did you know... Matching Two codes with ICD9 to 10

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 9th, 2014 - Last Review/Update January 30th, 2017

An exact match between two codes is not a common occurrence. For instance, in ICD-9-CM,a diagnosis code for a patient claim only describes a broken forearm. In ICD-10-CM, the same condition will now specify which forearm is broken which bone which portion of the bone the condition of the break when the patient was examined its ...

October 9th, 2014

DRIP Line ICD-10-CM Did you know... What is an RM?

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 9th, 2014 - Last Review/Update January 30th, 2017

From the payers’ perspective, RMs - "Reimbursement Mappings" provide a mechanism for mapping records containing ICD-10-CM codes to “reimbursement equivalent” ICD-9-CM codes. However, not all payers have used or will be using RMs to make the ICD-10-CM transition. To find out more about how payers determine payment, see your speciality book. NOTE: ...

October 8th, 2014

#2 DRIP Line ICD-10 -CM Did you know... ICD-10-CM/PCS Examples: Structural Differences

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 8th, 2014 - Last Review/Update August 9th, 2017

The examples below show the structural differences between ICD-9-CM and ICD-10-CM/PCS. ICD-9-CM Diagnoses Codes: 3–5 digits First digit is alpha (E or V) or numeric Digits 2–5 are numeric; and Decimal is after third digit Examples: 496 – Chronic airway obstruction, Not Elsewhere Classified (NEC) 511.9 – Unspecified pleural effusion V02.61 – Hepatitis B carrier ICD-10-CM Diagnoses Codes: 3–7 digits Digit 1 is ...

October 3rd, 2014

ICD-10 and Clinical Documentation CME/CE

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 3rd, 2014 - Last Review/Update January 30th, 2017

MedScape is offering a free training activity for healthcare providers who will be involved in clinical documentation with ICD-10. This activity is to make providers aware of the key elements of good clinical documentation. CME/CE Released: 09/15/2014; Valid for credit through 09/15/2015 Link ...

October 3rd, 2014

DRIP Line ICD-10-CM Did you know... Instructional Notes

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 3rd, 2014 - Last Review/Update January 30th, 2017

InstaCode's upcoming ICD-10-CM speciality coding books have coding tips to help refine the particular codes or groups of codes, such as “Code First” and “Use Additional Code." NOTE: This information and much more can be found at InstaCode Institute, with over 20 specialty books to help you transition to ICD-10. These books ...

September 15th, 2014

Medicare Definition of Timed Codes

By Wyn Staheli, Director of Research | Published September 15th, 2014 - Last Review/Update July 12th, 2016

Many procedure codes are considered "timed codes," that is, the number of units are determined by the amount of time spent performing the service. Medicare Claims Processing Manual, Chapter 5 clarification included here.

August 14th, 2014

Don't Let the New ICD-10 Catch You Off Guard

By David Berky | Published August 14th, 2014 - Last Review/Update January 25th, 2017

The Center for Medicare and Medicaid Services (CMS) has approved the final version for the new ICD-10-CM and ICD-10 PCS. Until coders and billers convert to this new ICD-10-CM coding system on October 1st, 2014 (now 2015), they will continue to use the ICD-9-CM codes and CPT/HCPCS codes. However, CMS is recommending that professionals start this new training and become well versed with these two new ICD-10 code sets.

July 16th, 2014

Hospital Medical Coders Must Switch To The ICD-10-PCS Codes For Billing Purposes

By David Berky | Published July 16th, 2014 - Last Review/Update January 25th, 2017

For numerous years, United States doctor's offices, medical clinics and hospitals have been using the standard ICD-9-CM on medical forms for inpatient procedures. This code, developed by the World Health Organization (WHO - the "ICD-9") and modified by the use (the "CM"), is used by medical professionals for billing and ...

July 16th, 2014

The Impact of ICD-10 Coding System on Medical Billing

By David Berky | Published July 16th, 2014 - Last Review/Update January 25th, 2017

Learn how the introduction of ICD-10 will impact the coding and billing of medical diagnosis and procedure.

May 2nd, 2014

CMS Makes ICD-10 Announcement

By | Published May 2nd, 2014 - Last Review/Update January 25th, 2017

On the evening of April 30th, the release of the 2015 Inpatient Prospective Payment System Proposed Rule included three separate references to the implementation of ICD-10: 1. "The ICD-10-CM/PCS transition is scheduled to take place on October 1, 2015. After that date, we will collect non-electronic health record-based quality measure data coded only in ICD-10-CM/PCS." - page 648 2. "ICD-10 will officially be implemented on October 1, 2015." - page 1065 3. "ICD-10-CM/PCS will officially be implemented on October 1, 2015." - page 1074 Today, May 2, 2014, CMS released the following statement:

January 28th, 2014

ICD-10 Guidelines that Chiropractic Physicians Should Remember

By | Published January 28th, 2014 - Last Review/Update January 27th, 2017

Depending on the publisher, there are about 30 pages of guidelines in the ICD-10-CM code set. The bulk of these guidelines, from section 1.C, are chapter-specific. Chiropractic physicians typically use codes from just four or five of the 21 chapters available in ICD-10-CM. These include, but are not necessarily limited to, ...

June 14th, 2013

Maybe ICD-10 Will Just Go Away...

By | Published June 14th, 2013 - Last Review/Update January 27th, 2017

Maybe ICD-10 will just go away... Or maybe not. In case you have not heard, the ICD-9 codes that you have been using on claim forms since the late 1970s will cease to exist as of October 1st, 2014. You may have also heard that the entire country was supposed to switch ...

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"Acupuncture|Alternative" & "Transition to ICD10" Articles

How To Properly Report Prolonged Services Using 99417 or G2212

Hypertension ICD-10-CM Coding Table, Guidelines, and Tips

New Biofeedback Codes to replace 90911 Eff 2020-01-01

Medicare Begins Covering Acupuncture Services

Medicare Announces Coverage of Acupuncture Services

Federal Workers Compensation Information

New Codes for Dry Needling

Medical ID Theft

The OIG Work Plan: What Is It and Why Should I Care?

Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain

5 Ways to Minimize HIPAA Liabilities

Wolters Kluwer Drug Pricing

DRIP Line ICD-10-CM Did you know... ICD-10-CM/PCS consists of two parts

Cervical diagnosis Using ICD-10 - July 2013

ICD-10 and Dental

Can Chiropractors Finally Code a "Subluxation" in ICD-10?

ICD-10 External Cause Codes Tell the Whole Story

Project Management Skills for ICD-10 Transitation

“If you fail to plan, you are planning to fail!”

ICD-10 PCS - Coding System

ICD-10-CM Abbreviations: NEC, NOS

CMS: 81 percent of Initial ICD-10 Test Claims Accepted

What is the difference between ICD-9-CM and ICD-10-CM

New Feature in ICD-10-CM: Combination Codes

Coding for ICD-10-CM: More of the Basics MLN Connectsâ„¢ Video

Coding for Laser Therapy

Understanding TOS Discounts and DMPOs

Drip Line Tip: External Cause and Unspecified codes in ICD-10

Acupuncture ICD-10 Common Codes

Acupuncture ICD-10-CM Billing

#1 The Alphabetic Index and Tabular List

ICD-10 TIP of the MONTH: The Documentation of Procedures

Clinical documentation; Supporting good patient care and proper ICD-10 coding - VIDEO

DRIP Line ICD-10-CM Did you know... Coding by the Book

Acupuncture and the Treatment of Headaches

#2 DRIP Line ICD-10-CM Did you know... What are GEMs?

DRIP Line ICD-10-CM Did you know... Matching Two codes with ICD9 to 10

DRIP Line ICD-10-CM Did you know... What is an RM?

#2 DRIP Line ICD-10 -CM Did you know... ICD-10-CM/PCS Examples: Structural Differences

ICD-10 and Clinical Documentation CME/CE

DRIP Line ICD-10-CM Did you know... Instructional Notes

Medicare Definition of Timed Codes

Don't Let the New ICD-10 Catch You Off Guard

Hospital Medical Coders Must Switch To The ICD-10-PCS Codes For Billing Purposes

The Impact of ICD-10 Coding System on Medical Billing

CMS Makes ICD-10 Announcement

ICD-10 Guidelines that Chiropractic Physicians Should Remember

Maybe ICD-10 Will Just Go Away...

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contact

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