"Emergency Medicine" Articles

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December 22nd, 2020

ICD-10-CM 2021 Codes for your Specialty

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020

19. Injury, poisoning and certain other consequences of external causes (S00-T88) Code: Description:S20.213A Contusion of bilateral front wall of thorax, initial encounterS20.213D Contusion of bilateral front wall of thorax, subsequent encounterS20.213S Contusion of bilateral front wall of thorax, sequelaS20.214A Contusion of ...

December 22nd, 2020

ICD-10-CM 2021 Codes for your Specialty

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020

20. External causes of morbidity (V00-Y99) Code: Description:V00.031A Pedestrian on foot injured in collision with rider of standing electric scooter, initial encounterV00.031D Pedestrian on foot injured in collision with rider of standing electric scooter, subsequent encounterV00.031S Pedestrian on foot injured ...

December 22nd, 2020

ICD-10-CM 2021 Codes for your Specialty

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020

3. Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) Code: Description:D57.03 Hb-SS disease with cerebral vascular involvementD57.09 Hb-SS disease with crisis with other specified complicationD57.213 Sickle-cell/Hb-C disease with ...

August 10th, 2020

Coding Injections for Pain Management

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 10th, 2020

Coding for pain management can get confusing. How many injections, the location, and when to use a modifier are all common questions. This article will cover some of the most common injections used in pain management. Trigger Point Injections Trigger point injections are reported by how many muscles are treated using an ...

August 10th, 2020

Modifier 50 — Four "Must Know" Tips For Getting Paid

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published August 10th, 2020

Modifiers added to an HCPCS or CPT© code alters the code description, providing clarity about the service for proper claim processing and reimbursement. Here are four things you must know about modifier 50 to ensure proper payment. - Modifiers are either informational or payment related. Informational modifiers provide additional...

July 14th, 2020

Are NCCI Edits and Modifiers Just for Medicare?

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published July 14th, 2020

The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...

April 20th, 2020

Emergency Room and Ancillary Services

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published April 20th, 2020

Billing for an Emergency department is not the same as billing for a hospital or in the provider's office; there are several differences and requirements. For example. the hospital will report a stay with Diagnosis Related Groups (DRG's), which include hospital resources used during the patient's stay, while office visits ...

April 15th, 2020

New CPT® Codes Approved for COVID-19 Antibody Identification

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published April 15th, 2020

On April 10, 2020, the American Medical Association approved and published a revision of code 86318 and added two new codes 86328 and 86769 for reporting Coronavirus [COVID-19] antibody testing.

February 10th, 2020

A 2020 Radiology Coding Change You Need To Know

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published February 10th, 2020

The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...

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December 19th, 2019

Reporting the Health Effects of Vaping Now and in April 2020

By Wyn Staheli, Director of Research | Published December 19th, 2019

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.

October 1st, 2019

Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published October 1st, 2019

Atrial fibrillation (AF) is the most common type of abnormal heart rhythm (arrhythmia). It is caused by a disorder in the heart’s electrical system. AF is the result of abnormal contractions of the atria (upper two chambers of the heart) causing them to quiver and beat out of sync with ...

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 19th, 2019

The Facts of Critical Care

By Namas | Published July 19th, 2019 - Last Review/Update July 30th, 2019

Critical care services remain to not only be an area of confusion for providers, coders, and auditors, but also a constant target for the carriers for audit. We can sit back and look at critical care and think of all of the ways the code descriptor and/or use could be ...

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 ...

May 31st, 2019

Auditing Hospitalist Services

By Namas | Published May 31st, 2019 - Last Review/Update June 4th, 2019

Auditing Hospitalist Services The inpatient side of coding and auditing can be enormously complex, with many more moving parts than are typically found in the outpatient setting. In this audit tip, we will discuss a few of the challenges that come with auditing one of the most important players in the ...

April 23rd, 2019

Coverage for Hearing Aids and Auditory Implants

By Brandon Dee Leavitt QCC, CMCS, CPC, EMT | Published April 23rd, 2019

For hearing impairment, Medicare is firm in its stance on when it will and will not cover hearing correction. In the PUB 100-02 Medicare Benefit Policy Manual, Chapter 16, Medicare cites the Social Security Act by explaining: "..."hearing aids or examination for the purpose of prescribing, fitting, or changing hearing aids" ...

March 18th, 2019

How to Report Imaging (X-Rays) of the Thumb

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published March 18th, 2019

If you've ever taken piano lessons, you know that the thumb is considered the first finger of the hand. Anatomically, it is also referred to as the first phalanx (finger). However, when you are coding an x-ray of the thumb, images are captured of the thumb, hand, wrist, and all ...

March 4th, 2019

Answers to Your Auditing & Compliance Questions

By Namas | Published March 4th, 2019 - Last Review/Update March 7th, 2019

National Alliance of Medical Auditing Specialists (NAMAS) hosts a forum where auditing and compliance professionals can get answers to their questions, and exchange information with other professionals across the country. Recently, we've received the following question regarding fracture care that we'd like to share below. Q: I recently noticed CPT 26600, ...

January 22nd, 2019

Home Oxygen Therapy

By Raquel Shumway | Published January 22nd, 2019

Home Oxygen Therapy Guidelines

January 4th, 2019

Nine New Codes for Fine Needle Aspirations (FNA) in 2019

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published January 4th, 2019

If your practice performs a lot of fine needle aspirations (FNA), you probably have the code options memorized (10021 without image guidance and 10022 with image guidance). However, the 2019 CPT codes now include nine (9) new FNA codes (10004-10012), one deleted FNA code (10022) and one revised FNA code ...

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...

July 9th, 2018

Documentation: Face to Face for Home Health Certification

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published July 9th, 2018

As a physician, you are responsible for providing appropriate, accurate supporting documentation of your face-to-face encounters (FTF) with your patients regarding home health care. Analysis of the recent errors identified by the Comprehensive Error Rate Testing (CERT) Review Contractor shows a continuing increase in denials related to documentation for the FTF. The ...

June 14th, 2018

Home Oxygen Therapy -- CMN for Oxygen

By Raquel Shumway | Published June 14th, 2018

The Certificate of Medical Necessity (CMN) for Oxygen is a required form that helps to document the medical necessity for oxygen therapy. It also documents other coverage criteria for the oxygen use. For payment on a home oxygen claim, the information in the supplier’s records or the patient’s medical record must be substantiated with the information in the CMN.

April 23rd, 2018

Critical Care Documentation

By Scott Kraft, CPC, CPMA | Published April 23rd, 2018 - Last Review/Update May 2nd, 2018

Critical care documentation should show critical need for the patient AND immediate action by the provider....

March 27th, 2018

Home Oxygen Therapy -- A Face-to-Face Encounter

By Raquel Shumway | Published March 27th, 2018 - Last Review/Update June 14th, 2018

What is required for a Home Oxygen Therapy, Face-to-Face Encounter.

March 8th, 2018

Documentation and Orders for Respiratory Assistive Device

By Medicare Learning Network | Published March 8th, 2018 - Last Review/Update March 27th, 2018

The Medicare Learning Network provides guidance on required documentation for a respiratory assistive device and ordering guidelines.

January 31st, 2018

Influenza, Are You Billing Correctly?

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published January 31st, 2018

With this year's Flu season being the most widespread on record, providers are seeing more patients and giving more immunizations for influenza than normal. Here are a few things to keep in mind during this flu season. Know the rules with your payers to ensure proper reimbursement and correct billing. For example, did you ...

January 11th, 2018

Preventative Services: Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)

By Find-A-Code | Published January 11th, 2018

The following information from the Medicare Learning Network provides guidance on Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)

November 10th, 2017

Escharotomy Procedural Cross-Walking CPT to ICD-10-PCS

By Brandon Dee Leavitt QCC, CMCS, CPC, EMT | Published November 10th, 2017 - Last Review/Update November 17th, 2017

An Escharotomy is used for "local treatment of burned surface" per the AMA Guidelines, when incisions are performed on the burn site. Notice, when cross-walking 16035 or 16036 to inpatient codes, Find-A-Code crosswalks lead to Body System H, Operation 8 - Division of the skin, and Operation N - Release of the skin. A division or release of the skin would be a ...

October 20th, 2017

PFSH Documentation: Q and A

By Shannon DeConda, CPC, CPC-I, CEMC, CEMA, CPMA, CRTT | Published October 20th, 2017 - Last Review/Update January 31st, 2018

When coding an E/M visit in the emergency department, would you count all PFSH listed even if they don't pertain to the indication as to why the patient arrived?

September 1st, 2017

Preventive Services: Cardiovascular Disease Screening Tests

By Find-A-Code | Published September 1st, 2017 - Last Review/Update February 2nd, 2018

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Cardiovascular Disease Screening Tests: 80061 - Lipid panel, this panel must include the following: 82465 - Cholesterol, serum, total 83718 - Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) 84478 - Triglycerides Z13.6 All Medicare beneficiaries without apparent signs or symptoms ...

March 28th, 2017

Respiratory Assist Devices (RAD) E0470 and E0471 - Billing Reminders

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published March 28th, 2017 - Last Review/Update July 28th, 2017

Add the KX modifier to all claims for RADs and accessories for the first through third months if all thecoverage criteria have been met. Add the KX modifier to all claims for the fourth month and thereafter if all the coverage criteria have been met and if the physician signed and dated a ...

February 27th, 2017

Documentation: Face to Face for Home Health Certification

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 27th, 2017 - Last Review/Update August 16th, 2017

March 29th, 2016

PQRS Measures by Specialty (2016)

By InstaCode Institute | Published March 29th, 2016

Download CMS's Preferred PQRS Measures Lists by Specialty. 17 Specialties to choose from. Find out exactly what CMS is expecting to see reported for your specialty.

February 24th, 2016

Nebulizer Therapy Billing Reminders - Modifiers, Dispensing Fees, and Orders

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 24th, 2016 - Last Review/Update August 3rd, 2017

The ICD-10-CM code describing the condition necessitating nebulizer therapy must be included on each claim for equipment, accessories, and/or drugs. When ever a unit dose code is billed, it must have a KO, KP, or KQ modifier. (Exception: The KO, KP, and KQ modifiers should not be used with code J7620.) When billing miscellaneous equipment or accessories (E1399), the claim must ...

December 1st, 2015

Burnout and Emergency Medicine

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 1st, 2015

When it comes to Burnout, Emergency Medicine is hit the Hardest according to MedPage Today. The results come from a survey of burnout among U.S. Physicians. The mean average on those reporting burnout was 45.8%. The emergency physicians were certainly reporting higher burnout at more than 60%. There are many factors contributing to the emergency physician’s burnout, such as the intense environment, economic pressures from healthcare, as well as Medicare's quality indicators, which make doctors accountable for things they have no control over.

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"Emergency Medicine" Articles

ICD-10-CM 2021 Codes for your Specialty

ICD-10-CM 2021 Codes for your Specialty

ICD-10-CM 2021 Codes for your Specialty

Coding Injections for Pain Management

Modifier 50 — Four "Must Know" Tips For Getting Paid

Are NCCI Edits and Modifiers Just for Medicare?

Emergency Room and Ancillary Services

New CPT® Codes Approved for COVID-19 Antibody Identification

A 2020 Radiology Coding Change You Need To Know

Reporting the Health Effects of Vaping Now and in April 2020

Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes

Medical ID Theft

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

The Facts of Critical Care

5 Ways to Minimize HIPAA Liabilities

Auditing Hospitalist Services

Coverage for Hearing Aids and Auditory Implants

How to Report Imaging (X-Rays) of the Thumb

Answers to Your Auditing & Compliance Questions

Home Oxygen Therapy

Nine New Codes for Fine Needle Aspirations (FNA) in 2019

Wolters Kluwer Drug Pricing

Documentation: Face to Face for Home Health Certification

Home Oxygen Therapy -- CMN for Oxygen

Critical Care Documentation

Home Oxygen Therapy -- A Face-to-Face Encounter

Documentation and Orders for Respiratory Assistive Device

Influenza, Are You Billing Correctly?

Preventative Services: Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)

Escharotomy Procedural Cross-Walking CPT to ICD-10-PCS

PFSH Documentation: Q and A

Preventive Services: Cardiovascular Disease Screening Tests

Respiratory Assist Devices (RAD) E0470 and E0471 - Billing Reminders

Documentation: Face to Face for Home Health Certification

PQRS Measures by Specialty (2016)

Nebulizer Therapy Billing Reminders - Modifiers, Dispensing Fees, and Orders

Burnout and Emergency Medicine

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