Medicare Compliance & Reimbursement - 2010 Issue 12
YOUR PART B QUESTIONS ANSWERED: Think Twice Before Reporting
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Article Overview
This Q&A-style article reviews common Part B coding situations that can affect claim accuracy and compliance. It discusses imaging bundling concerns, face-to-face requirements for certain E/M reporting, use of modifier 53 for an incomplete procedure, and when supplies may or may not be separately reportable. The content is aimed at coders, billers, and clinicians working with CPT, ICD, and Medicare-related guidance.
Why This Topic Matters
The article helps readers spot situations where routine billing choices may conflict with payer edits, documentation expectations, or site-of-service rules. It is useful for reducing avoidable denials and improving awareness of when additional documentation or payer-specific review may be needed.
Article Sections
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CT and CTA Reporting on the Same Date
Discusses imaging reporting for same-day studies of the same anatomic area and references payer edit logic, related radiology guidance, and documentation considerations.
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Nurse Code Calls for Face-to-Face Encounter
Covers a skilled nursing facility-related E/M question involving physician review of test results, patient contact, and related visit considerations.
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Don't Let Modifier 53 Stop Proper Coding
Reviews reporting of a discontinued procedure, including the circumstances surrounding interruption and the need for related diagnosis reporting.
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Supplies Coding Depends On POS
Explains general supply-reporting considerations in office settings, including fee schedule bundling and payer differences.
What You Will Learn
- How the article approaches same-day imaging scenarios involving related studies
- What the article says about direct patient contact in a nursing-facility-related E/M question
- When the article discusses a discontinued procedure and associated reporting considerations
- How the article frames office supply reporting and payer-specific exceptions
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Physician practices
- Radiology staff
- Facility coding professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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