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By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published July 14th, 2021
Pain is a common diagnosis among all specialties so it should not be surprising to find there are 162 ICD-10-CM codes for reporting it and over 80 mentions in the ICD-10-CM Official Guidelines for Coding and Reporting which describe when certain types of pain should be reported and how the codes should be sequenced.
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By Wyn Staheli, Director of Research | Published October 1st, 2020 - Last Review/Update October 6th, 2020
New codes for Cytokine Release Syndrome (CRS) are effective October 1, 2020 based on the grade/severity of the symptoms. This article covers the new grading scales.
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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.
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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. ...
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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 ...
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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 ...
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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 ...
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November 26th, 2018
Allergy Immunotherapy Coding Guidelines (CMS) Effective: 01/01/2006
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published November 26th, 2018
Immunotherapy (Allergy Shots) is a medical treatment to used to treat and prevent reactions or desensitize the immune system to specific allergens that trigger allergy symptoms. Payers have specific coverage guidance and rules for reporting injections, the specific type of antigen(s) provided and how they should be reported.
Below are the coding guidelines from ...
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October 30th, 2018
Documentation Requirements for Allergy Testing 10/29/2018
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 30th, 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 ...
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October 30th, 2018
Common Allergy CPT Codes and MUEs
By Find-A-Code™ | Published October 30th, 2018
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 ...
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October 29th, 2018
Allergy Testing 10/29/2018
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 29th, 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 ...
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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...
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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.
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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 ...
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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 ...
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