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Drugs and Biologicals Pub-100 Ch 17

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Watch out for New ICD-10-CM Codes

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New ICD Codes for: Low Back Pain, Cervicogenic Headache, Non-Radiographic Axial Spondyloarthritis (nr-axSpA), and Social Determinations of Health (SDOH). These codes became effective on October 1, 2021.

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PCS Coding for Ankle Fracture - Look Deeper Into the Codes!

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If you're looking for ankle fractures in ICD-10-PCS, you may need to look a little deeper. Let's take a look at coding an ankle fracture such as a trimalleolar fracture. PCS coding can be confusing as it is nothing like CPT coding; with CPT we can simply code an ankle ...

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Coding Lesions and Soft Tissue Excisions

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There are several considerations to be aware of before assigning a code for lesions and soft tissue excisions. The code selection will be determined upon the following: Check the pathology reports, if any, to confirm Morphology (whether the neoplasm is benign, in-situ, malignant, or uncertain) Technique Topography (anatomic location) The size Tissue Level Type of closure required Layers ...

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ICD-10-CM 2021 Codes for your Specialty

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4. Endocrine, nutritional and metabolic diseases (E00-E89) Code:            Description:E70.81          Aromatic L-amino acid decarboxylase deficiencyE70.89          Other disorders of aromatic amino-acid metabolismE74.810        Glucose transporter protein type 1 deficiencyE74.818        Other disorders of glucose transportE74.819    ...

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ICD-10-CM 2021 Codes for your Specialty

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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 ...

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ICD-10-CM 2021 Codes for your Specialty

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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 ...

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ICD-10-CM 2021 Codes for your Specialty

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1. Certain infectious and parasitic diseases (A00-B99) Code:            Description:A84.81          Powassan virus diseaseA84.89          Other tick-borne viral encephalitisB60.00          Babesiosis, unspecifiedB60.01          Babesiosis due to Babesia microtiB60.02          Babesiosis due to Babesia duncaniB60.03        ...

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ICD-10-CM 2021 Codes for your Specialty

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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 ...

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Incident To

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Just about any large clinic you visit will have non-physician practitioners, or NPPs. These will include physician assistants, nurse practitioners, and clinical nurses for example. Practices and clinics can bill under the NPPs if they are credentialed with the payer, but the reimbursement is only 85% of the fee schedule. There ...

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New Value-Based Payment Models for Primary Care (Primary Care First and Direct Contracting)

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This article summarizes the new Medicare value-based payment models: Primary Care First and Direct Contracting.

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Coding Injections for Pain Management

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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 ...

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Are NCCI Edits and Modifiers Just for Medicare?

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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 ...

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New CPT® Codes Approved for COVID-19 Antibody Identification

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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.

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LATEST COVID-19 INFORMATION FOR BILLING NON-FACE-TO-FACE SERVICES

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Healthcare providers and the population at large are concerned about safe access to care considering the COVID-19 pandemic. As a result, we have received many inquiries this week about how to bill for “telehealth” services. Let’s first address that true telehealth services have some pretty stringent requirements from CMS, including that ...

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Coronavirus - What in the World is it and How is it Coded? 2020-02-20

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On December 31, 2019, we learned of a deadly outbreak of an unknown virus, with an unknown cause. We have since learned the virus was identified in Wuhan, China as a novel coronavirus (2019-n-CoV). Until we have more information on the 2019-nCoV, persons with an underlying medical condition are considered high ...

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