DecisionHealth's Coding Answers 2010 Updates

Updates by Month:

December 2010:

Chapter

Description of changes

CPT Codes

Adds new section "Report from the 2011 AMA CPT® Symposium"

Deletes section "Report from the 2010 AMA CPT Symposium"

Evaluation and Management Services

Adds new section "Prepare to provide annual wellness visits: what you need to know"

Observation Care

Updates section "8 tips for billing observation care"

Replaces section "Payer dictates code for middle day of observation" with new section "Look for new E/M codes for subsequent observation in 2011"

Updates section "Observation care after a procedure: Can you bill?"

Updates and renames section "Tips to use the initial observation care codes" as "Tips for submitting the initial observation care codes to Medicare"

Updates section "Admission and discharge on same day ok"

Folds section "Q&A: Coding for observation care" into section "5 scenarios showing proper use of observation care codes"

Deletes sections "Medicare’s rules on observation care" and "Medicare’s rules on observation care 2" Links to online manual chapters reprinted in these sections now are provided throughout the chapter

Folds section "Summary" into section "Overview"

Updates and renames section "Examples of observation codes filed incorrectly" as "3 examples of observation codes filed to Medicare incorrectly"

November 2010:

Chapter

Description of changes

Diagnosis Codes – ICD-10-CM

Adds new section "Look for partial code freeze after October 2011"

Folds section "Overview" into section "Changes ahead with ICD-10-CM"

Modifier 53 vs. 52

Adds new section "Beware the bite of modifier 53"

Folds section "In a nutshell: When to use -52 vs. -53" into section "Avoid confusing a discontinued procedure (modifier 53) with reduced services (modifier 52)"

Obstetrics and Gynecology

Adds new section "Coding multiple NSTs performed the same day"

October 2010:

Chapter

Description of changes

Diagnosis Codes – V Codes

Adds new section "ICD-9 expands definition of status 'V' codes"

Modifier 51

Adds new section "Modifier 51: Who appends it to the claim?"

Updates section "Separate procedures versus code separately"

Place of Service
(renamed from "Site of service")

Adds new section "Warning: OIG audits uncover major problems with physicians' POS selection"

Updates section "Place-of-service differential"

Splits out and updates new section "Valid place of service codes"

Deletes section "Pharmacy POS code named"

September 2010:

Chapter

Description of changes

Cardiology

Adds new section "Billing 93016 for stress test supervision in the hospital"

Diagnosis Codes – Annual Updates

Adds new sections:

Deletes sections:

  • "H1N1, venous embolism and ‘never events’ among new diagnosis codes"
  • "New ICD-9-CM diagnosis codes for fiscal 2010 (effective 10/1/09)"
  • "Revised ICD-9-CM diagnosis codes for fiscal 2010 (effective 10/1/09)"
  • "Invalid ICD-9-CM diagnosis codes for fiscal 2010 (effective 10/1/09)"

Modifiers 73 and 74: ASC

Enhances section "Overview"

August 2010:

Chapter

Description of changes

Drugs

Updates section “Drug waste doesn't have to be a billing waste

Modifiers 58, 78 & 79

Updates section “Which one you should you use

Splits out & updates new section “Medicare pay for services billed with modifier 78” from “Which one you should you use”

Splits out & updates new section “Modifier 76 vs. 78” from “Which one you should you use”

Updates section “Post-op complications: A closer look

Deletes section “-58 vs. -78 when a related procedure is performed during a post-op period?”

Adds new section “Modifier 79 under scrutiny

Ophthalmology Services

Adds new section “Co-management when ophthalmologist, optometrist are members of the same practice

July 2010:

Chapter

Description of changes

Cardiology

Updates section “Correctly code your TEEs

Correct Coding Policy

Revises and consolidates sections “Codes don’t guarantee Medicare pay” and “The rest of the story from official Medicare guidelines” into new section “Medicare guidelines explain the rationale behind CCI

Adds new section “Tips for when you may unbundle CCI edits

Revises section “Modifiers highlighted in CCI narratives

Drugs

Updates section “Drug waste doesn't have to be a billing waste

June 2010:

Chapter

Description of changes

Category III Codes

Adds new section “Acoustic cardiography, PRP get new Category III codes

Electrophysiology Coding

Adds new section “Proper coding of a coronary sinus catheter

Evaluation and Management Services

Adds new section “Billing Medicare for telehealth services

May 2010:

Chapter

Description of changes

Diagnosis Codes – V Codes

Adds new section “Use correct follow-up V-code when patient is healthy

Musculoskeletal System

Consolidates sections “Head,” “Neck (soft tissues) and Thorax,” “Spine (vertebral column),” “Shoulder,” “Forearm and Wrist,” and “Hand and Fingers” under new section titled “Common coding challenges by body area

Adds new subsection, “Pelvis and Hip Joint,” under “Common coding challenges by body area

Splits section “AAOS confirms E/M with fracture care” out from section “Fracture care codes”

Obstetrics and Gynecology

Adds new section “Don't forget new ICD-9 codes for postpartum infection

Splits section “No written policy includes urinalysis in annual gyn exam” out from section “Some payers require S-codes for preventive gyn exams”

April 2010:

Chapter

Description of changes

Advance Beneficiary Notice

Updates section “Correct modifiers for claims expected to be denied

Adds new section “CMS revises GA modifier, introduces the GX

Labs in Physician Offices

Updates section “Section IV: Qualitative drug screens

Pumps and Ports

Adds new section “Five tips to reduce denial risks for pump implants

March 2010:

Chapter

Description of changes

Coding Tips & Resources

Adds new section “Tips for resubmitting claims after retroactive coverage changes

Renames section “Unpaid claims: Should you resubmit?” as “What to do about unpaid claims

HIV

Adds new section “Medicare covers HIV screenings, issues new G-codes

Modifier 52

Updates section “Overview” and renames it “Using the 52 modifier with an E/M

February 2010:

Chapter

Description of changes

CPT Codes

Adds new section “Look at this year's claims data to predict next year's CPT codes

Electrophysiology Coding

Updates section “Comprehensive EP evaluation services

Urology

Adds new section “Urology acronym-to-code crosswalk

Updates section “Kidney

January 2010:

Chapter

Description of changes

Cardiology

Adds new section “Cardiac CT Angiography (CTA) gets Category I codes

Deletes section “Use Category III codes for cardiac CTA”

CPT Codes

Adds new section “Report from the 2010 AMA CPT Symposium

Deletes section “Analysis of CPT 2009 code changes”

Injections: Surgical

Revises section “Facet joint blocks

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