Anthem has sent a letter to the AMA to announce they are rescinding the policy reducing payment for physicians when billing an E/M with a modifier 25 and a procedure that has zero or 10 global days. Anthem was planning on taking a 25 percent reductio… For more, read here: AAPC Blog
Continue ReadingModifier 58 Versus 78; Which Should You Use?
Sometimes coders are confused when they should apply modifier 58 Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period and modifier 78 Unplanned Return to the Operating… For more, read here: AAPC Blog
Continue ReadingHow to Code Flu – from Prevention to Care
Flu season is here, prompting a great deal of confusion about how to code. I decided to spend some time on the Centers for Disease Control and Prevention (CDC) website and other resources to try to clarify the murky in this very sick flu season. Car… For more, read here: AAPC Blog
Continue ReadingCase Studies: Modifier 59 and X[ESPU] Use
When I last wrote “Modifier 59 – To Use or Not to Use”, I promised to follow it up with some real-life examples of when we should be using the 59 or the new Medicare X[ESPU] modifiers. Let’s look at some clinical examples and first determine if the … For more, read here: AAPC Blog
Continue ReadingModifier 59 – To Use or Not to Use
I often call Modifier 59 the prednisone of modifiers. That is because it is very powerful and can do a lot for you, like prednisone is for the patient. But at the same time, it is a two-edged sword, the modifier 59 is exceptionally dangerous when used… For more, read here: AAPC Blog
Continue ReadingNew FESS Codes for 2018
2018 brings us new functional endoscopic sinus surgery codes (FESS) which bundle a total ethmoidectomy with both a frontal sinusotomy and a sphenoidotomy with and without removal of tissue. 2018 CPT® also provides a new bundled code for a frontal and… For more, read here: AAPC Blog
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New FESS Coding for 2018
AAPC’s Knowledge Center welcomes Barbara Cobuzzi as a regular contributor. Nasal Sinus Endoscopy According to the American Rhinologic Society, several nasal sinus endoscopy services were identified as potentially misvalued because billing patt… For more, read here: AAPC Blog
Continue ReadingExplore 2018 Changes for Otolaryngology
Here’s the clarity you need to use new procedure codes, modifiers, and bundling rules correctly. CPT® 2018 introduces important changes for nasal/sinus endoscopy coding, including several new codes that bundle endoscopic procedures often performed tog… For more, read here: Healthcare Business Monthly
Continue ReadingUnderstanding Incident-to Services
Most practices use incident-to services at some time or other, whether it is an encounter where a nurse or medical assistant just takes a blood pressure or gives an injection, or it can … For more, read here: AAPC Healthcare Business Monthly
Continue ReadingSpecific Modifiers for Distinct Procedural Services
There have been quite a few blogs and articles lately addressing Medicare’s new -X{EPSU} modifiers to describe subsets of the 59 modifier for “distinct procedural service” via Transmittal … For more, read here: AAPC Blog
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