A lot of people have been asking questions about how to code FESS surgeries with the new combination codes when three or four sinuses are operated on. Sinus and FESS We have been expecting an AMA CPT® Assistant article with guidance this year, but no … For more, read here: AAPC Blog
Continue ReadingAdvocacy to Change 31241’s Pay to Outpatient
Advocates are seeking to convince the Centers for Medicare & Medicaid Services (CMS) to pay for outpatient care of patients receiving 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. The new code for 2018 was assigned… For more, read here: AAPC Blog
Continue ReadingOIG: Many Outpatient PT Claims Fail to Comply
The Office of Inspector General (OIG) did a study of physical therapy claims and documentation for Medicare patients and issued a report this month in March. Their findings are of great concern for the PT and rehabilitation specialty. The OIG reviewed… For more, read here: AAPC Blog
Continue ReadingE/M Update Opinions Shared at Listening Session
A representative from the Hospital and Ambulatory Policy Group at the Centers for Medicare & Medicaid Services (CMS) held a listening session regarding proposed updates to the documentation guidelines for evaluation and management (E/M) services o… For more, read here: AAPC Blog
Continue ReadingMedical Coding Tissue Transfer or Rearrangement
I often see incorrect medical coding for “flaps”, which were adjacent tissue transfers, 14000-14350. Coders do not always understand that you can only code for the closure of the primary and secondary defect, but not for each flap that is created. Sur… For more, read here: AAPC Blog
Continue ReadingPost-Operative Complications in the Global Period
Is the caring for, and treatment of post-operative complications in the global period coded and billable? To answer this question, You first must know who the third-party payer is because different payers have different rules. What’s the Globa… 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 ReadingAMA Updates Flap and Turbinectomy Codes For 2018
Other than the FESS CPT® changes for 2018, there are a few more CPT® updates to note for the upcoming year. The first changes have to do with Flaps (skin and/or deep tissues). Additional instructions were added to these codes, stating: “The regions … For more, read here: AAPC Blog
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