Coding News – Page 4 – CRN Healthcare Solutions

Billing 95165 Is Nothing to Sneeze At

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jul 11, 2019

The professional service of preparation and provision of antigens for allergen immunotherapy — reported using CPT® 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple … For more,...

Differentiate Separate Procedures with Modifiers 59 and X[ESPU]

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jul 8, 2019

When you have distinct, separate procedures, know which modifiers will get the claim paid in full. Modifier 59 Distinct procedural service acts as a “universal unbundling” modifier for procedures that are normally included as part of another procedur… For more,...

Cyber Threats to Physician Practices Are Growing

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jun 24, 2019

Here’s how to fight back. Most of us are concerned about being personally attacked by cybercriminals, and we must have that same increased awareness within our medical practices. Cybercriminals consider medical practices ripe for the picking. Security For more, read...

AMA on Evaluation and Management Guidelines

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jun 18, 2019

Medical coders who were unsure what documentation non-Medicare payers would expect in light of the Patients Over Paperwork Initiative now have more to go on. The initiative reduced documentation requirements for outpatient evaluation and management (… For more,...

Assistant at Surgery Modifiers Require Specific Documentation

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jun 17, 2019

Over my almost 30-year surgical coding career, the documentation for assistant surgeons consisted of only the name of the assistant surgeon in the operative note header. Most often there was no mention of the role of the assistant surgeon in the body … For more,...

DOJ Re-evaluates Compliance Programs

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jun 11, 2019

The Department of Justice (DOJ) Criminal Division issued, April 30, a 19-page document entitled Evaluation of Corporate Compliance Programs. This document applies broadly to all industries where compliance is integral to operations and is not targeted… For more,...

You’ll Need This to Get Balloon Dilation of the Eustachian Tube Paid

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jun 7, 2019

Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube (BDET), published by the American Academy of Otolaryngology ̶ Head and Neck Surgery, June 4, is important because BDET is newer technology and may be rejected for payment by third… For more,...

Auditing Postoperative Sinus Debridements

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | May 23, 2019

An auditor asked the question of postoperative sinus debridements while discussing functional endoscopic sinus surgery (FESS). It was asked if postoperative debridements are coded and chargeable when a septoplasty or a turbinate procedure is performed… For more,...

E/M Documentation for Teaching Docs Changes July 1, 2019

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | May 21, 2019

There is a change in Medicare policy forthcoming regarding evaluation and management (E/M) services documentation requirements for teaching physicians. It is important to train teaching physicians, residents, and nurses who document E/M services of a… For more,...

10 Reasons to Refuse Job Counter Offers

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | May 14, 2019

I was recently speaking with a recruiter for HIMIGINE Solutions, James Mason Henk, about employers who make counter offers after employees give their notice that they are leaving for a new position. He has a list of TOP 10 REASONS NOT TO ACCEPT … For more, read...

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OIG: Many Outpatient PT Claims Fail to Comply

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Apr 5, 2018 | Billing, Coding, Documentation, Legal

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,...

Medical Coding Tissue Transfer or Rearrangement

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Mar 26, 2018 | Coding, Otolaryngology

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,...

AMA Updates Flap and Turbinectomy Codes For 2018

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jan 28, 2018 | Coding, Otolaryngology

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,...

New FESS Codes for 2018

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jan 10, 2018 | Billing, Coding, Otolaryngology

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,...

New FESS Coding for 2018

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jan 9, 2018 | AAPC, Billing, Coding, Otolaryngology

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...

Explore 2018 Changes for Otolaryngology

by Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO | Jan 2, 2018 | Billing, Coding, 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,...

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