James Smith

Be Well-Versed With the Multiple Scope Rule

Here are four medical coding strategies every ortho coder needs to know. If your orthopedist carries out several procedures during a knee arthroscopy on the same patient on the same day, you will need to understand the multiple-scope rule to figure out... Read >

Which Nerve Conduction Study Code Is Right for you?

Selecting the proper code to describe your nerve conduction test can prove to be a demanding proposition; but that need not be the case if you learn three important areas: Here are some steps to boost your medical coding and billing know how and to make... Read >

Code the More Complex Procedure With 69610-RT

In a particular situation, a physician assessed the patient's right ear and cleared the canal of all cerumen. The tympanic membrane was visualized, which had retained a tube. He removed a tube in the anterior superior aspect of the eardrum with a Rosen ne... Read >

Hyaluronic Acid Injections: 'Count Correctly' to get your Rightful Reimbursements

For some time, Hyaluronate injections have had its own J code. However it has been changed from 'unspecified' to its own assigned code, back to 'unspecified' and then back to an assigned HCPCS code. Now that all hyaluronate injections fall under the same ... Read >

Diagnoses Codes: Be Well-Versed With 'Uncertain Behavior'

If you always use diagnosis code 238.2 while reporting 11100 for a biopsy procedure your physicians carry out, you are setting your practice up for a rough ride. The key to understanding when to use the 'uncertain behavior' diagnosis code is understanding... Read >

Four Tips to Overcome MUE Denials

So are your receiving denials from Medicare? One possibility could be you are running up against medically unlikely edits (MUEs). Medical claims billing: The MUEs, which are designed to prevent overpayments, caused by gross billing mistakes, normally a r... Read >

Medical Coding: Get More Insight on Debridement and Active Wound Care Code

It's natural to be confused about when to choose a debridement code or an active wound care code. But this time CPT presents a clearer understanding of the same with revised codes and guidelines that clarify how to select between the two code groups. This... Read >

Medicare Reimbursement: Modifiers KX, EY keys to DME Reimbursement

Providing refractive lenses for cataract surgery patients is it? Well, you will need to unravel your DME MAC's complex coding and billing rules to get yourself your deserved Medicare reimbursement. Test: Often ophthalmology coders describe durable medic... Read >

Codes 94620, 94621 for Pulmonology Stress Test

So you're finding it a chore to differentiate between the two codes for pulmonary stress test. Is it? The important thing you need to do is to look out for clues in their descriptions. Read through this specialty coding article to help your understanding.... Read >

Perfect your Twin Delivery Claims

You need to be well-versed with procedure and diagnosis codes if you are to code right for your ob-gyn practice. Do you know how to report a twin cesarean delivery? A simple answer would be 59510 with modifier 22 attached. But this may not as simple as... Read >

Emergency Department Coding: Know the NOPP Levels Well to Be Bang on Target

While going about your Emergency department coding , you need to be well-versed with some key topics such as NOPP levels so that you bag the rightful reimbursements for your practice. Without a good understanding on nature of presenting problems (NOPP... Read >

Medicare Physician Reimbursement: Modifiers GE & GC

Medicare physician reimbursement: As long as you know the requirements for Medicare's teaching physician rules, you can ensure that your ob-gyn gets paid for evaluation and management services and minor surgical procedures carried out in a teaching settin... Read >

Modifier 25 and 57: Know These Modifier Basics

Here are three guidelines to unlock the secrets to rightful physician reimbursement for separately identifiable E/M services using modifier 25. 1) First, see to it that your dermatologist carried out a separate service. You should append modifier 25 wh... Read >

Standby: Take a Look at Documentation of 4 Areas before Submitting Claims

As we know, CPT's evaluation & management section includes only one code for standby time; however limited choices do not guarantee payment. Take a look at these four areas to see you get your well-deserved payments. You should code based on availabilit... Read >

Depth and Location Key to Ulcer Reporting

Your dermatologist carries out a decubitus ulcer excision or debridement; here you will have to choose from about 25 possible codes. You will have an easier time selecting the right code if you are aware about the following: Find out whether the wound c... Read >