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1

HOW TO IDENTIFY AND APPLY ICD-10 COMBINATION CODES Lower back pressure ulcer, stage II could be reported inICD-9 using two codes-707.03 Pressure ulcer, lower back and 707.22 Pressure ulcer stage II. Under ICD-10, however, a single code is used to depict the condition -132 Pressure ulcer of right lower back, stage 2. Thus, ICD-10 pressure ulcer codes are combination codes that include: MEDICAL BILLING AND CODING TRENDS PRACTICES CAN’T IGNORE Medical Billing and Coding Trends Practices Can’t Ignore in 2021. The healthcare sector has been reluctant to embrace technology, one of the main concerns being patient safety. Medical billing and coding rules and the codes themselves are changed periodically, and new codes introduced from time to time. To improve any facility’s bottom-line CPT CODE UPDATES FOR BREAST PROCEDURES IN 2021 In 2021, there are major changes to CPT codes for breast procedures which include 15 revised codes and two deletions. Expert coders in medical billing companies are up-to-date on all the new changes and can help physicians select the correct codes based on these updates, which is important to avoid audits and get timely reimbursement. BILLING AND CODING LABORATORY PANELS AND THEIR COMPONENTS 8596 E. 101st Street, Suite H Tulsa, OK 74133. Main: (800) 670 2809 Fax: 972-466-5385 E-mail: info@managedoutsource.com KNOW THE RULES TO REPORT REMOTE PATIENT MONITORING (RPM A lot has been happening with regards to reporting remote patient monitoring (RPM) aka remote physiologic monitoring and our medical billing and coding company is keeping track of the developments.. The Centers for Medicare and Medicaid Services (CMS has expanded reimbursement codes available for RPM over the years in order to help providers meet the growing demand for virtual BILLING FOR TESTOSTERONE SHOT Two CPT codes are used for each type such as: 84402: Testosterone, free. 84403: Testosterone, total. If a testosterone test measures total amount of testosterone and free testosterone, both CPT codes should be used for billing that service. For example, you should use only 84402 for ‘Testosterone, Free (Direct), Serum.’. WHY AND HOW TO USE ICD-10 EXTERNAL CAUSES CODES ICD-10 External Cause Codes (V00-Y99) W85-W99 Exposure to electric current, radiation and extreme ambient air temperature and pressure. Y35-Y38 Legal intervention, operations of war, military operations, and terrorism. Y70-Y82 Medical devices associated with adverse incidents in diagnostic and therapeutic use. Y83-Y84 Surgical and

other medical

BILLING AND CODING FOR PHYSICIAN HOME VISITS Codes for Established Patients. 93347 Self-limited or minor problem, 15 min. 99348 Low to moderate problem, 25 min. 99349 Moderate to high problem, 40 min. 99350 Patient unstable or significant new problem requiring immediate physician attention, 60 min. If other services such as advanced care planning, diagnostic services, and some minor RADIOLOGY PRIOR AUTHORIZATIONS A single authorization for CPT code 70540, 70542, or 70543 includes imaging of the Orbit, Face, Sinuses, and Neck. Multiple authorizations are not required. As the pre-authorization process can be very time-consuming, requiring constant follow-up by the radiology office, it is more practical to outsource the task. NOTABLE DENTAL BILLING AND CODING UPDATES FOR 2021 Notable Dental Billing and Coding Updates for 2021. Every year, the American Dental Association (ADA) makes changes to CDT codes and many practices outsource dental billing to stay on top of these updates, document patient care provided and submit insurance claims to meet payer guidelines. Several CDT code changes came into effect on January

1

HOW TO IDENTIFY AND APPLY ICD-10 COMBINATION CODES Lower back pressure ulcer, stage II could be reported inICD-9 using two codes-707.03 Pressure ulcer, lower back and 707.22 Pressure ulcer stage II. Under ICD-10, however, a single code is used to depict the condition -132 Pressure ulcer of right lower back, stage 2. Thus, ICD-10 pressure ulcer codes are combination codes that include: MEDICAL BILLING AND CODING TRENDS PRACTICES CAN’T IGNORE Medical Billing and Coding Trends Practices Can’t Ignore in 2021. The healthcare sector has been reluctant to embrace technology, one of the main concerns being patient safety. Medical billing and coding rules and the codes themselves are changed periodically, and new codes introduced from time to time. To improve any facility’s bottom-line CPT CODE UPDATES FOR BREAST PROCEDURES IN 2021 In 2021, there are major changes to CPT codes for breast procedures which include 15 revised codes and two deletions. Expert coders in medical billing companies are up-to-date on all the new changes and can help physicians select the correct codes based on these updates, which is important to avoid audits and get timely reimbursement. BILLING AND CODING LABORATORY PANELS AND THEIR COMPONENTS 8596 E. 101st Street, Suite H Tulsa, OK 74133. Main: (800) 670 2809 Fax: 972-466-5385 E-mail: info@managedoutsource.com KNOW THE RULES TO REPORT REMOTE PATIENT MONITORING (RPM A lot has been happening with regards to reporting remote patient monitoring (RPM) aka remote physiologic monitoring and our medical billing and coding company is keeping track of the developments.. The Centers for Medicare and Medicaid Services (CMS has expanded reimbursement codes available for RPM over the years in order to help providers meet the growing demand for virtual BILLING FOR TESTOSTERONE SHOT Two CPT codes are used for each type such as: 84402: Testosterone, free. 84403: Testosterone, total. If a testosterone test measures total amount of testosterone and free testosterone, both CPT codes should be used for billing that service. For example, you should use only 84402 for ‘Testosterone, Free (Direct), Serum.’. WHY AND HOW TO USE ICD-10 EXTERNAL CAUSES CODES ICD-10 External Cause Codes (V00-Y99) W85-W99 Exposure to electric current, radiation and extreme ambient air temperature and pressure. Y35-Y38 Legal intervention, operations of war, military operations, and terrorism. Y70-Y82 Medical devices associated with adverse incidents in diagnostic and therapeutic use. Y83-Y84 Surgical and

other medical

BILLING AND CODING FOR PHYSICIAN HOME VISITS Codes for Established Patients. 93347 Self-limited or minor problem, 15 min. 99348 Low to moderate problem, 25 min. 99349 Moderate to high problem, 40 min. 99350 Patient unstable or significant new problem requiring immediate physician attention, 60 min. If other services such as advanced care planning, diagnostic services, and some minor RADIOLOGY PRIOR AUTHORIZATIONS A single authorization for CPT code 70540, 70542, or 70543 includes imaging of the Orbit, Face, Sinuses, and Neck. Multiple authorizations are not required. As the pre-authorization process can be very time-consuming, requiring constant follow-up by the radiology office, it is more practical to outsource the task.

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Interested in being added to this list of clients? Contact us for a free consultation. With us, you can save 30%-40% on operating costs. Call 1-800-670-2809. WHY OUTSOURCE MEDICAL BILLING? It is a personal decision for many practices depending on their needs and their staffs expertise. Medical billing is the most important business process in healthcare revenue cycle management (RCM) and thus a crucial aspect for healthcare practices and their providers.It is important to handle the medical billing process meticulously because the facility’s or medical practice’s cash flow BILLING AND CODING LABORATORY PANELS AND THEIR COMPONENTS 8596 E. 101st Street, Suite H Tulsa, OK 74133. Main: (800) 670 2809 Fax: 972-466-5385 E-mail: info@managedoutsource.com KEY STRATEGIES FOR IMPROVING CLINICAL DOCUMENTATION IN 2020 Precise, complete, trustworthy, and timely documentation is critical to validate services provided, reduce risks, and improve patient care. With accurate clinical documentation, a medical billing company can help healthcare providers submit valid claims for reimbursement. If the information presented in the documentation does not provide a complete and accurate picture of the care received JUNE IS ALZHEIMER’S & BRAIN AWARENESS MONTH Alzheimer's and Brain Awareness Month is the perfect time to hold conversation about the brain, Alzheimer’s disease, and other

dementias.

JUNE IS OBSERVED AS SCOLIOSIS AWARENESS MONTH Recent Posts. June Is Scoliosis Awareness Month – Supporting People with Spinal Disorder June 7, 2021; ICD-10 Codes for Common Cycling Injuries June 4, 2021 ANESTHESIA CODING AND BILLING Anesthesiologists face specific coding challenges due to cancelled anesthesia, monitored anesthesia care, failed medical direction, invasive line placement rules, and start/stop times. RADIOLOGY PRIOR AUTHORIZATIONS A single authorization for CPT code 70540, 70542, or 70543 includes imaging of the Orbit, Face, Sinuses, and Neck. Multiple authorizations are not required. As the pre-authorization process can be very time-consuming, requiring constant follow-up by the radiology office, it is more practical to outsource the task. URINALYSIS MEDICAL BILLING GUIDELINES AND PROCEDURE CODES Urinalysis is the analysis of urine for the diagnosis and monitoring of several medical conditions such as urinary tract infections, bleeding in the urinary system, or kidney or liver disease as well as diabetes, some diseases of the blood, and bladder stone. BILLING FOR TESTOSTERONE SHOT A study published in the Journal of Clinical Endocrinology & Metabolism at the beginning of this year points out that an increasing number of older and middle-aged men in the United States are being tested for low testosterone levels and being prescribed testosterone medications over the past decade. On the basis of this study, we can say there should be a hike in the number of patients

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OSI » Blog

2019 CPT CODE UPDATES FOR FINE NEEDLE ASPIRATION BIOPSY(IES) Posted on May 8, 2019May 8, 2019

by Julie Clements

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Fine Needle Aspiration (FNA) is a simple biopsy technique in which a thin needle is passed through the skin to obtain a sample of a fluid or tissue from a swelling or lump. In 2019, there are several changes to FNA CPT codes. Partnering with an experienced MEDICAL BILLING AND

CODING COMPANY

is the best way for physicians to keep up with these updates and report FNA procedures for optimal reimbursement. FNA – A SIMPLE OFFICE DIAGNOSTIC PROCEDURE FNA is usually done in the breast, thyroid gland or lymph nodes in the neck, groin, or armpit. It is an effective technique for rapid tissue diagnosis of a suspicious lump, cyst or mass discovered in these areas during a physical exam, CT scan, mammogram or ultrasound. A relatively non-invasive, less painful and quicker method than surgical biopsy, FNA can help make a diagnosis or rule out conditions such as cancer. This simple office technique which is performed through the skin comes with many benefits: * Rapid, highly accurate diagnosis

* Economical

* Samples can be taken from various sites in one sitting * Minimal discomfort for the patient * Makes possible many ancillary techniques such as bacterial culture, flow cytometry, cytogenetics, etc. * Safe with low rate of complications * Requires little recovery and results are available quickly FNA CODING CHANGES 2019 Prior to January 1, 2019, FNA biopsy(ises) was reported separately with imaging guidance. Changes in 2019 include: * A single code to report fine needle aspiration of an initial lesion, without imaging guidance * New CPT codes to report FNA biopsy(ises) according to number of separate lesions biopsied in the same session, same day and by imaging modality used to guide the biopsy, including ultrasound, fluoroscopy, computed tomography (CT), and magnetic resonance (MR) * New add-on CPT codes to report each separate lesion beyond the first lesion based on whether imaging guidance is used-and, if so, which type (ultrasound, fluoroscopy, CT, or MR). The FNA code changes for 2019 are as follows:

_ __ __ __NEW_:

10021

Fine needle aspiration biopsy, without imaging guidance; first

lesion

#+10004

each additional lesion

#10005

Fine needle aspiration biopsy, including ultrasound guidance; first

lesion

#+10006

each additional lesion

#10007

Fine needle aspiration biopsy, including fluoroscopic guidance;

first lesion

#+10008

each additional lesion

#10009

Fine needle aspiration biopsy, including CT guidance; first lesion

#+10010

each additional lesion

#10011

Fine needle aspiration biopsy, including MR guidance; first lesion

#+10012

each additional lesion _ __ __DELETED_: Code 10022 _Fine needle aspiration; with imaging guidance_ has been deleted. _NO CHANGE_: Evaluation of fine needle aspirates is still reported with CPT codes 88172 and 88177.

POINTS TO NOTE

* AAPC points out that providers can “mix and match” the primary and add-on codes in any combination necessary to report medically-necessary services rendered. For example, FNA of an initial lesion using CT guidance can be reported along with an add-on code to report FNA of one additional lesion without guidance. * In each case, only one primary (“initial lesion”) code can be reported, and modifier 59_Distinct procedural service_ should be appended to any add-on (“each additional lesion”) codes reported, if the add-on code(s) and the initial code describe different types of imaging, such as when reporting FNA of an initial lesion using CT guidance, and FNA of an additional lesion using MR, ultrasound, fluoroscopy, or no guidance. This rule applies regardless of whether the lesions are ipsilateral or contralateral to each other, and/or whether they are in the same or different organ/structures. * Imaging should not be reported with any of the new FNA codes. * In 2019, CPT clearly defines fine needle aspiration (FNA) biopsies and core needle biopsy: * _Fine needle aspiration (FNA) biopsy_is performed when material is aspirated with a fine needle and the cells are examined cytologically. * _Core needle biopsy_is typically performed with a larger bore needle to obtain core sample of tissue for histopathologic evaluation. * When FNA biopsy is performed on one lesion and core needle biopsy is performed on a separate lesion, same session, same day using the same type of imaging guidance, both the core needle biopsy and the imaging guidance for the core needle biopsy can be reported separately

with modifier 59.

* When FNA biopsy is performed on one lesion and core needle biopsy is performed on a separate lesion, same session, same day using different types of imaging guidance, both the core needle biopsy and the imaging guidance for the core needle biopsy may be reported with

modifier 59.

Here is an example of correct coding provided by the American Academy of Clinical Endocrinologists (AACE): * Ultrasound guided fine needle aspiration biopsy on a single, left thyroid nodule CPT Code 10005 – RT * Ultrasound guided fine needle aspiration biopsy on a left thyroid nodule and a right thyroid nodule: CPT Code 10005- RT; CPT Code

+10006-LT

In this case, modifier 59 would not be appended since the CPT description of code 10006 indicates an additional lesion. Proper documentation is necessary to ensure accurate coding. The documentation should: * Identify the location of each treated lesion * Provide a detailed description of each treated lesion * When guidance is used, identify the type of modality (such as ultrasound, fluoro, CT, MR) for every lesion treated * Explain medical necessity for each treated lesion OUTSOURCING MEDICAL BILLING and coding can ensure accurate claim submission. Experienced coders in such companies are knowledgeable about the new and revised CPT codes and descriptions for fine needle aspirations and can submit error-free claims for this commonly performed procedure. CategoriesBlog , Medical

Coding Updates

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