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Reader Question: Debridement May Be Bundled

19. March 2014

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Question: Our orthopedic surgeon did a debridement of the labrum along with a rotator cuff repair and decompression and partial clavicle resection. The operative note follows: “There were large bony spurs present on the lateral aspect of the humerus as well…

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ICD-10: CMS to Offer ‘End-to-End’ ICD-10 Testing This Summer

19. March 2014

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The agency intends to select participants by April. You are already aware of the ICD-10 testing period that will launch in just a few weeks, but CMS has even more in-depth system up its sleeve that will ensure that claims…

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Physician Note: CMS: Time Is on Your Side for Psych Billing

19. February 2014

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Revisions to CPT’s psychiatry and psychotherapy codes last year led to helpful new coding opportunities for practices—but were also wrought with errors, CMS has determined. In an effort to quell the problems that these codes were creating, the agency issued MLN…

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Part B Payment: Bilateral Cerumen Removals Could Prompt Denials

19. February 2014

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Medicare decides not to pay for two cerumen removals in the same visit. When  CPT® clarified the language in  CPT® 2014 regarding cerumen removal, it seemed like good news. But thanks to a CMS rule, that news could be turning sour. Background:  CPT® 2014 changed the…

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2013 Coding Wrap-Up: Take This Quiz to Determine How Well You’ve Studied This Year’s Coding Regs

14. January 2014

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You can’t go into 2014 without firm knowledge of the current rules. The calendar is about to turn to 2014, but before you move toward January and the New Year, make sure you’ve got the 2013 coding rules down pat.…

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Pecos Edits: Beware ‘N544′ Errors Now That PECOS Edits Are Active

14. January 2014

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Unless CMS retroactively reverses the decision, those edits were turned on Jan. 6. You may have gotten used to pushing the PECOS edits off of your plate thanks to CMS’s multiple delays, but now that the time is here, the…

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Part B Coding Coach: Help – Don’t Hinder – Your Total Hip Replacement Recording By Following This Expert Advice

18. December 2013

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Never skip the underlying cause, infections, or dislocations. If you’re overlooking the underlying cause for the replacement surgery and any infections or dislocations in the replaced hip, then you could be leaving precious dollars your physician ethically deserves on the…

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Part B Payment: Final 2014 Fee Schedule Confirms 20.1 Percent Conversion Factor Cut

18. December 2013

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Services hit hardest include ECGs, lesion destruction. If you’re looking for a silver lining to the Final 2014 Medicare Physician Fee Schedule, it’s that although the conversion factor will be steeply slashed by 20.1 percent, it could have been worse,…

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Part B Coding Coach: Navigate the New-Versus-Established-Patient Maze with Expert Tips

20. November 2013

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Different locations, same physician? Use established patient codes. When reporting many common E/M services, you must ask yourself two questions: First, is the patient new or established? And second, what are the documented levels of history, physical exam, and medical…

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ICD-10: J45 Shifts Focus to Severity for Asthma Reporting

20. November 2013

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Hint: Identify symptoms and medication use for accurate reporting. Asthma is a common condition that you may diagnose and treat at your Part B practice, so it’s vital to know the specifics of reporting this condition using ICD-10 codes before…

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