Mar 18, 2003 The Coding Institute Acquires Ingenix® Line of Coding Newsletters

The Coding Institute is pleased to announce the acquisition of the Ingenix line of newsletters. The addition of these newsletters will increase the company’s ability to provide valuable coding and compliance information to healthcare professionals nationwide.

Jun 13, 2002 MNT Works: Discover Nuts and Bolts for Optimum Reimbursement of Nutrition Therapy Services

NAPLES, FL (Medical Coding Wire) Medicare recently began covering medical nutrition therapy (MNT) services for certain patients with diabetes and kidney disease. Many physicians are unfamiliar with these codes because final rules for their use were only recently developed.

Jun 11, 2002 Patient Telephone Intake Form

Copy of a sample patient intake form for Medical Office Biling and Collections subscribers to download.

Mar 25, 2002 Three-Month Carrier Grace Period Is Over...

Effective April 1, carriers nationwide implemented the new 2002 changes for CPT, ICD-9 and HCPCS codes, and if you are still coding by 2001 rules, your claims will be denied.

Mar 14, 2002 CMS Clarifies Reporting of Diagnostic Test Results

CMS Program Memorandum AB-01-144 (effective Jan. 1, 2002) offers physicians much-needed direction on when to use signs or symptoms as the reason for ordering a test, as well as when to use the test results as the diagnosis. Carrier restrictions and ambiguity left many PM&R coders confused over whether to use the patient’s symptoms as the reporting diagnosis for tests such as electromyography (EMG) (95860-95872) or nerve conduction studies (95900-95904).

Mar 14, 2002 Know When to Use Glaucoma Screening Codes versus E/M or Eye Codes

Ophthalmologists initially welcomed Medicare’s decision to cover glaucoma screening effective Jan. 1, 2002. However, using these codes requires understanding the limitations of G0117 and G0118.

Mar 14, 2002 IVUS and Diagnostic-Procedure Codes Can Be Billed Together

Cardiologists should not assume that reimbursement for intravascular ultrasound (IVUS), whether coronary or peripheral, is simple. Code descriptors were modified in CPT 2000 so the codes could be added to diagnostic as well as therapeutic procedures. However, carriers have yet to revise existing policies and may restrict coronary IVUS to therapeutic procedures only and reject peripheral IVUS altogether.

Feb 14, 2002 New Trigger Point Injection Codes Afford More Precision

When CPT 2002 was introduced, PM&R coders were pleased to see new trigger point injection codes (20552-20553), along with new codes for carpal tunnel injections (20526) and tendon origin/insertion injections (20551). Because trigger point injections are among the most commonly performed pain management procedures in PM&R practices, the new codes were significant to physiatrists, particularly since the old trigger point injection code (20550) was vague and confusing, and often resulted in denials when billed for more than one site. Many carriers, however, have yet to release guidelines for billing these new codes, which have been in effect since January 1. Knowing the eight injection sites and how to break down the number of muscles injected will help coders differentiate between these new codes and determine when it is most appropriate to use them.

Feb 14, 2002 CMS Delay Impacts FNA and Bone Marrow Coding for OPPS

CMS has delayed the effective date of the payment rates announced for the Medicare hospital outpatient prospective payment system (OPPS) until further notice. The delay is due to errors in the Nov. 30, 2001, Federal Register announcing the final ambulatory payment classification (APC) groups due to go into effect Jan. 1, 2002. CMS will continue to pay for services covered under the OPPS under the rates in effect on Dec. 31, 2001, until the revised rates are published, no later than April 1, 2002. For pathologists paid under OPPS for fine needle aspiration and bone marrow aspiration or biopsy, continue to report these services with the 2001 CPT codes until the new APC rates are effective.

Feb 14, 2002 Coding Initiative Recalls Arthroscopy Bundling Indicator Edit

A coding edit in Correct Coding Initiative version 8.0 (CCI 8.0), in effect Jan. 1-March 31, 2002, caused major concern among orthopedic coders, who felt the code bundling was out of line with other CCI edits, American Academy of Orthopaedic Surgeons (AAOS) guidelines and conventional coding wisdom. As a result, CCI has issued a recall of the edit, effective April 1, 2002.

Feb 14, 2002 Deletion of G Code Should Prompt Call to Part B Carriers

Cardiologists who review data gathered by a non-looping event monitor and report G0016 should take note: HCPCS 2002 has deleted G0016 without providing further advice on how interpretation should be billed.

Jan 15, 2002 CCI 8.0 Includes Eyelid Reconstruction, Screening

Version 8.0 of the Correct Coding Initiative (CCI), effective Jan. 1, 2002, includes several significant new edits for ophthalmologists: Two eyelid reconstruction codes include lesion removal; eye exam and E/M codes include Medicare’s new glaucoma screening G codes; and an exam under anesthesia includes gonioscopy. CCI also made some minor edits.

Jan 15, 2002 CMS Serves Up Payment for Nutrition Therapy

As of Jan. 1, 2002, Medicare will pay registered dietitians and nutritional professionals for services provided to patients with diabetes and kidney disease.

Jan 14, 2002 Tonsillectomy/UPPP Bundling: Clear the Way to Payment

Otolaryngologists who review Correct Coding Initiative version 8.0 (CCI 8.0) may be disappointed to find that the CCI now bundles tonsillectomy — 42826 (tonsillectomy, primary or secondary; age 12 or over) — with uvulopalatopharyngoplasty (UPPP) — 42145 (palatopharyngoplasty [e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty]) — and gives the edit a “0” indicator (i.e., physicians cannot append a modifier to 42826 to bypass the edit).

Jan 14, 2002 Fine Needle Aspiration Edits Top List of Latest Coding Initiative Changes

Correct Coding Initiative version 8.0 (CCI 8.0) includes more than 8,000 new edits valid Jan. 1-March 31, 2002. The most important changes for general surgeons involve fine needle aspiration (FNA); endoscopies of the colon, rectum and anus; and laparoscopic enterectomy performed in conjunction with an open partial colectomy.

Jan 14, 2002 Carriers Set the Pace on Billing for Biventricular Device Implantation

With the Food and Drug Administration’s (FDA) approval of the Medtronic InSync cardiac resynchronization system in August 2001, the way was cleared for biventricular pacemaker implantation to help patients who have moderate to severe heart failure and remain symptomatic despite stable, optimal medical therapy.

Jan 14, 2002 New OB Anesthesia Codes Better Describe Service Provided

One of the biggest changes to the anesthesia section of CPT for 2002 was the addition of a new subsection of codes for obstetrical services and the deletion of several related codes. With obstetrical anesthesia being such a complex area of care, practitioners and coders welcome the changes as a way to report services more accurately and need to know how to use the new codes correctly.

Jan 14, 2002 Medicare Adopts Specialty Designation for Pain Management

Effective Jan. 1, 2002, CMS recognizes a specialty designation for pain management physicians. Although Medicare’s adoption of this specialty code, -72, represents a major achievement for the field of pain management, the code is only for tracking pain management services. Medicare fees and coverage will be unaffected.

Jan 4, 2002 Medicare Honors Nutrition Therapy, Pain Management Claims

Medicare began honoring claims for nutrition therapy and pain management on Jan. 1, 2002.