Question: We are having a disagreement in our coding department. Our cardiologist sees an inpatient at the hospital, but it’s a patient she knows from the office. Should she bill an initial hospital service code or a subsequent hospital service code when she sees this patient, who she knows and has seen many times? Answer: […]
Archives for February 2019
Screening for Skin Cancer
Dermatologists frequently see patients for skin checks, to examine their skin for signs of pre-malignant or malignant lesions. Some of these patients have a personal history of malignant skin neoplasms, and some do not. The appointments may be scheduled annually or bi-annually. Will insurance pay for screening for skin cancer? Medicare and private insurances are […]
Diagnosis Coding for Dermatology
Diagnosis notes for dermatology Be sure to match the diagnosis to the procedure. For example, For skin tag removal, use skin tag For treatment of warts, use warts For excision of malignant lesions, use a malignant lesion code Describe conditions in the physical exam Only use diagnosis of “inflamed” seborrheic keratosis if the exam describes […]
Coding for Breast Procedures: Biopsy, Localization Devices, and Surgery
From biopsy to localization device to mastectomy, coding for breast procedures can be challenging. This article summarizes the rules related to these services. Fine needle aspiration of a breast mass, or aspiration of a cyst Fine needle aspiration (FNA) of a breast mass is reported with codes 10021—10012. CPT® developed new codes for FNA in 2019. […]
Chronic Care Management Services (CCM), CPT® 99491: new code in 2019
CPT® has added 99491 to the section of chronic care management codes. The other code in this section is 99490 and there are two codes in the complex chronic care management section, 99487 and 99498. This article will discuss CPT® 99491. For in-depth information about existing codes, read our feature about chronic care management here on […]
Overview of Medicare Telehealth Services
Please see the Telemedicine article for the rules and guidelines for use during the COVID-19 public health emergency. Medicare covers some services performed via real-time audio and video between a patient in an underserved area and a physician or other practitioner who is not in the same place as the patient. Requirements for Medicare telehealth […]
Screening Codes Guide – G0442, G0443, G0444, G0446, G0447
Medicare pays for some screening services for its beneficiaries, using HCPCS codes. These screening codes are time-based HCPCS codes with relatively low wRVU values and payment. This coding guide includes an explanation of the guidelines for each of these codes, and information about bundling, diagnosis coding, specialty and site of service restrictions, and much more.
Pre-operative Clearance in Primary Care
Primary care practices are frequently asked to do preoperative evaluations or clearances on their own patients by a surgeon. Although a routine history and physical mandated by the hospital is included in the surgical payment, patients may need an evaluation by their primary care clinician, a cardiologist, pulmonologist, or other practitioner prior to surgery. These […]