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CDC Issues Coding Guidance for Vaping

In a very rare and unprecedented move, The Center For Disease Control (CDC) has issued ICD-10 Coding Guidance for coding encounters related to e-cigarette or vaping use on 10/17/2019. Usually left to AHA Coding Clinic, the CDC has issued ICD-10 Coding Guidance this document “Vaping Coding Guidance 2019” and can be found here: https://www.cdc.gov/nchs/data/icd/Vapingcodingguidance2019_10_17_2019.pdf

CPT & Anesthesia Code Removals from “IP Only List”

Author here is by David Waldman, CPC and is shared with express permission. Below is my formal comment to CMS regarding the removal of CPT® 00670 from the inpatient only list for 2019 OPPS/ASC Final Rule. We had received a denial in the past for ACDF procedure with instrumentation where it was performed on observation…
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My Modifier Moment- 78

    Modifier 78 is another global modifier used to show a payer why a service in the global period should be reimbursed.    It differs from 58 as it is not used on a planned service or a more extensive service but is used for situations that are unexpected or unusual but are related…
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My Modifier Moment-Modifier 58

  Modifier 58 can be often confused with modifier 78.    Modifier 58 is a staged or related service done in the post operative period of another global procedure by the same physician. Modifier 58 also resets the global period unlike modifier 78.    The other error frequently made is adding this modifier on procedures…
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All About Seventh Character “A”

  This coding tip has to do with the seventh character “A” used in chapter 19 of the ICD-10-CM book. If you read the guidelines in Chapter 19 (Injury, Poisoning, and Certain Other Consequences of External Causes) you will see that the seventh character “A” means initial encounter and is used for each encounter where…
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Coding Tip of the Week– ICD-10 Coding of Cervical Disc Disorders

There are many different ICD-10 codes to choose from when coding cervical disc disorders. For purposes of this post, we will only focus on the M50 series in general, and not the specifics of each subcategory. If you look in the ICD-10 book at the M50 series, you will see a note. The note states “Code…
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Coding Tip of the Week–Choosing the Correct CPT for Unilateral Hip X-rays

Sometimes there still is confusion on the CPT coding for a unilateral hip x ray. At first glance, it sounds easy enough because there are only 3 to choose from. You have 73501 for 1 view, 73502 for 2-3 views, and 73503 for a minimum of 4 views. Piece of cake, right? So, say you’re…
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Modifier Moment-59

The 59 modifier is one of the most misused. I believe it lies in the fact that many coders rely on Encoders but do not apply the known coding guidelines to the information given.  For example we are told when we place 2 codes in an Encoder “ a modifier MAY be used to override…
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Modifier Moment- 25

25 modifier use and mis-use By CPT definition this modifier is used to unbundle a “ (significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service)” So how do you tell when the evaluation is significant or separately identifiable? In some cases it’s…
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Orthopaedic and anesthesia providers to pay $3.2 million to settle false claim act allegations

FOR IMMEDIATE RELEASE Thursday, March 29, 2018  ATLANTA – The U.S. Attorney’s Office for the Northern District of Georgia has announced that Georgia Bone & Joint (GBJ), Southern Bone & Joint a/k/a Summit Orthopaedic Surgery Center (Summit Surgery Center), Southern Crescent Anesthesiology, PC (SCA), Sentry Anesthesia Management, LLC (Sentry), and David LaGuardia (LaGuardia) agreed to…
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