Reader Question: Nail Down Chest PT Codes

Question: A patient with cystic fibrosis received chest physical therapy in the office, and the pulmonologist demonstrated breathing control, percussion, and vibration techniques to the patient. The patient’s mother performed the [...]

Posted on: 21 June 2017 | 5:06 am

Reader Question: Spirometry Must Be Supported With Specific ICD-10 Codes

Question: We performed spirometry and the doctor wrote that it was for “chronic bronchitis,” but we don’t see that listed on our payer’s local coverage determination. Can you advise what we [...]

Posted on: 21 June 2017 | 5:06 am

Reader Question: Be Ready to Answer EOB Questions

Question: One of our patients called the other day and asked us several questions about an explanation of benefits (EOB) she had recently received. She said it “looks like a bill.” [...]

Posted on: 21 June 2017 | 5:06 am

Reader Question: Some Payers Will Reimburse Consults

Question: We saw a 55-year-old new patient who has been smoking for 30 years. She was referred for consult by her GP after experiencing frequent shortness of breath. The pulmonologist performed [...]

Posted on: 21 June 2017 | 5:06 am

You Be the Coder: Get Specific When COPD Patient Has Bronchitis

Question: One of our COPD patients presented with bronchitis. Our pulmonologist wants to only report J44.0 (Chronic obstructive pulmonary disease with acute lower respiratory infection) but the coder wants to report [...]

Posted on: 21 June 2017 | 5:06 am

Appeals: Did You Submit A Claim With Clerical Errors? Look to Reopening

You may not need a full appeal in this instance, MAC staffers advise. It’s a common situation — you submit a claim with great confidence that it [...]

Posted on: 21 June 2017 | 5:06 am

Coding Errors: CMS: Pulmonologists Logged Sky-High Initial Hospital Visit Error Rates

Avoid making the same mistakes these doctors made. You see a patient in the hospital and perform her initial workup, then report the appropriate E/M code. Easy, [...]

Posted on: 21 June 2017 | 4:06 am

ICD-10-CM: Proposed ICD-10 Codes Could Change Your Mesothelioma Coding in October

At last, coders may finally have a place to turn for secondary mesothelioma and other conditions. Mesothelioma coding could be set for a pretty big overhaul as [...]

Posted on: 21 June 2017 | 4:06 am

Reader Question: This MAC Reveals How It Reviews Modifier 25 Claims

Question: Our office manager is always nervous when we submit a claim with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care [...]

Posted on: 22 May 2017 | 4:05 am

Reader Question: Get the Lowdown for State Refund Amounts

Question: Two years ago, we saw a patient who came to our office for shortness of breath. Her insurer later wrote to us and said we had to refund an overpayment [...]

Posted on: 22 May 2017 | 4:05 am