Definition of Mohs Micrographic Surgery CPT code Mohs micrographic surgery is a special technique used to treat complex or ill-defined skin cancer and requires a single physician to provide two distinct services. The first service is surgical and involves the destruction of the lesion by a combination of chemosurgery and excision. The second service is that of a pathologist and includes mapping, color coding of specimens, microscopic examination of specimens, and complete histopathologic preparation. This work requires a specially trained physician acting as both surgeon and pathologist. CPT code 17311,…
Read MoreList of I-OCE (Outpatient code edit) edits Part 2
Edit Number Edit Hospital Type Edit Description Edit Result/Claim Disposition Provider Action/Response 81 OPPS edit Mental health service not payable outside the partial hospitilization program This edit occurs when a mental health service that is not payable outside the PH Program is submitted on a 012X or 013X TOB without condition code 41. The claim will be returned to provider. The provider should resubmit the claim once the problem(s) is/are corrected. 82 OPPS edit Charge exceeds token charge ($1.01) This edit occurs when modifier FB is attached to a procedure…
Read MoreNew Practice Surgery Medical Coding Charts
Surgery Medical coding Chart 1 PREOPERATIVE DIAGNOSIS: Adenocarcinoma in situ of cervix. POSTOPERATIVE DIAGNOSIS: Awaiting pathology report. PROCEDURE: Cold conization of cervix. SURGEON: ASSISTANT: None. ANESTHESIA: Dr. PACKS: Vaginal pack of half-inch plain gauze placed in endocervix and vagina. DRAINS: None. ESTIMATED BLOOD LOSS: Less than 50 cc. FINDINGS OF PROCEDURE: The patient was brought to the operating room where she was identified, anesthetized, and placed in low lithotomy position, prepped and draped in usual manner.Time-out was taken.She was given 2 g of Ancef IV. The exam under anesthesia revealed…
Read MoreList of I- OCE (Outpatient code edit) edits Part 1
Edit Number Edit Hospital Type Edit Description Edit Result/Claim Disposition Provider Action/Response 1 Both OPPS and non-OPPS edit Invalid diagnosis code This edit occurs when the principal diagnosis field is blank, there are no diagnoses listed, or the diagnosis code is not valid for the selected version of the program. Each ICD-10-CM diagnosis code is edited for completeness and validity. Codes without the required number of digits are considered invalid. Codes are also checked to insure that they were valid at the time of the patient’s visit. Date validity is…
Read MoreList of MCE (Medicare Code Editor) edits
Medicare Description Explanation 1 INVALID DIAGNOSIS OR PROCEDURE CODE The Medicare Code Editor checks each diagnosis including the admitting diagnosis and each procedure against a table of valid ICD-10-CM and ICD-10-PCS codes. If an entered code does not agree with any code on the internal list, it is assumed to be invalid. 2 EXTERNAL CAUSES OF MORBIDITY CODES AS PRINCIPAL External causes of morbidity codes are ICD-10-CM codes beginning with the letter V through Y. They describe the circumstance causing an injury, not the nature of the injury, and therefore…
Read MoreSuperb Coding tips for Brain Imaging Studies
Basics of CPT code 78600 & 78601 Brain imaging in nuclear medicine provides functional diagnostic information of the central nervous system. Brain imaging is particularly useful when paired with information from a patient’s clinical evaluation and other brain imaging studies, such as computerized tomography (CT) and magnetic resonance imaging (MRI). In medical coding, we have separate procedure codes for brain imaging studies. 78600 – Brain imaging, less than 4 static views; 78601 – Brain imaging, less than 4 static views; with vascular flow Before we move ahead, let us check some similar…
Read MoreAutoimmune hemolytic anemia ICD-10 CM Coding guide
Basics of Autoimmune hemolytic anemia ICD-10 CM Coding Autoimmune hemolytic anemia (AIHA) is a rare immune disorder. It happens when your body mistakes red blood cells as foreign substances and attacks them. ICD-10 code D59. 10 for Autoimmune hemolytic anemia, unspecified is a medical classification as listed by WHO under the range – Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism . D59.1 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.…
Read MoreVertebroplasty, Kyphoplasty and Sacroplasty CPT coding tips
Definitions of Vertebroplasty, Kyphoplasty and Sacroplasty CPT coding Percutaneous Vertebroplasty: a minimally invasive procedure performed under fluoroscopic or computed tomography guidance. The cement that is injected into the vertebral body hardens immediately, reinforcing the collapsed vertebrae and providing immediate relief of pain. Percutaneous Sacroplasty: this procedure, essentially identical, to the work done in the percutaneous vertebroplasty and entails guided injection of PMMA through a needle inserted into the fracture zone. It is most often described as a minimally invasive procedure employed as an alternative to conservative management (3-5) for sacral…
Read MoreBest coding guide for Initial & Subsequent Observation Care CPT codes
Basics about Initial observation Care E/M CPT codes Significant changes were made to the Evaluation and Management (E/M) Hospital Inpatient and Observation Care Services subsection of the Current Procedural Terminology (CPT®) 2023 code set. Other E/M subsection revisions were discussed in previous CPT Assistant issues. In this issue, the newly combined subsection of hospital inpatient and observation care services for both new and established patients will be discussed. Combining these services into one subsection has required the deletion of seven codes and revision of 11 existing codes. While this new subsection uses…
Read MoreFatigue ICD-10 CM Coding Guide
Basic information on Fatigue ICD-10 CM codes Fatigue is a condition marked by drowsiness and an unusual lack of energy and mental alertness. It can be caused by many things, including illness, injury, or drugs. Fatigue is a lack of energy and motivation. R53.83 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Fatigue being a symptom, as per the ICD 10 coding guidelines, symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a related definitive diagnosis has not been established…
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