The most important section in diagnosis coding is the Pregnancy codes. Yes, there has been lot of changes in the pregnancy chapter. Coding of breast mass or lump has become more specific now. Similarly, the new specific Z codes for antenatal screening has been added. Also, you would have learnt now Z3A codes should not be used with the abortion codes. Some of the codes have been revised in this chapter. Read also: CPT coding guidelines for TURP CPT codes ICD 10 codes for Tubal or Ectopic Pregnancy Yes, ectopic…
Read MoreSample Coded Report for CPT code 99282
Chief Complaint & History of Present Illness : cc: I have something in my eye HPI: this is a 67 yo female who has the sensation that something is in her eye. It began gradually last night. It is more irritated if she opens her eye but light does not bother it. SHe denies any change in her baseline vision. She denies ha but had 15 seconds of pain lateral to her eye last night. She has a history of 3 eye surgeries. One was a cataract surgery. Medical Decision…
Read MoreCPT code 38792 & Lymphoscintigraphy 78195 : Sentinel Injection coding
Basics of CPT code 38792 Sentinel node is the first in the chain of lymph nodes which drains lymphatic fluid from the malignant tumor. In sentinel lymph node injection the physician tries to identify the first lymph node receiving lymphatic drainage from a tumor. Sentinel lymph node injection is done commonly for breast cancer and melanoma. The injection is usually done several hours before or a day before surgical procedure to remove sentinel nodes. Mainly CPT code 38792 and 78195 are used for coding sentinal node injection and imaging. According…
Read MoreCPT code 63020, 63030 & 63035 Coding tips
Basics of Procedures code CPT code 63020, 63030 & 63035 Being a medical coder, I think spinal surgery procedure are very interesting procedures to code. As we have learnt previously how we have coded the epidural spinal injection procedures in interventional radiology. The new codes for spinal injection are bundled codes and easy to use. The use of Fluoroscopic guidance code 77003 for spinal procedure should be used very carefully, because now it has been bundled in most of the CPT codes. Today, we will learn more about spinal surgery procedures. We…
Read MoreAmazing tips for CPT code 19281, 19283, 19285 and 19287
Breast biopsies are very common procedure in interventional radiology coding. When I started coding breast biopsy, I used to code the biopsy and imaging guidance separately. But, later with new updates, CPT codes for breast biopsy and imaging guidance were bundled. This has made the job of a coder lot easier. Also, now we have separate CPT code for breast biopsy without guidance and breast biopsy with guidance. The CPT code 19100 and 19101 are used for breast biopsies without imaging guidance. Also to report image guided breast biopsy with…
Read MoreEndometrial Biopsy CPT code Coding tips
Biopsies are diagnostic procedures to obtain a tissue sample from the body in order to examine it. In interventional radiology, we have separate CPT codes for biopsy of different parts of the body. The most common and diverse coding is for Breast biopsy in Interventional radiology. However, we are here to learn how to find out CPT code for endometrial biopsy. Coding biopsy is very confusing while coding medical charts; we tend to code an open procedure code for a minimal invasive procedure. We face a similar situation for coding…
Read MoreThoracentesis CPT code : Best Coding tips
Basics about Thoracentesis cpt code Thoracentesis is a procedure performed to remove excess fluid (blood or pus) that has accumulated in the space between the outside of the lungs, the pleura, and the chest wall. There are two types of thoracentesis, therapeutic thoracentesis is performed to relieve the symptoms of fluid accumulation and diagnostic thoracentesis is performed to determine the cause of the fluid build-up. Procedure code 32554 and 32555 are used to report thoracentesis CPT code, either with or without imaging. Read also: Coding tips for Central Venous Catheter Placement for Medical coders Thoracentesis…
Read MoreSuperb coding tips for CPT code 36473, 36474, 36475 and 36476
Basics about CPT code 36473, 36474, 36475 and 36476 As we know there have been many changes in Procedures codes in 2017. I have already discussed about the removal of moderate sedation from more than 400 CPT codes in 2017. Also, we have new cpt codes for coding moderate conscious sedation in 2017. Today, again we are here to learn more about new CPT codes of 2017. We have two new CPT code 36473 and 36475 for coding endovenous ablation therapy. Varicose veins are caused by venous insufficiency as a result…
Read MoreCPT code 36245, 36246, 36247 & 36248: Vascular Coding tips
Basics of CPT code 36245, 36246, 36247 & 36248 Procedure or CPT codes 36245, 36246, 36247 & 36248 are used in coding vascular family. These codes are used for selective catheter placement in an abdominal, pelvic, or lower extremity branch of a single vascular family of the arterial system. A catheter is introduced first into an extremity artery, with the preferred introduction site being a femoral artery, although an upper extremity artery may also be used. A small skin incision is made over the planned insertion site. An introducer sheath is placed…
Read MoreInpatient Sample Medical Coding Chart Example 1
In Inpatient coding, medical coders have to see lot of patient information. I have shared all the specific reports for coding inpatient charts in my previous post, inpatient coding features and characteristics. Today I am sharing a inpatient medical coding charts, which is coded with ICD 10 codes and DRG codes. This charts will include only History and physical exam Progress Notes Discharge Summary Since, these are the key reports I am sharing only these reports, hope this report will help you learn about Inpatient coding. Read also: What are…
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