DAVID STERN, MD (Practice Velocity) Q.We have so many MRSA (methicillin-resistant Staphylococcus aureus) I&Ds (incision and drainage). The follow-up for changing the packing are numerous and time-consuming, and it feels wrong to have them just included in the global procedure like any other wound check or suture removal. What’s the right way to handle this? Annie Miranda, Hopewell Junction, NY A. This is a complicated question. To code these procedures, you can consider using the …
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March 2012
February 2012
December 2011
November 2011
Nebulizer Supplies, Diltiazem IV, Influenza Vaccines with E/M Codes, and Critical Care Coding in Urgent Care
Q.I am using an EHR, but it does not seem to code nebulizer treatments correctly. It produces codes 94640 (nebulizer treatment) and J7620 (albuterol/ipra – tropium bromide), but it misses the codes for administration set, with small volume non-filtered pneumatic nebulizer, disposable (A7003) and tubing (A7011 ). Why is this? A.The administration set code (A7003) and tubing code (A7011) code are actually bundled into the code for the treatment (ie, they are included in 94640). …
Read MoreRule Number One: Code for Services Rendered
DAVID STERN, MD (Practice Velocity) Q.Which CPT codes can be used for diagnosis codes 786.50 (unspecified chest pain) and 414.9 (chronicischemic heart disease-unspecified) to maximize a Medicare patient bill? A.The basic rule of coding is that you should code for the services rendered, not to “maximize a patient bill.” In other words, you should code the best codes that indicate the actual services that were performed. For these codes, you could code for a cardiac …
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October 2011
September 2011
Medical Necessity in E/M Coding, Part 3: Correctly Coding the Physical Exam
DAVID STERN, MD (Practice Velocity) Some coding auditors do not understand the urgent care setting. As a result, they have been inappropriately downcoding evaluation and management (E/M) levels— not based on levels of documentation, but rather on whether the documentation is supported by their “view” of medical necessity, even though these auditors have usually never been providers and lack clinical experience. In this situation, the best defense is a strong offense. This column reviews medical …
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