DAVID STERN, MD (Practice Velocity) Q. What codes should we use in place of the discontinued 90701 (tetanus vaccines, diphtheria, tetanus toxoids, and whole cell pertussis vaccine [DTP], for intramuscular use) and 90718 (tetanus and diphtheria toxoids [Td] absorbed when administered to individuals 7 years or older, for intramuscular use) that were discontinued effective July 1, 2012? A. You should use 90714 (Tetanus and diphtheria toxoids [Td] absorbed, preservative free, for use in individuals 7 …
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September 2012
E/M Coding for Multiple Visits, Contracted Case-rate Billing, Comparing Payor Reimbursement Policies
DAVID STERN, MD (Practice Velocity) Q. We sometimes have patients who require two visits to clear impacted cerumen in their ears. In some cases, this procedure requires a 24-hour regimen to soften the cerumen prior to flushing the ear. How do we bill for the second visit and does it change how we bill if we find a second diagnosis after we clear the cerumen? A. For the second visit, you may code for all …
Read MoreHospital Emergency Departments and Urgent Care Proximity, New vs. Established Patients using E/M Coding, Private Practice Urgent Care Coding
DAVID STERN, MD (Practice Velocity) Q. If a practice buys or opens an urgent care facility that is not in a hospital nor affiliated with a hospital, should we be using routine E/M codes for our visits? Secondly, do we have to follow the Emergency Medical Treatment and Active Labor Act (EMTALA) Guidelines? A. Yes. You should use the same E/M codes as used by the physician offices (990201-99215). EMTALA does not apply to urgent …
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July/August 2012
June 2012
Benchmarks for E/M Codes; Place of Service (POS) Codes
DAVID STERN, MD (Practice Velocity) Q. Is there a benchmark for E/M codes in the urgent care setting? For instance, are there a certain percentage of 99213 vs. 99214 for established patients? Currently out urgent care providers’ coding is being compared to CMS Family Practice standard. A. To my knowledge, there is no published information detailing E/M distribution for urgent care facilities. If there was, however, it would simply document what was actually being coded …
Read MoreCoding of Multiple Wound Repairs, Coding an E/M, IV Infusion, Coding of the Comprehensive Metabolic Panel
DAVID STERN, MD (Practice Velocity) Q. We have a patient with several lacerations to both of his hands. On his left hand, we sutured a total of three lacerations that have a grand total of 3.5 cm and on his right hand, we sutured on laceration with a total of 3.0 cm. What is the best way to code this? A. Assuming that all the procedures were simple wound repairs, you would simply add the …
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May 2012
