The U.S. healthcare system is and will continue to be dependent on clinical codes and is thus equally dependent on accurate and complete clinical documentation.
E/M coding and reimbursement for hospital outpatients could change dramatically if CMS finalizes its proposal to replace current E/M CPT® codes with three G-codes.
Our experts answer questions about NCCI edits for injections, modifier -25, modifier -59, laminotomy with insertion of Coflex distraction device, billing mammogram for needle placement, and auditing electronic orders.
In January 2013, CMS introduced 42 therapy functional reporting G codes (nonpayable). These G codes are to be reported in conjunction with therapy services (physical, occupational, and speech). CMS also introduced seven complexity/severity modifiers to be used with these G codes.
Radiation oncology uses high-energy radiation to shrink or kill tumors or cancer cells with minimal harmful effects to healthy surrounding cells. To correctly code for radiation oncology services, coders need to understand the various elements of the treatment.
Our experts answer questions about modifiers for diagnostic interventional procedures, Medicare recognition of CPT® code 9066, reporting add-on code for psychotherapy with interactive complexity, reporting G0378 for all payers, and wound care coding.
Being audited is rarely fun. After all, you're probably going to lose money, face a fine, or both. More and more entities are auditing healthcare claims-Recovery Auditors, Medicare Integrity Contractors, MACs, FIs, commercial payers, and on and on.
Editor's note: Facilities need to address coding, payment, and coverage issues for molecular pathology. This article is the first in a series and discusses molecular pathology coding.
The AMA added five new nuclear medicine codes to the radiology section of the 2013 CPT Manual, while revising and deleting a number of codes that represented outdated technology or were bundled into placement procedures.
