I am billing for the ASC. Where can I find a list of codes allowed to be billed in an ASC per Medicare?
Of interest is code 67028 with drug code J2778, J0178, J9035.
Thank you!
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Tag Archives: direction
Nurse visit for medication management,looking for direction
Hoping somene can help
When patients are prescribed high risk medication such as suboxone,fentanyl,or other opiates it is common practice to have those pt come in for random pill counts,presumptive urine test and or send out urine.
Typically a lot of of work goes into the visit such as supervision of sample given(suboxne pt) reviewing med list for compliance,updating Narcotic agreements by confirming or updating pharmacy information, reviweing results of urine test with Provider and queing presciption to provider (MDM),documenting patients responce to medication,such as breakthrough pain,or symptoms of withdrawal. The Nurse visits are scheulded inbetween visits with the Proivder ,which I feel is an extensin of the Providers care ,perhpas even an "Incident To"
Currently we only use the lab code 80305 for the urine as the office manager feels that is all that should be coded.When I look at the critera for 99211 I honestly feel these Nurse visits should be more than just the presumptve lab and feel we could use both the 99211 and the 80305(wen performed)however I’m new at coding and a little reluctant to rock the boat without knowing for sure
Very much appreciate help from those in the know
When patients are prescribed high risk medication such as suboxone,fentanyl,or other opiates it is common practice to have those pt come in for random pill counts,presumptive urine test and or send out urine.
Typically a lot of of work goes into the visit such as supervision of sample given(suboxne pt) reviewing med list for compliance,updating Narcotic agreements by confirming or updating pharmacy information, reviweing results of urine test with Provider and queing presciption to provider (MDM),documenting patients responce to medication,such as breakthrough pain,or symptoms of withdrawal. The Nurse visits are scheulded inbetween visits with the Proivder ,which I feel is an extensin of the Providers care ,perhpas even an "Incident To"
Currently we only use the lab code 80305 for the urine as the office manager feels that is all that should be coded.When I look at the critera for 99211 I honestly feel these Nurse visits should be more than just the presumptve lab and feel we could use both the 99211 and the 80305(wen performed)however I’m new at coding and a little reluctant to rock the boat without knowing for sure
Very much appreciate help from those in the know
Hip Scope Coding Direction
How would this be coded? and codes to compare the unlisted codes to if it goes that way?
Left hip arthroscopic acetabular rim trimming, Left hip arthroscopic femoral head oseteochondroplasty, left hip arthroscopic labral debridement, left hip arthroscopic iliopsoas tendon lengthening, left hip endoscopic iliotibial band lengthening and trochanteric bursectomy?
Thank you all for your help.
Patient-Administered Injection of Clinic-Provided medication under direction of LPN
I reviewed a chart note in which the nurse documented that the patient administered his own IM injection under the direction of the LPN (who directed the patient on good aseptic technique, safety rules, and understanding the principles of giving intramuscular injections in the patient’s thigh.)
Since the medication was provided by the clinic but the patient administered the IM injection under the direction of the LPN, what codes can be submitted?:confused:
Medical Billing Courses – Advancing Your Career in the Right Direction
Have you ever thought about starting your career as a Medical Billing Specialist? If yes, then you should start by completing a few courses for it. These courses will not only teach you a few necessary skills, but they will also ensure you of a great, successful career in the future.
About Medical Billing Specialists
A Medical Billing Specialist is essentially responsible for maintaining all the patients’ diagnosis and treatment records in a physician’s office. In addition, he or she is in charge of:
Scheduling and confirming appointments
Carrying out a vast array of administrative work
Data entry and bookkeeping
Completion of claim forms and verifying patients’ signatures
Presenting insurance benefits to the patients as well as adhering to insurance policies and procedures
Interacting with all healthcare providers (internal and external)
Documenting the daily activities in proper medical terms
The Training
Training can either be attained through attending a community college or training school, or by taking some online Medical Billing Courses. To set your foot in this career, you must pursue an associate or bachelor’s degree in business administration or accounting right after graduating from high school. These degrees usually take approximately a year or two to complete and can be followed by opting for a range of different certifications.
These certifications are recognized by the American Medical Billing Association in the United States. Not only are they a great way to improve your credentials, but they also allow you to increase your chances of getting ahead in this field, and boost your income potential by at least 20%.
The Coursework
In general, most of the course cover the following areas of study:
Coding of Diagnosis
Information Technology
Insurance claims and billing
Introduction to different procedures used in coding medical records
However, a number of courses are also offered nowadays by the American Health Information Management Association. These usually last around 15 months and cover different aspects such as:
Medical Terminology
Medical Office Procedures
Ethical Coding and Billing Practices
Healthcare Delivery Systems
Computer Basics in Health Care and
Path-physiology and Pharmacology
Thus if you’re thinking of starting a lucrative career in the healthcare industry or advancing within this profession, then taking up some additional Medical Billing Courses is a great way to proceed within this profession.
Lisa Thomas is your guide to medical careers.
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Coding Clinic gives direction on heart failure, obstetrics, and linking language
Coding Clinic gives direction on heart failure, obstetrics, and linking language
by Laurie L. Prescott, MSN, RN, CCDS, CDIP
We are more than six months into the transition to ICD-10-CM/PCS, and at times it appears there are more questions than answers.
The last few weeks have brought us some direction, though, including the release of approximately 1,900 new ICD-10-CM codes for 2017. (The list can be found on CMS’ website.) We also have a list of approximately 3,600 new ICD-10-PCS codes for 2017. (This is also available on CMS’ site.) Of course, we will also be looking for changes in DRG mappings and the CC/MCC lists, which will likely appear later this summer.
The transition to ICD-10 was not a one-time process that ended on October 1, 2015?it will continue for quite some time. As CDI specialists, we must keep informed of the new information, including the latest guidance offered by AHA Coding Clinic for ICD-10-CM/PCS®.
The latest release, First Quarter 2016, focused on ICD- 10-CM diagnosis codes, in comparison to 2015, which focused more on the procedure side. One thing remains constant, though: It seems like every Coding Clinic offers some guidance that makes me think, "Finally, it’s about time!" yet also contains other pieces of advice that simply prompt more questions.
Heart failure differentiation
Let’s start with the long-awaited direction related to differentiation of heart failure. Coding Clinic heeded the American College of Cardiology and will now allow the more current descriptions of heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) to be coded as systolic and diastolic heart failure, respectively. This guidance is highly welcomed.
Obstetrics admission
For those who review obstetrical cases, there is guidance related to selection of principal diagnoses related to an obstetrics admission. The condition prompting the admission should be sequenced as the principal diagnosis for an obstetrical patient. If there is a complication of the delivery, the appropriate code would be assigned as a secondary diagnosis. Coding Clinic provides the example of an admission for premature rupture of membranes with a laceration complicating a delivery. In such a scenario, the principal diagnosis is pregnancy complicated by premature rupture of the membranes, and a secondary diagnosis of laceration would be assigned.
There is also guidance related to ICD-10-PCS code assignment for the repair of obstetrical lacerations; it instructs us to code the body part as related to the degree of the laceration or the deepest level of the repair as described (perineum, perineal muscle, rectal mucosa, and anal sphincter, for example).
Linking language
ICD-10-CM provides many opportunities to assign combination codes, especially those related to diabetes and the many complications associated with this condition. CDI specialists at your facility no doubt have worked diligently with providers to document the relationship using "linking language."
The question posed in this latest Coding Clinic asks if the provider must document the relationship between the two diagnoses or whether the coder can assume the relationship and assign the appropriate combination code. The answer provided (on p. 11 of Coding Clinic) actually left me more perplexed. It states:
The classification assumes a cause-and-effect relationship between diabetes and certain diseases of the kidneys, nerves and circulatory system. Assumed cause and effect relationships in the classification are not necessarily the same in ICD-9-CM as ICD-10-CM.
Several examples provided seem to infer that the relationship between diabetes and conditions such as polyneuropathy and ESRD can be assumed, unless of course there is documentation that indicates another identified cause.
Coding Clinic also reinforced the existing understanding that there is no assumed relationship between osteomyelitis and diabetes, as previously stated in Coding Clinic, Fourth Quarter 2013, p. 114.
So, although the direction related to osteomyelitis reinforces previous instruction, the direction related to diabetes and other conditions of the kidneys and nervous/ circulatory systems is brand-new and not particularly clear. What conditions are assumed and what are not? Where is "linking" required in documentation? I hope to receive further guidance related to these examples.
Review the latest Coding Clinic guidance related to diabetes and its manifestations to make sure that your CDI specialist team interprets these pieces of advice consistently. When you discover one of these "shades of gray" areas within the guidance, submit your questions to the Coding Clinic editorial board for clarification (they can be submitted at www.ahacentraloffice.org). The only way to learn is to ask questions.
Editor’s note: Prescott is the CDI education director at HCPro in Middleton, Massachusetts, and a lead instructor for its CDI-related Boot Camps. Contact her at [email protected]. The article originally appeared in CDI Journal.