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How are y’all reporting 15734 to Medicare? The patient underwent two 15734. I reported it on one line with 2 units. Medicare is denying for exceeding the units although MUEs allow up to 4 units. Should I report it on two lines with a m59, m51, or m76 on the second line or no modifier at all?
Payment for anesthesia services increases with time. Per national Correct Coding Initiative (CCI) chapter 2 guidelines, anesthesia time: …is defined as the period during which an anesthesia practitioner is present with the patient. It starts when the anesthesia practitioner begins to prepare the patient for anesthesia services in the operating room or an equivalent area […]
AAPC Knowledge Center
The 2018 CPT® code book introduces two new codes to report anesthesia during colonoscopy, one of which is applicable specifically for a screening exam. But if a screening colonoscopy reveals diagnostic findings, proper coding for the anesthesia service may differ, depending on the payer. CPT® Sticks with Screening Code 00812, Regardless of Findings CPT® 2018 deletes […]
AAPC Knowledge Center
Beginning Jan. 1, 2018, clinicians may report on Medicare Part B claims submitted for items and services the applicable HCPCS Level II modifiers established for patient relationship categories. Although the use and selection of these modifiers are not be a condition of payment, yet, clinicians should prepare for the likelihood of them becoming applicable components […]
AAPC Knowledge Center
Many quality measures in the Quality Payment Program include ICD-10-CM codes in either the numerator, denominator, exclusions, or exceptions, and used to determine patient eligibility. The accuracy of any measure, and the ability for eligible clinicians to meet data completeness, risk being compromised when ICD-10 codes are updated (October 1). Workflows that are not automatically updated, such as claims and registries, are particularly vulnerable. […]
AAPC Knowledge Center
When billing for professional services, you should report 96372 Therapuetic, prophylactic, or diagnostic injection, specify substance, or drug; subcutaneous or intramuscular for each medically appropriate injection provided, as instructed in CPT Assistant (May 2010; Volume 20: Issue 5): Question: What is the appropriate CPT code to report when a patient receives two or three intramuscular […]
AAPC Knowledge Center
In July 2017, the Centers for Medicare & Medicaid Services (CMS) began requiring medical offices with 10 or more practitioners in nine states (Florida, Kentucky, Louisiana, New Jersey, Nevada, North Dakota, Ohio, Oregon, and Rhode Island) to report claims data on post-operative visits furnished during the global period of specified procedures using CPT® 99024 Postoperative […]
AAPC Knowledge Center
When calculating time spent performing a time-based procedure or service, include only those items specifically detailed in the code descriptor. For example, when reporting critical care services (e.g., 99291-99292), you may include the time spent interpreting cardiac output measurements or chest X-rays, performing ventilator management or vascular access, and other services enumerated within CPT® as […]
AAPC Knowledge Center
Endobronchial ultrasound (EBUS) combines a bronchoscope with ultrasound to visualize the bronchi and adjacent structures, and to obtain tissue for biopsy. Sampling by EBUS differs from transbronchial lung biopsy(s) (+31632) or transbronchial needle aspiration biopsy(s) (+31633), neither of which includes an ultrasound component. Two codes describe EBUS to obtain transtrtacheal and transbronchial sampling: 31652 Bronchoscopy, […]
AAPC Knowledge Center