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Latest articles

Should ROM Testing be Reported with Evaluation and Management Services?
January 9th, 2018 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT
Reporting the performance of range of motion testing (95851-95852) at the same encounter of an Evaluation and Management (EM) service, produces an NCCI edit resulting in payment for the EM service and denial of the ROM testing. Read the article to learn what other codes ROM testing is considered incidental to.
OIG Advisory Opinion Recinded - Lessons Learned
December 21st, 2017 - Wyn Staheli
In the compliance world, it is important to know when the OIG makes an advisory opinion on a subject. For example, the advisory on Time of Service or Prompt Pay Discounts helps to ensure that providers are creating policies and procedures which will meet the standards of the OIG in the case ...
Specialty Exceptions — 2018 PE RVU Changes
December 13th, 2017 - Raquel
Some specialties are not included in the new PPIS PE/HR RVU changes
Escharotomy Procedural Cross-Walking CPT to ICD-10-PCS
November 10th, 2017 - Brandon Dee Leavitt CPC, QCC
An Escharotomy is used for "local treatment of burned surface" per the AMA Guidelines, when incisions are performed on the burn site. Notice, when cross-walking 16035 or 16036 to inpatient codes, Find-A-Code crosswalks lead to Body System H, Operation 8 - Division of the skin, and Operation N -...
Four Final Rules Affecting CMS Payments for 2018
November 7th, 2017 - Wyn Staheli
It’s a season for changes. CMS just finalized four rules which directly impact the following payment systems: Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018 Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes for 2018 HHAs: Payment Changes for 2018 Quality Payment Program Rule for Year 2 This ...

Editors choice articles

Health Care Fraud - Don’t Do It!
July 31st, 2017 - Chris Woolstenhulme, CPC, CMRS
If you wonder if what you are doing is fraud, DON’T DO IT! The government takes this extremely serious. I don't need to tell you this.  I have often been apprehensive about making a mistake and I wonder, will it be fraud? Will I spend time in jail for accidentally sending in a duplicate ...
Pre-op visits: True or False?
December 29th, 2015 - Codapedia Editor
Are the following statements true or false? • The PCP cannot be paid to do a pre-op assessment of a Medicare patient prior to surgery because of the new consult rules. • The surgeon can never be paid to do a pre-op visit if s/he is going to take the patient to surgery. • The...
Billing Incident to Services-Whose Number Should Be Used?
December 29th, 2015 - Seth Canterbury, CPC, ACS-EM
Should You Bill Incident to Services for a Medicare Patient Under The Number of the “Supervising Physician” or the “Ordering Physician”? This issue was first clarified in the preamble of the 11/1/01 Federal Register (available here on p. 23 of the file, p. 55267 of the...
Cloned E/M notes
December 29th, 2015 - Codapedia Editor
Have you ever read a physician office note and thought it was strangely familiar? Or, not just familiar but identical to another note? Well, Medicare contractors have noticed the same thing, and the Office of Inspector General has included this on their 2011 Work Plan. Medicare contractors have...
Cardiology Coding Unmasked - Part 2 Therapeutic Cardiology Procedures, CPT Codes (92980-92982; 92984; 92995-92996), Medical Necessity Issues (ICD-9-CM)
December 29th, 2015 - Nancy Maguire
92980 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel 92981 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; each additional...

Latest questions/posts

Hereditary cancer testing ICD10 codes
1st    Jan 22nd, 2018 - DCM

Lower extremity angioplasty with thrombolysis infusion.
1st    Jan 17th, 2018 - kwesner

1st    Jan 17th, 2018 - Kwatson

Modifier 25 with New patient visit codes and procedure on same day
   Jan 16th, 2018 - daystarjj 4 

CPT 94664
1st    Jan 10th, 2018 - KarS

6 month repeat colonoscopy
1st    Jan 3rd, 2018 - halifax gastro

vaccine admin billing
1st    Dec 18th, 2017 - Maha 2 

Procedure code 99222
1st    Dec 14th, 2017 - sghant01

code rejection
1st    Dec 8th, 2017 - docterry

Modifier for the Medicare AWV screening questions
   Dec 5th, 2017 - ltingley 3 

Bone Marrow Aspiration/Biopsy
   Dec 5th, 2017 - CODER218

Substance-Use Disorders tx
1st    Nov 28th, 2017 - tahneeluvisi

Harmonic Scapel
   Nov 21st, 2017 - Streeter 1 

Pathology billing
   Nov 15th, 2017 - npott1 9 

Physical Exam for Military (specifically Feet)
   Nov 7th, 2017 - alleegator13

Diagnosis Code
   Nov 1st, 2017 - rdinaso    11 

Use of Ophthalmology CPT Codes
1st    Nov 1st, 2017 - MM

Phlebectomy Procedure
   Oct 30th, 2017 - shoppe 1 

Skull Based Coding Help
   Oct 27th, 2017 - rdinaso    11 

Coding for CKD stage and Kidney transplant
1st    Oct 26th, 2017 - ssingh17


New Codapediasts

Jan 22nd, 2018:  DCM
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Jan 18th, 2018:  Scheduling specialist
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