Neurology|Neurosurgery - Articles

Treating the Genitofemoral Nerve?
January 25th, 2022 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Finding which CPT code is appropriate for certain nerves can get complicated. Recently I was asked which CPT code would be used for radiofrequency ablation of the genitofemoral nerve and for a second procedure: release of psoas tendon under ultrasound guidance. Radiofrequency Ablation of the Genitofemoral Nerve I found is there is no code ...

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Stay out of Trouble — Understand the Qualified Medicare Beneficiary (QMB) Program
October 7th, 2020 - Wyn Staheli, Director of Research
To assist low-income Medicare beneficiaries, CMS created the Qualified Medicare Beneficiary (QMB) program; a Medicaid benefit which pays for Medicare deductibles, coinsurance, or copays for any Medicare-covered items and services for Medicare Part A, Part B, and Medicare Advantage (Part C). Providers/suppliers are prohibited from billing premiums and cost sharing to Medicare beneficiaries who are enrolled in QMB.
New Codes for Cytokine Release Syndrome (CRS)
October 1st, 2020 - Wyn Staheli, Director of Research
New codes for Cytokine Release Syndrome (CRS) are effective October 1, 2020 based on the grade/severity of the symptoms. This article covers the new grading scales.
Are NCCI Edits Just for Medicare?
July 14th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...
Hypertension ICD-10-CM Coding Table, Guidelines, and Tips
April 16th, 2020 - Wyn Staheli, Director of Research & Aimee Wilcox, Director of Content
Coding hypertension properly requires knowing all the guidelines. This article summarizes how hypertension is coded using ICD-10-CM and includes tips, definitions and a very helpful coding table summarizing your options.
A 2020 Radiology Coding Change You Need To Know
February 10th, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...
Hypertension ICD-10-CM Code Reporting Table
November 25th, 2019 - Wyn Staheli, Director of Research
In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following table shows some of these options.
Federal Workers Compensation Information
October 1st, 2019 - Wyn Staheli, Director of Research
When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program. Division of Federal Employees' Compensation (DFEC) website Division of Federal Employees' Compensation (DFEC) provider ...
List of Cranial Nerves
September 3rd, 2019 - Find-A-Code
Cranial nerves are involved with some of our senses such as vision, hearing and taste, others control certain muscles in the head and neck. There are twelve pairs of cranial nerves that lead from the brain to the head, neck and trunk. Below is a list of Cranial Nerves and ...
Medical ID Theft
August 16th, 2019 - Namas
Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...
The OIG Work Plan: What Is It and Why Should I Care?
August 9th, 2019 - Namas
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
5 Ways to Minimize HIPAA Liabilities
July 12th, 2019 - BC Advantage
Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...
How to Properly Report Monitoring Patients Taking Blood-thinning Medications
June 18th, 2019 - Wyn Staheli, Director of Research
Codes 93792 and 93792, which were added effective January 1, 2019, have specific guidelines that need to be followed. This article provides some guidance and tips on properly reporting these services.
Documentation of E/M services for Neurology (Don't Forget the Cardiology Element)
June 13th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
According to Neurology Clinical Practice and NBIC, the neurologic exam is commonly lacking in documentation due to the extensive requirements needed to capture the appropriate revenue. With the lack of precise documentation, it results in a lower level of E/M than that which is more appropriate, which can cost a physician a lot ...
Coverage for Hearing Aids and Auditory Implants
April 23rd, 2019 - Brandon Dee Leavitt QCC, CMCS, CPC, EMT
For hearing impairment, Medicare is firm in its stance on when it will and will not cover hearing correction. In the PUB 100-02 Medicare Benefit Policy Manual, Chapter 16, Medicare cites the Social Security Act by explaining:  "..."hearing aids or examination for the purpose of prescribing, fitting, or changing hearing aids" ...
Spinal Cord Stimulator Used for Chronic Pain
April 1st, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Chronic pain is a condition that can be diagnosed on its own or diagnosed as a part of another condition. When coding chronic pain, there is no time frame defining when pain becomes chronic pain; the provider’s documentation should be used to guide the use of these codes. ICD-10-CM Diagnosis Codes ...
Rhizotomy Procedures
September 26th, 2018 - BC Advantage
The terms “rhizotomy” and “Radiofrequency Ablation” (RFA) both mean “destruction of a nerve.” Another term for this is “neurolysis.” The CPT coding choices for a rhizotomy procedure reflect the methods chosen to destroy the nerve(s). Nerve Destruction choices include the following: Chemical Neurolytic Blocks - These require substances that are...
Q/A: How Do I Release a Patient from PI When They Still Have Problems?
August 10th, 2018 - Wyn Staheli, Director of Research
Once a PI patient is released with symptoms, or without symptoms, and a prognosis of likely exacerbations with a future medical estimation of $1500 over then next 2 years, how am I supposed to release them from care when they still have ongoing needs? We have discussed this with several different experts. The consensus is....
When is 97112 Neuromuscular Re-education Billable?
March 13th, 2018 - Dr. Evan Gwilliam, VP for PayDC
Q: I just received a note from an attorney regarding a patient who was rear ended about 40 mph and ended up with neuropathy in her upper and lower extremities. We treated her for about 3 months after previous care failed to give much relief. I used flexion distraction and deep muscle stimulation to break up adhesions from the injury and used the 97112 code of neuromuscular re-education. The insurance company said that code was not warranted for her spinal sprain diagnosis and denied all of the services. Do you know how I could justify it? It greatly improved her condition with each visit and the patient said we provided the greatest relief she received.
Important CDI and Coding Updates
February 1st, 2018 - Richard Pinson, MD, FACP, CCS, and Cynthia Tang, RHIA, CCS
COPD and Pneumonia The requirement for code J44.0 (chronic obstructive pulmonary disease with acute lower respiratory infection) to be coded first when a patient has pneumonia and COPD has been eliminated as of October 1. The 2018 version of ICD-10-CM replaced the "use additional code" with "code also." According...
Sleep Apnea Terminology
January 3rd, 2018 - Find-A-Code
Apnea-Hypopnea Index (AHI): The average number of episodes of apnea and hypopnea per hour of sleep without the use of a positive airway pressure device. Respiratory effort related arousals (RERAs) are not included in the calculation of the AHI. Sleep time can only be measured in a Type I or (facility based polysomnogram) Type II sleep study. BiPAP: Bilevel positive airway ...
Auditing Neurologic Exams: Tips for Success
June 30th, 2017 - Laurie Oestreich
As an auditor, you may be asked to audit encounters that occur in various multi-specialties. It can be difficult to remember the ins and outs of each specialty, especially if you do not consistently work in a particular specialty. Neurology is one of those specialties that can appear daunting due ...

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