CE Articles

Unpack CPT coding for implant and foreign body removals

Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, describes the difference between an implant and a foreign body removal and outlines CPT coding for these procedures.

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Communication gaps in denials management point to need for improvement

Although most organizations do a good job of tracking denials by reason, payer, and volume, they miss the mark when communicating information about appeals, according to the results of HIM Briefings’ 2022 Denials Management Survey.

Applying HCPCS modifiers -GA, -GX, -GY, and -GZ for non-covered services

Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.

Healthcare News: OIG estimates New York provider received $1.1 million in Medicare overpayments for psychotherapy services

A New York City provider received an estimated $1.1 million in Medicare overpayments for behavioral health services that did not comply with billing requirements, according to a recent Office of Inspector General (OIG) report.

Q&A: Hospital prior authorization requirements for outpatient spinal surgeries

Q: Which outpatient spinal procedures require prior authorization for Medicare reimbursement?

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New on JustCoding Platinum!

Platinum members can access a coding case study featuring ICD-10-CM and CPT codes for cardiac catheterization. If you are not a Platinum member and you want to upgrade your account, please call customer service at 800-650-6787.

Free quiz

Test your knowledge with this week’s free quiz, which features CPT codes for diagnostic radiology services.

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SelectCoder Tip of the Week

ICD-10-CM code F07.81 (postconcussional syndrome) should not be used for the patient who has a current concussion (see the Excludes1 notes). Postconcussional syndrome is a complex disorder resulting from traumatic brain injury and is not associated with the severity of the initial injury. No documented loss of consciousness with the initial injury is necessary for a diagnosis of postconcussional syndrome, but the physician must specify this disorder.

Interested in more coding tips and claim validation tools? Click here to sign up for a demo or to learn more about SelectCoder.

Platinum Newsletters

Platinum members can view the latest stories from Briefings on APCs and Briefings on Coding Compliance Strategies.

Product Spotlight

NCCI Modifier Review: Navigate Chapter-Specific Coding and Reporting Guidance

During this 60-minute webinar on Thursday, April 28, Sarah L. Goodman, MBA, CHCAF, COC, CHRI, CCP, FCS, will review the latest National Correct Coding Initiative (NCCI) guidance for hospital reporting. Listeners will learn when to use modifiers to prevent and override procedure-to-procedure and Medically Unlikely Edits, tips for reporting and billing, and case scenarios for the most challenging modifiers.

For more information, call 800-650-6787 or visit the HCPro Healthcare Marketplace.

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Sarah Gould, CPC
Editor
JustCoding News: Outpatient
editor@justcoding.com

HCPro
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