Take the challenge. Correct Coding: 99213-25, 20552 Diagnosis: M79.70 There continues to be a lot of confusion on proper coding for trigger-point injections. Two CPT4 codes can be used: 20552—Injection(s); single or multiple trigger point(s), one or two muscle(s); and 20553—Injection(s); single or multiple trigger point(s), three or more muscle(s). The CPT4 codes are based…
Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2
A patient returns for a follow-up visit of their chronic idiopathic gout without tophi with complaints of pain and tenderness. After a thorough examination, the rheumatologist treats the patient for an acute flare of the left knee. How is this coded? M1A.1620, M10.062 M1A.1620 M10.061 M10.062 From ICD-10 coding guidelines, what are the steps to…
Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2
Take the challenge. D—Even though the patient’s chief complaint is for a follow-up of chronic idiopathic gout without tophi, the patient is presenting with an acute flare of idiopathic gout of the left knee. Acute gout and chronic gout have specific coding guidelines, because they each have an Excludes 1 note. This indicates they are…
ICD-10: An Ode to Code
When the code that you need is not clear Just keep this poem quite near If you’re struck by a parrot Just grin and bear it ICD-10 has you covered my dear. W61.02XA Struck by parrot, initial encounter And if you’re ever struck by a cow I don’t even want to know how Rest assured:…
Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1
What is the ICD-10 guideline to code for osteoporosis without a current pathological fracture? There is no rule. Code for the osteoporosis, and code for the pathological fracture. Code for the osteoporosis from the M81._ category, and code for the history of a pathological fracture. None of the above is correct. How many characters are…
Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1
Take the challenge. C—The guideline for coding from category M81._ is that an additional code is needed if the physician has knowledge that the patent had a past pathological fracture. The code for personal history of (healed) pathological fracture is Z87.310. B—Osteoporosis with a current pathologic fracture is one of the few ICD-10 codes that…
Understanding the Z Codes in ICD-10
Two months into the transition, the ICD-10 code set is still not exactly the most enticing reading material. But there is still so much to learn and apply, that it is necessary for physicians, coders and billers to stay abreast of the coding and billing guidelines. Although all of the guidelines and conventions may be…
Revenue Cycle Management in Physician Practice Improves with Staff Communication, Training
One month has passed since the U.S. healthcare system overcame a historical milestone with the conversion from billing ICD-9-CM to ICD-10-CM. Although the transition to ICD-10 had a major impact on coding operations, its far-reaching tentacles go beyond coding alone and are deeply rooted in the entire revenue cycle. There is room to criticize the…
Rheumatology Coding Corner Answer: Proper Coding for Post-Traumatic Osteoarthritis
CPT: 99213, 73500-RT, 73500-LT ICD-10: M16.52 This E/M service entailed: The history is detailed; The examination is expanded problem focused; and The medical decision making is of low complexity. The X-ray reviewed was for radiologic examination, hip, unilateral: one view for the left hip and for the right hip. M16.52—The diagnosis identifies unilateral post-traumatic osteoarthritis…
Rheumatology Coding Corner Question: Coding for Post-Traumatic Osteoarthritis
Post-Traumatic OA A 70-year-old female patient comes in for a follow-up visit for pain and stiffness in her left hip. She injured her hip in a skiing accident three years before and reports the X-rays at that time showed no fractures. Due to no obvious fracture at the time, she was given ibuprofen and advised…
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