'X' Modifiers in Dermatology
UPDATE! (2/12/2015) On 1/26/2015, CMS issued an updated bulletin on the new 'X' modifiers. CMS has stated that providers can continue to use modifier 59 if they were using it appropriately before. ht
Are you compliant with the HIPAA Mega Rule?
"mega-rule" regulations went into effect March 26, 2013 . Even if you
have previously implemented a HIPAA plan, you have new regulations you must
follow and implement immediately. View Press
Billing Frozen Sections (88331) on the same day as Mohs
There are two scenarios where it is permissible to bill 88331 (pathology consultation during surgery with frozen section) on the same day as Mohs Micrographic Surgery. 1. A provider wants to confirm
BREAKING ALERT - Federal Budget tweaks 2018 Physician Fee Schedule for multiple Medicare carriers
UPDATE as of 02/28/2018 1. ECS has confirmed with its CMS sources that the Work GPCI
issue as discussed below will be retroactive to 01/01/2018. 2. Medicare Contractor Updates... WPS Medicare - has
CAUTION billing for compounded "Levulan" (aminolevulinic hydrochloride)
We are getting asked if it is appropriate to bill for generic/compounded aminolevulinic acid HCl prepared by a compounding pharmacy using J-code J7308, typically associated with Levulan (manufactured
D48.5 versus D49.2
ICD-10 codes D48.5 and D49.2 are often used incorrectly and are often confused. However, carriers typically accept either of them for procedures like biopsies or shave removals that require medical n
Dermatology Preventive/Screening Exam Visit Caution
Be careful when ICD-10 coding for "screening"
CPT has a series of “preventive screening” exams based on age. (These are in
the CPT code range of 99381-99387 ) Many patients are reque
Dermatology Superbills with ICD-10
We get asked about dermatology superbills with ICD-10 quite often. Due to the more-specific nature of ICD-10 and the number of commonly used dermatology diagnoses, we have been unsuccessful at develo
Modifier 25 and Dermatology
Original Article Posted 6/30/2013 - Updated 7/14/2016 New Rules for the bundling of E/M visits with Minor Procedures (codes with 0 or 10 postop days) In January 2013, CMS released updated instruction
Modifier 25 Audits in full effect! Are you at risk of an audit?
We've been warning DermCoder clients and our customers since
2013... the OIG, CMS, and commercial carriers are targeting Modifier 25 abuse!
The audits are happening NOW , and we're now receivin
Myths and Facts about Unspecified codes in ICD-10
We have been receiving a number of calls and emails and
coding questions regarding the “discontinued” use of all unspecified codes
after October 1 st , 2016.
Many entities are incorrectly or
Pathology Date of Service Confusion
On September 19, 2017, CMS issued a bulletin (SE17023) clarifying the date of service for billing claims for clinical lab and pathology specimens. That bulletin had stated that when billing for patho
Pathology Technical Component Denials When Patient was at Hospital or SNF same day
Question: I am hoping you can help clarify an issue/ trend we are seeing with our pathology claims (CPT code 88305 & 88304) with Medicare. We have a dermatopathologist with an in-house lab that perfo
Repeat Surgical Procedures When your Carrier doesn't like modifier 76
When multiple surgical procedures are being billed (e.g., four 11402 excisions, 9 AKs, multiple Mohs removals, multiple additional stages of Mohs, etc.), a number of different questions come into pla