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This information changes often and many insurance companies differ in their handling of claims reimbursement. Please speak with our practice management or coding consultant to make sure the code you use are up to date.
Acupuncture:
Acupuncture, one of the main forms of therapy in traditional Chinese medicine (TCM), has been practiced for at least 2,500 years. In acupuncture, certain points on the body are stimulated by the insertion of fine needles. Unlike the hollow hypodermic needles used in mainstream medicine to give injections or to draw blood, acupuncture needles are solid. The points can be needled between 15° and 90° relative to the skin's surface, depending on treatment. Acupuncture is thought to restore health by removing energy imbalances and blockages in the body. Practitioners of TCM believe that there is a vital force or energy called qi (pronounced "chi") that flows through the body and between the skin surface and the internal organs, along channels or pathways called meridians.
There are 12 major and eight minor meridians. Qi regulates the spiritual, emotional, mental, and physical harmony of the body by keeping the forces of yin and yang in balance. Yang is a principle of heat, activity, brightness, outwardness, while yin represents coldness, passivity, darkness, interiority, etc. TCM does not try to eliminate either yin or yang, but rather keep them in harmonious balance. Acupuncture may be used to raise or lower the level of yin or yang in a specific part of the body in order to restore the energy balance.- General CPT Codes
- 99201-205: Initial Office Consultation (not treatment)
- 99211-215: Review Office Consultation (not treatment)
- Acupuncture CPT Codes
- 97810: Acupuncture, one or more needles, without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient
- 97811: Each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles
- 97813: Acupuncture, one or more needles, with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient
- 97814: Each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles
- Bodywork/Massage CPT Codes
- 97010: modality; hot or cold packs- 15 minute increment
- 97124: massage treatment-15 minute increment
- 97140: myofascial release, manual therapy- 15 minute increment
ICD-9 CodesFor CAM practitioners you most often bill with the ICD-9 code given by a physician. As acupuncturists and other practitioners cannot legally offer a western diagnosis in most states/cases it is perplexing to be asked to submit a code when a patient may have not see their physician first or at all. In most situations, one of the following codes is sufficient for billing purposes. - 307.81: Headaches, tension
- 715.9: Osteoarthritis
- 719.41: Shoulder Pain
- 719.42: Elbow Pain
- 719.43: Wrist Pain
- 719.45: Hip Pain
- 719.46: Knee Pain
- 723.1: Cervicalgia (Neck Pain)
- 724.2: Lumbar Back Pain
- 724.5: Back Pain (Unspecified)
- 719.47: Foot Pain
- 913.8: Forearm Injury (Unspecified)
- 959.3: Wrist Injury
- E812.0: Collision with Motor Vehicle (driver)
- E812.1: Collision with motor vehicle (passenger)
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Allergy & Immunology:
995.3 is a billable ICD-9-CM medical code that can be used to specify a diagnosis on a reimbursement claim.
CPT Codes
A Cost-Benefit Analysis lists the following tests as those that are most likely performed at the point of care. This information is intended to enable payors to reimburse for APOCT by simply programming their systems to accept these CPT codes and reimbursement amounts.
Laboratory Chemistry Tests
Laboratory Microbiology/Immunology Tests
Laboaratory Urinalysis/Microscopic Examinations/Misc. Tests
Laboratory Blood Tests for Anemia, Leukemia, Infection, Bleeding Disorders: Hematology Tests
Laboratory Immunohematology Tests
Holter Monitoring
Spirometry Tests
Bone Mineral Density Tests
Pulse Oximetry
Exercise Testing
Resting ECG
Ambulatory Blood Pressure (ABP)
Coloposcopy
Rhinolaryngoscopy
Sigmoidoscopy
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Anesthesiology:
Anesthesia coding is “in a world of its own” when it comes to coding. CPT® codes describe what the surgeon did to the patient as do the Anesthesia codes. Differing from one another, Anesthesia coding is based both on the surgical procedure and the anesthetic. During this audio presentation we will review different anesthesia codes and how to properly apply them in your practice. Additionally we will look at the base and time units needed for proper claim submission. Talking through the changes to Anesthesia for 2009, with descriptions of the new procedures and when it would be appropriate to apply them in your practice.
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Cardiology:
simplify the coding process with this one-stop resource developed exclusively for those who code for cardiology, cardiothoracic surgery and vascular surgery. The Coding Companion® for Cardiology/Cardiothoracic/Vascular Surgery includes complete 2009 CPT® and ICD-9-CM code sets specific to your specialty in a quick-find, single-page format that includes the official description and a detailed illustration for each code. Each page also features other relevant information to help your staff find the correct codes, including lay descriptions, coding tips, terminology, cross coding and national Medicare relative value units.
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Cytology:
Cytology, more commonly known as cell biology, studies cell structure, cell composition, and the interaction of cells with other cells and the larger environment in which they exist. Cytology can also refer to cytopathology, which analyzes cell structure to diagnose disease. Microscopic and molecular studies of cells can focus on either multi-celled or single-celled organisms. Recognizing the similarities and differences of cells is of the utmost importance in cytology. Microscopic examination can help identify different types of cells. Looking at the molecules which form a cell, sometimes called molecular biology, helps in further description and identification. All fields of biology depend on the understanding of cellular structure. The field of genetics exists because we understand cell structure and components. To understand Cyology CPT & IC9-CM coding CLICK HERE
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Dentistry:
Over 1,000 crosswalks between dental (CDT) and medical (CPT®) codes.
Exclusive! Updated Medical Fee Information 50th, 75th, 90th percentiles, medicare rates, and global fee periods.
Locate thousands of diagnostic codes (ICD9) that support medical necessity.
Medical insurance policies that explain coverage decisions about what dental services or items are reasonable and necessary.
Provides details on the indications and limitations of medical necessity and document requirements.
Introduction to medical-dental cross coding reimbursement.
Can a dentist bill medical insurance? State statutes on the legal basis for the dentist to render services within the scope of his/her license.
Updated Dental (CDT) codes with corresponding Medical (CPT) codes and a list of primary diagnostic (ICD9) codes that support medical necessity
Instructions on how to complete the CMS 1500 Claim form, which will help create a clean claim
Information on reducing coding errors and audit exposure
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Dermatology:
Consolidate the coding process with the one-stop resource developed exclusively for those who code for plastic surgery, OMS and dermatology. This comprehensive guide includes complete 2010 CPT® and ICD-9-CM code sets specific to plastic surgery, OMS and dermatology in an easy-to-use, one-page format. Each page has the CPT® code with its official description, a detailed illustration, and the one-page format includes lay descriptions, coding tips, terminology, cross coding and national Medicare relative value units. Getting to the code information you need has never been so easy. CPT is a registered trademark of the American Medical Association
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Emergency Medicine:
Consolidate the coding process with the one-stop resource developed exclusively for those who code for emergency medicine. This comprehensive guide includes complete 2008 CPT® and ICD-9-CM code sets specific to emergency medicine in an easy-to-use, one-page format. Each page has the CPT® code with its official description, a detailed illustration, and the one-page format includes lay descriptions, coding tips, terminology, cross coding and national Medicare relative value units.
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Endocrinology:
Endocrinology EMR Software
Bizmatics Endocrinology Electronic Medical Record Software is designed to meet the specific needs of the Endocrinology specialty. The Endocrinology specific Electronic Medical Record includes many custom templates for history of present illness, complaints, review of systems, medication prescribing, immunization tracking and CPT coding. The software also incorporates an electronic superbill and E&M coder that has been customized for the Endocrinologist. We recognize that no system has it all, which is why we will work with you to customize the software to your needs. Bizmatics offers the very best "EMR for Endocrinologists".
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Gastroenterology:
The AGA Institute, ACG and ASGE, and their advisors work closely throughout the year regarding the AMA’s current procedural terminology (CPT) process. For 2010, several changes were made to the CPT codes used to report gastroenterology services, outlined in the CPT 2010 codebook, including changes made under the following code descriptors: - Cholangioscopy/pancreatoscopy.
- CT colonography.
- Photo-dynamic therapy.
- Evaluation and management: consultations.
- Concurrent care and transfer of care.
- Gastrostomy.
- Hemorrhoid.
- ICD-9-CM codes.
Hepatology:
2009 Ingenix Coding Companion for Oncology/Hematology Consolidate the coding process with the one-stop resource developed exclusively for those who code for oncology and hematology. This comprehensive guide includes complete 2009 CPT® and ICD-9-CM code sets specific to oncology and hematology in an easy-to-use, one-page format. Each page has the CPT® code with its official description, a detailed illustration, and the one-page format includes lay descriptions, coding tips, terminology, cross coding and national Medicare relative value units.
Homeopathy:
Homeopathy is a medical system that treats a disease or symptoms with minute doses of a substance or drug that would induce similar symptoms in a healthy person. A "homeopath" is the person or doctor who provides these types of remedies. A homeopath believes that the body produces symptoms as one way it fights disease. Thus, those small doses help produce the symptoms that will treat the disease.
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Medical Genetics:
Division of Medical Genetics
Medical Genetics is the specialty of medicine that involves the diagnosis and management of hereditary disorders. Medical genetics differs from Human genetics in that human genetics is a field of scientific research that may or may not apply to medicine, but medical genetics refers to the application of genetics to medical care. For example, research on the causes and inheritance of genetic disorders would be considered within both human genetics and medical genetics, while the diagnosis, management, and counseling of individuals with genetic disorders would be considered part of medical genetics. In contrast, the study of typically non-medical phenotypes such as the genetics of eye color would be considered part of human genetics, but not necessarily relevant to medical genetics (except in situations such as albinism). Genetic medicineis a newer term for medical genetics and incorporates areas such as gene therapy, personalized medicine, and the rapidly emerging new medical specialty, predictive Medicine.
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Nephrology:
CODE PATHWAYS FOR UROLOGY/NEPHROLOGY
Code Pathways for Urology/Nephrology provides decision trees that lead coders through physician operative reports to the appropriate procedure code. Coders answer questions in the decision trees to determine the CPT codes that best describe the services provided. In most instances, the questions are simple yes/ no queries, but in some cases, readers will be asked to select from modalities or other differentiators to reach the appropriate code.
Neurosurgery:
2010 Neurosurgery Coding Update
Here's what you will learn: - Effectively use modifiers to obtain appropriate reimbursement for neurosurgical procedures.
- Spinal electrode placement, both trial and permanent - make sure your coding is squeaky clean.
- Properly code for a generator in spinal stimulators.
- Learn the changes in reimbursement for, and application of:
radiosurgery codes
spinal injection codes - Key components and supporting codes for spinal and cranial surgery.
- Excess utilization: Learn which procedures are being scrutinized.
Neurology:
2010 Neurology Coding Update
Neurology changes are coming in with 2010.
Learn everything you need to prepare for the 2010 coding and billing changes…in just one hour
Don’t risk delays or denials by using outdated codes – plan ahead for the 2010 coding and compliance changes for your neurology providers. HIPAA no longer allows a grace period for providers or payers to ease into the coding updates. The effective date of the annual transaction code set changes is the “drop dead” date. Update yourself with this 60-minute, information packed audio conference.
Get the tools you need to code correctly and confidently, such as:
The latest neurology CPT codes and modifier additions and changes.
Find out the latest news on the status of consultation E/M services for Medicare – Are they in or out for 2010?
Review the 2010 ICD-9 code additions and revisions, including new diagnosis codes that will help your neurology practice more accurately report the complaint of “nerves”.
Discover what’s up with all the new “E” codes for 2010 and the corresponding changes in the ICD-9 Guidelines for reporting these External Causes diagnosis
Sneak Peek – potential 2010 HCPCS code changes.
Bulletproof your neurology practice: provider services that are on the 2010 OIG Workplan --Understand why and what you need to do to protect your providers.
Evaluate prospective RBRVS changes from CMS and the potential impact on your neurology provider’s bottom line
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Obstetrics & Gynecology:
Simplify the coding process with this one-stop resource developed exclusively for those who code for obstetrics and genecology. The Coding Companion for OB/GYN includes complete 2009 CPT and ICD-9-CM code sets specific to your specialty in a quick-find, single-page format that includes the official description and a detailed illustration for each code. Each page also features other relevant information to help your staff find the correct codes, including lay descriptions, coding tips, terminology, cross coding and national Medicare relative value units.
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Ophthalmology:
Code Pathways for Ophthalmologyprovides decision trees that lead coders through physician operative reports to the appropriate procedure code. Coders answer questions in the decision trees to determine the CPT codes that best describe the services provided. In most instances, the questions are simple yes/no queries, but in some cases, readers will be asked to select from modalities or other differentiators to reach the appropriate code.
Orthopedics:
The Coding Guides from PMIC are the ultimate coding reference for your medical specialty. (These were previously titled Codelink and later CPT Easy Links)
Starting with a comprehensive introduction to CPT and ICD-9-CM coding, each Coding Guide includes a glossary of coding and billing terminology, correct coding requirements, and documentation guidelines, followed by CPT codes for the specialty with ICD-9-CM code links, and third party payer guidelines. The selection of CPT codes and ICD-9-CM links included in each Coding Guide are based on a computer analysis of over 188 million actual health insurance claims submitted to third party payers.
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Pediatrics:
Ensure accurate billing and prompt payment—and help drive high-quality care—with the premier comprehensive guidebook focused exclusively on pediatric coding. The 15th edition provides fast and easy access to all new and updated Current Procedural Terminology (CPT®) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Updates include best practice principles of coding for 2010.
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Physical Medicine & Rehabilitation:
The CPT codes are not static. Each year, additions, deletions, and revisions are made to existing CPT codes. Upcoming changes typically are announced in November. It is highly recommended that physical therapists (PTs) maintain an up-to-date working knowledge of CPT, and review and prepare for any changes that may occur at the beginning of each calendar year. Besides being aware of upcoming changes in CPT, the physical therapist should understand how the changes might affect payers' payment policies. The CPT process is owned by the American Medical Association, an advocacy arm of the medical profession.
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Plastic Surgery:
Developed to make coding as fast an accurate as possible. Comprehensive guide for Coding and Billing Plastic Surgery/Dermatology Professionals arranged by CPT® code containing at-a-glance ICD-9-CM and HCPCS crosswalks, coding tips, plain English descriptions, RVUs, CCI edits, and modifiers. NEW for 2010 — FREE access to Contexo Media's e-link so your information is up-to-date throughout the year.
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Podiatry:
Simplify the coding process with this one-stop resource developed exclusively for those who code for podiatry. The Coding Companion® for Podiatry includes 2010 CPT® and ICD-9-CM code sets specific to your specialty in a quick-find, single-page format that includes the official description and a detailed illustration for each code. Each page also features other relevant information to help you staff find the correct codes, including lay descriptions, coding tips, terminology, cross coding, and national Medicare relative value units.
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Preventive Medicine:
■ Preventive Medicine E&M services should be reported using the age appropriate code from the Preventive Medicine Services
section of the most current CPT manual.
■ Services rendered should be reported using 99381-99387 for new patients or 99391-99397 for established patients.
These codes include counseling/anticipatory guidance/risk factor reduction interventions which are provided at the time of the
initial or periodic comprehensive preventive medicine examination.
■ If an abnormality/ies is encountered, or a preexisting problem is addressed in the process of performing a preventive medicine
E&M service, and if the problem/abnormality is significant enough to require additional work to perform the key components of a
problem-oriented E&M service, then the appropriate Office/Outpatient code 99201-99215 should also be reported.
Modifier-25 should be added to the Office/Outpatient code to indicate that a significant; separately identifiable E&M service
was provided by the same physician on the same day as the preventive medicine service.
Note: An insignificant or trivial problem or abnormality that is encountered in the process of performing the
preventive medicine E&M service and which does not require additional work and the performance of the key
components of a problem-oriented E&M service should not be reported.
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Pulmonology:
Simplify coding with this one-stop resource developed exclusively for those who code for ENT, allergy, and pulmonology. The Coding Companion® forENT/Allergy/Pulmonology includes 2010 CPT® and ICD-9-CM code sets specific to your specialty in a quick-find, single-page format that includes the official description and a detailed illustration for each code. Each page also features other relevant information to help your staff find the correct codes, including lay descriptions, coding tips, terminology, cross coding, and national Medicare relative value units.
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Radiology:
2010 Coding and Billing Professional for Radiology
Radiology coding has never been so easy. Organized by CPT® code and full of information that makes coding more efficient, these handy guides will be your constant reference. - NEW! Online access — e-Links make it simple for you to stay current with any changes to the CCI edits and code-specific RVUs that occur during the year
- CPT® Alphabetic Index — helps you find the right tabular section easily
- Coding Tips for CPT® surgical procedures — assists you in making the correct code choice
- Anesthesia crosswalks — aids in selecting the appropriate anesthesia code linked to CPT® surgery codes
- Even more illustrations for procedures — provides you visual clarification for coding
- 2010 CPT®, ICD-9-CM and HCPCS Level II codes relevant to your specialty — saves you time
- Plain English Descriptions of CPT® codes — guides code selection and verification and explains associated conditions or medical indications
- CPT® to ICD-9-CM crosswalk — assists you in identifying medical necessity
- Includes NCCI edits — helps you identify which codes are bundled and which codes can be billed separately
- Code-specific RVUs — determine fees at a glance
- Pub 100 references, global days, assistant-at-surgery and prior approval requirements integrated with the associated CPT® code — code more efficiently
- Modifiers that are appropriate for each code from the RBRVS — know which modifiers can or cannot be used with each procedure
Radiotherapy:
Coding Specifications Codes required to document patient has prostate cancer without a secondary malignant neoplasm diagnosis of a specified site (respiratory, digestive, and of other specified sites) and is receiving external beam radiotherapy: A line item ICD-9-CM diagnosis code for prostate cancer without an ICD-9 diagnosis code for a secondary malignant neoplasm and a CPT procedure code are required to identify patients to be included in this measure. All measure-specific coding should be reported ON THE SAME CLAIM. Prostate cancer line item ICD-9-CM diagnosis codes
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Rheumatology:
CPT® is Current Procedural Terminology, which was developed by the American Medical Association for coding medical procedures. Our selection of 2010 CPT® books contain all codes, modifiers, and descriptions for the current year. CMS Deadlines: CMS no longer allows a 90-day grace period for using discontinued codes, so get your books early and stay up-to-date! You must use valid CPT codes for services performed on or after January 1, 2010.
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Surgery:
Gain deep insight and practical application for the 2010 code changes for General Surgery and Gastroenterology. This 2-hour course covers the essential information for your specialty on the code changes for 2010.
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Toxicology:
In August, 2009, NMS Labs provided communication regarding important changes to our
service menu effective December 07, 2009. This notice is to inform you of subsequent
modifications to those requirements for select tests. Detailed below are the modifications to
the December 07, 2009 database letter.
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Urology:
Medicare Payment Information for Common Urology CPT® Codes Medicare physician pymt. non-facility: Medicare professional fee to a physician when a procedure is performed in the office or in an ASC if the procedure is not on the Medicare-approved ASC list (see explanation below). These fees are based on the assumption that the space, equipment and overhead costs are absorbed by the physician. N/A in this column means the procedure is rarely or never performed in the non-facility setting. There are other sites of service that are considered non-facility as well. Medicare physician pymt. facility: Medicare professional fee to a physician when a procedure is performed in a hospital or in an ASC if the procedure is on the Medicare-approved ASC list (see explanation below). These fees are based on the assumption that the space, equipment and overhead costs are absorbed by the hospital or ASC. There are other sites of service that are considered facility as well.
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