Practice Management
“Urgent care” was in its infancy and electronic medical records were practically the stuff of science fiction when the ICD-9 codes were released in 1979. The Centers for Medicare and Medicaid Services (CMS) takes one giant leap toward catching up with the launch of ICD-10 codes on October 1. As of that date, ICD-9 codes will no longer be accepted. CMS has said the new coding set is expected to “advance public health research and …
Read MoreQ. We had a patient come in with an open fracture of the distal interphalangeal joint of the right index and middle fingers, ICD-9 [International Classification of Diseases, 9th Revision, Clinical Modification] code 816.12. The provider set and splinted them both. Can I bill procedure code 26765 (“Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each”) twice? A. A diagnosis of open fracture means that the skin has been …
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Q. We treat a lot of fractures in our urgent care clinic, and I understand there are changes for coding these in ICD-10-CM [International Classification of Diseases, 10th Revision, Clinical Modification]. What will we need to be aware of? A.Most of the changes made in ICD-10-CM were to chapter 19, “Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88),” because of the need to identify laterality and 7th-character extensions that indicate the type of …
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Q. We perform a lot of intravenous (IV) infusions in our urgent care facility. Sometimes we also perform IV pushes and hydration at the same time as the infusion. What is the correct way to code multiple IV infusions? Do we have to document start and stop times for each IV service? A. If an IV infusion and IV push are performed concurrently in the same IV site, you should only bill one “initial” code. …
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Q. Have there been any updates from CMS (Centers for Medicare & Medicaid Services) regarding the new -X modifiers that were introduced in January of this year? A. CMS released MLN Special Edition article SE1503 on January 22, 2015 (see http://www.cms.gov/Outreachand- Education/Medicare-Learning-Network-MLN/MLN MattersArticles/Downloads/SE1503.pdf), stating that there would be forthcoming guidance as to the appropriate use of the new -X {EPSU} modifiers and “that guidance will include additional descriptive information about the new modifiers” before implementing …
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