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Archive for October, 2009

If your payer denies 77003 when you bill it with 64640, stating that the codes are mutually exclusive, can you use 77002 instead for the guidance (C-arm imaging) of the needle?

Yes you can use 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]). This often is the complaint CPT code to report in conjunction with 64640 (desctruction by neurolytic agent; other peripheral nerve or branch).

The reason is: Code 77002 describes fluoroscopic guidance during pain management injection procedures when your physician needs guidance for needle placement in areas other than the spine. If you submit 64640, it signals the payer that you’re not reporting a spinal injection.

Code 77003 is for fluoroscopic guidance of the procedures included in the descriptor. The injection represented by 64640 falls outside those parameters.

If your provider performed the destruction procedure in an ambulatory surgery center or hospital outpatient department, append modifier 26 (professional component) to report your provider’s professional component of the fluoro-scopic needle guidance. You also need to check with your local payer about specific guidelines for these procedures. The most recent CCI edits do not bundle 77002 and 64640 as a comprehensive/component pair or as mutually exclusive. But you need to keep a check on whether your local payer has different bundling policies.

If you want to know more on this and get the complete list of CPT codes, there are various one-stop medical coding websites to get you there. Some websites also offer free trial, which you can choose to go for before registering yourself for one. So get going!

The news is doing the rounds that consultation codes (99241-99255) will not exist in the year 2010. Pediatrics coders are pondering as to how it’s going to affect their practice.

CMS has proposed ending coverage of consultation codes (99241-99255) to boost payments for primary care services. The AMA intends to make use of these codes at least till CPT 2010. For Medicare and private payers that adopt Medicare’s consultation coverage change, you need to use E/M codes (99201-99215 for office visits or 99221-99223 for hospital care rather than using consultation codes (99241-99245 for outpatient consults and 99251-99255 for inpatient consults).

The proposed rule suggests redistributing the savings that would result from invalidating consultation codes into payments for E/M services like office visits (99201-99215, office or other outpatient visit…) and initial hospital care (99221-99223).

If enacted, the consult pay elimination could benefit general pediatricians who might witness a payment hike from increased frequently used office visit codes. However, pediatric specialists tend to bill more consultations could see a downslide in revenue.

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Along with good nutrition and weight loss, there are some additional strategies that you can use to speed up weight loss while keeping cravings at bay and allowing you to eat more of the foods you enjoy without guilt. One of these strategies involves the use of “fat binders,” which usually consist of supplements like chitosan fiber that help prevent fat from being absorbed from food during digestion by binding to fat molecules, making them too large to be absorbed into your system. Instead, they simply get flushed out as waste.

Fat-binding supplements also act as appetite suppressants, since the fiber they contain makes you feel full faster after eating. This in itself can help with portion control, discouraging overeating. Although suppressing appetite is not their primary purpose, they have been shown in some studies to actually be more effective than some other supplements specifically marketed for their ability to reduce appetite, like hoodia.

Whereas some appetite suppresants simply “trick” your brain into believing that you are full when you are not, which can lose effectiveness quickly, the fiber contained in fat blockers directly reduce hunger by satisfying cravings. Other sources of fiber can have the same effect, if not Read the rest of this entry »