DECEMBER'S CODING CHALLENGE
A 50-year-old male patient diagnosed with ankylosing spondylitis comes to the office for a routine follow-up visit and weekly methotrexate injection. The patient reports increased low back pain and stiffness for the previous three weeks, which is interfering with his recreational activities and ability to perform household chores that require bending and lifting. The patient states he has no other musculoskeletal pain or any joint swelling. The problem-pertinent review of system is negative. He is on...
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NOVEMBER'S CODING CHALLENGE
Skilled nursing facility patients
A 53-year-old obese female Medicare patient with rheumatoid arthritis returns to the office for a follow-up visit. She currently resides in a skilled nursing facility. She is on sulindac, methotrexate, and folic acid. The patient's methotrexate dose was increased at her last visit two months ago. She reports that her arthritis is doing well, except in her left knee, which has been very swollen and stiff for the past two weeks. She denies fever and reports that she experiencing epigastric pain for the...
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OCTOBER'S CODING CHALLENGE
Medically Unlikely Edits (MUE)
A 53-year-old obese female patient with rheumatoid arthritis returns to the office for a follow-up visit. She is currently on sulindac, methotrexate, and folic acid. The patient's methotrexate dose was increased at her last visit two months ago. She reports that her arthritis is doing well, except in her left knee, which has been very swollen and stiff for the past two weeks, and her right index finger, which has been swollen. She denied fevers and reports that she has had epigastric pain for the...
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SEPTEMBER'S CODING CHALLENGE
A 46-year-old male patient with osteoarthritis in his right knee comes in for a routine follow-up office visit. The patient had an intraarticular corticosteroid injection in his right knee six weeks ago with reported improvement in knee pain and stiffness. The patient reports stiffness in the knee lasting 5 to 10 minutes after long car rides and in the morning one to two times per week. He reports mild knee pain when climbing stairs. The patient has no other complaints and no comorbidities. He is currently...
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AUGUST'S CODING CHALLENGE
A 33-year-old obese female patient with rheumatoid arthritis returns to the office for a follow-up visit. She is currently on sulindac, methotrexate, and folic acid. The patient's methotrexate dose was increased at her last visit two months ago. She reports that her arthritis is doing well, except for her knees, which have been very swollen and stiff for the past two weeks. She denies fevers and reports that she has had epigastric pain for the past three weeks, which has progressively worsened and...
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JUNE'S CODING CHALLENGE
When do new, revised, or deleted CPT codes become effective?
A. Immediately upon release
B. January 1st of each year
C. October 1st of each year
D. When Medicare releases a new medical policy
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MAY'S CODING CHALLENGE
Incident- to Billing
Example A:
A 68-year-old established male patient presents for a follow-up visit for osteoarthritis and painful swollen knees. His physician was on vacation and the other physician was with another patient, so he was seen by the nurse practitioner.
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APRIL'S CODING CHALLENGE
Trigger Point Injections – Do's and Don'ts
Mary, age 51 years, returns to the rheumatology office for a follow-up visit for her diagnosis of rheumatoid arthritis. The physician takes a detailed history and performs an expanded problem-focused exam. The medical decision is of low complexity. During the visit, the patient complains of stiffness and swelling in the left hand, elbows, and neck. The rheumatologist performed an X-ray of the left hand, two views, and reads the results during the visit. Because of the severity of the swelling, the...
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March's Coding Challenge
Medical Necessity of a Diagnostic Ultrasound Office Visit
A 72-year-old female patient returns to the office for a routine follow-up visit for osteoarthritis. The patient reports that her right knee has been more swollen and stiff in the past three weeks. She is currently on celecoxib and ranitidine.
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February's Coding Challenge
To Code or Not to Code? That Is the Question!
Coding is not a scary thing when you follow the guidelines set forth in the Current Procedural Terminology (CPT) book and carriers' medical policies. Take this quiz to test your coding knowledge.
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January's Coding Challenge
Medical Necessity of 20610
A 72-year-old patient comes in for a routine follow-up visit for osteoarthritis. The patient reports that her right knee has been more swollen and stiff in the past three weeks. The patient is on celecoxib and ranitidine.
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