As an answer to our member requests we will now also display the coding corners that are now published in The Rheumatologist. The coding corner are written by Melesia Tillman, CPC-I, CRHC, CHA she is one of the certified coders on staff at the college. If you have any coding or billing questions, you may contact her at (404) 633 -3777 ext. 820 or via email
+ 2012
– 2012
MAY'S CODING CHALLENGE
A 54-year-old female with rheumatoid arthritis is seen by the rheumatologist for a follow-up visit.
APRIL'S CODING CHALLENGE
Evaluation and Management
There are four components to an evaluation and management visit. Which one should drive the visit?
MARCH'S CODING CHALLENGE
New Patient vs. Established Patient Quiz
A 65-year-old female patient comes to see Dr. Raven at her new practice. The last time this patient saw Dr. Raven was eight weeks ago at her old practice. What type of patient visit is this?
FEBRUARY'S CODING CHALLENGE
A 62-year-old male patient returns to the office for a follow-up visit for his gout.
JANUARY'S CODING CHALLENGE
Eligibility Quiz for Front Office Staff
A new patient calls to schedule a visit with the rheumatologist. What main question concerning financial arrangements should you ask before finishing the call?
+ 2011
– 2011
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...
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...
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...
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...
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...
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
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.
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...
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.
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.
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.
+ 2010
– 2010
December's Coding Challenge
A 54-year-old female with rheumatoid arthritis (RA) and osteoporosis (OP) returns to the rheumatology practice for a follow-up visit. She reports that the pain in her hands and feet is slightly worse than last visit.
November's Coding Challenge
Medical Necessity of 20610
On January 11, 2010, a 68-year-old female returns to the office for her monthly abatacept infusion treatment; she has an established diagnosis of moderate rheumatoid arthritis. She is currently on a nonsteroidal antiinflammatory drug and also takes glucosamine-chondroitin.
October's Coding Challenge
A 68-year-old female who is a new Medicare patient is scheduled for a visit with the rheumatologist. She was referred to the rheumatologist by her primary care physician for postmenopausal osteoporosis.
September's Coding Challenge
A 68-year-old established male patient with osteoarthritis of the lumbar region returns to the office for a scheduled paravertebral facet joint injection. The patient is currently on a nonsteroidal antiinflammatory drug, ranitidine, and glucosamine-chondroitin.
August's Coding Challenge
ICD-9 Coding
A diagnosis is the foundation of all patient visits. It is the medical necessity of why the patient is seeing the rheumatologist.
July's Coding Challenge
Modifiers: The Key to Proper Reimbursement
Understanding how and when to use a modifier is a major key to coding. Modifiers will often determine if a charge is reimbursed or denied.
June's Coding Challenge
Evaluation and Management Components
Can you and your coding or billing staff pass this quiz?
If a patient comes in with two established problems that are worsening, what is the level for the number of diagnoses or treatment options?
A. Minimal
B. Limited
C. Multiple
D. Extensive
E. None of the above
May's Coding Challenge
Established, New, or Consult? You Decide
On March 2, 2010, a patient who has not seen Dr. Baker since January 4, 2008 returns for a visit. Dr. Baker is on vacation, so the patient sees Dr. Clark, who is a partner in the practice and also a rheumatologist. What type of patient would this be for Dr. Clark?
A. Established
B. New
C. Consult
April's Coding Challenge
A rheumatologist is called to the hospital to see a 60-year-old male patient with rheumatoid arthritis two days after an uncomplicated total knee replacement.
March's Coding Challenge
A 68-year-old male established patient with osteoarthritis of the lumbar region returns for a scheduled paravertebral facet joint nerve injection.
February Coding Challenge
As the new recovery audit contractors (RAC) begin their audits of Medicare claims, it is even more important that your billers know how to bill charges correctly. If you aren't sure if your billers are prepared for the RAC, have them take this quiz—or take it yourself to test your own knowledge.
True or false: You can bill and report separately for local anesthetic medication that is mixed with the injected medication (steroid).
A. True
B. False
January Coding Challenge
A 43-year-old established female patient diagnosed with rheumatoid arthritis comes to the office for her first infliximab infusion.
