We have had so many requests for additional information on ICD-10-CM coding for overlapping breast quadrants.
So, instead of answering individual questions, I created this video.
It’s my first video, so please be patient as I work out transition and audio issues.
Let me know your thoughts on the presentation and your recommendations on how I can make improvements.
I shared this site with a group of new coders, and I would like to share it with you.
CMS has released ICD-10-CM and PCS web-based courses on the Medicare Learning Network.
Now, before you ask, “why would CMS provide training on ICD-10-CM?” Let me tell you. This course is fantastic.
It’s an in-depth learning opportunity for new coders and an excellent refresher for experienced coders.
I took the ICD-10-CM course because I was curious, and I was very impressed.
It’s a one-hour course, broken into four lessons (15 minutes each). At the end of each lesson, you review the covered content to test your understanding.
Upon completing the entire course, it has a final assessment that you are required to achieve at least a 70% passing grade, and you will receive a certificate of completion.
It does not provide CEUs, but the reward for learning should not be CEUs. Instead, it should be to challenge yourself, test your understanding, and stay current in the industry.
Featured coffee – Almond Cream
CMS has published the Quarterly updates to the Medicare Physician Fee Schedule Database (MPFSDB) with an effective date of July 6, 2021.
I’m just focusing on two bilateral surgery indicator changes, and I’ll explain why.
According to MLN Matters Number: MM12289 Revised, the bilateral surgery indicators for CPT codes 69705 and 69706 were changed, and the effective date is January 1, 2021.
These are the CPT® descriptors for both codes:
69705 – Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral
69706 – Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral
69705 has a revised bilateral indicator of 0, and 69706 is revised to indicator 2.
If you review the Medicare Fee Schedule Database, you’ll see that both CPT codes currently have an indicator of 1.
So here are the “changes.”
69705 – currently has a bilateral indicator of 1. The one indicator means that the code was valid for bilateral billing, and you could submit the CPT code on a single line with modifier 50 and a quantity of 1.
Hopefully, no one reported the code with the 50 modifier because there is a code (69706) that describes the bilateral procedure.
If you depend on your encoder or coding software, you may have a problem.
So, hopefully, your vendor or IT support team will update the encoder or coding software to change the 1 indicator to 0.
The 0 indicator means the concept of “bilateral” does not apply. It would be inappropriate to report the code as a bilateral procedure because there is a CPT code to describe the bilateral procedure, 69706.
69706 – currently has a bilateral indicator of 1. This means that the code was valid for bilateral billing, and you could submit the CPT code on a single line with modifier 50 and a quantity of 1.
Hopefully, no one reported the code with the 50 modifier because that would mean the patients have four eustachian tubes/two heads.
Again, if you depend on your encoder or coding software, you may have a problem.
And, hopefully, your vendor or IT support team will update the encoder or coding software to change the 1 indicator to 2.
The 2 indicator means the payment adjustment does not apply. The CPT code descriptor indicates the procedure is bilateral, and it would be inappropriate to report the CPT code with 50 modifier.
So, I’m sharing this to point out another reason why coders should not depend totally on encoders or coding software.
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Coffee With a Medical Coding Auditor 