How to code correctly for laceration repairs?

Answering a few questions will help you code correctly for laceration repairs (such as staples, sutures, or similar closure materials): Was the repair limited to the epidermis, dermis, and subcutaneous tissue, or did you need to probe more deeply? Use simple repair codes for superficial wounds (epidermis and dermis) that need only a single-layer closure. […]


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Controlling Gestational Diabetes

Gestational diabetes is diabetes that a woman can develop during pregnancy. When you have diabetes, your body cannot use the sugars and starches (carbohydrates) it takes in as food to make energy. As a result, your body collects extra sugar in your blood. We don’t know all the causes of gestational diabetes. Some—but not all—women […]


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ICD-10 Codes – Type 1 Diabetes Mellitus

Diabetes means your blood glucose or blood sugar is too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems […]


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Medicare Reimbursement for Pre-Diabetes Screening

Pre-Diabetes Screening involves the testing of asymptomatic, high-risk individuals to assess whether they meet the criteria for either prediabetes or type 2 diabetes. Screening for prediabetes and diabetes is more frequently done in health care settings than in community settings. The process used to target and test patients may include a team approach, employing various […]


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Official Guidelines for Diabetes Mellitus – 2021 Update

The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the following guidelines for coding and reporting using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). These guidelines should be used as […]


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Coding Diabetes Mellitus in ICD-10-CM

Results of a recent coding and clinical documentation pilot study indicate that the ICD-10-CM coding classification changes made for diabetes mellitus have significantly improved coding for this disease. The results of the study noted that although a few ICD-10-CM “unspecified” diabetes codes were assigned, the majority of the diabetes codes sufficiently captured the diagnoses as […]


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Using Correct Combinations – Modifier 59

One of the most frequent errors can result from using the wrong modifiers. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. In this article, we will be discussing wrong […]


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Using Correct Combinations – Modifier 24 and 25

One of the most frequent errors can result from the submission of invalid modifier combinations. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. The most commonly used wrong modifier […]


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Time-Based Billing for CPT Evaluation and Management

Within the guidelines of the CPT code book, CPT has stated; “When counseling and/or coordination of care dominates (more than 50%) the physician/patient and/or family encounter (face-to-face time in the office or other outpatient setting or floor/unit time in the hospital or nursing facility), then time may be considered the key or controlling factor to […]


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