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Billing/Coding

Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2

From the College  |  February 17, 2016

A patient returns for a follow-up visit of their chronic idiopathic gout without tophi with complaints of pain and tenderness. After a thorough examination, the rheumatologist treats the patient for an acute flare of the left knee. How is this coded? M1A.1620, M10.062 M1A.1620 M10.061 M10.062 From ICD-10 coding guidelines, what are the steps to…

Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 2

From the College  |  February 17, 2016

Take the challenge. D—Even though the patient’s chief complaint is for a follow-up of chronic idiopathic gout without tophi, the patient is presenting with an acute flare of idiopathic gout of the left knee. Acute gout and chronic gout have specific coding guidelines, because they each have an Excludes 1 note. This indicates they are…

How to Avoid Legal Pitfalls

Richard Quinn  |  January 22, 2016

In busy rheumatology practices, mountains of paperwork for insurance companies and federal healthcare programs make it hard to keep track of what’s legal. Missing documentation is the most common way to spark an investigation. Here are a few considerations to help you avoid legal pitfalls…

ICD-10: An Ode to Code

Robert H. Shmerling, MD  |  January 19, 2016

When the code that you need is not clear Just keep this poem quite near If you’re struck by a parrot Just grin and bear it ICD-10 has you covered my dear. W61.02XA Struck by parrot, initial encounter And if you’re ever struck by a cow I don’t even want to know how Rest assured:…

Rheumatology Coding Corner Questions: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1

From the College  |  January 19, 2016

What is the ICD-10 guideline to code for osteoporosis without a current pathological fracture? There is no rule. Code for the osteoporosis, and code for the pathological fracture. Code for the osteoporosis from the M81._ category, and code for the history of a pathological fracture. None of the above is correct. How many characters are…

Rheumatology Coding Corner Answers: ICD-10 Coding Guidelines, Conventions Refresher Quiz Part 1

From the College  |  January 19, 2016

Take the challenge. C—The guideline for coding from category M81._ is that an additional code is needed if the physician has knowledge that the patent had a past pathological fracture. The code for personal history of (healed) pathological fracture is Z87.310. B—Osteoporosis with a current pathologic fracture is one of the few ICD-10 codes that…

The RUC’s Work & Where You Fit In

Mary Beth Nierengarten  |  January 4, 2016

To ensure adequate and appropriate reimbursement, rheumatologists must provide detailed information about their services to the people advocating on their behalf. With the proper information, advocates can then do the work necessary to secure the appropriate values for these services. These advocates are members of the Relative Value Update Committee (RUC), a volunteer committee of…

Rheumatology Coding Corner Answer: Coding for Acute Flare of Idiopathic Gout

From the College  |  December 17, 2015

Take the challenge. M10.072—Acute gout has an Excludes 1 note of chronic gout (M1A.-). This means that acute gout and chronic gout cannot be coded for the same encounter, as the codes are mutually exclusive. M45.6—The patient is diagnosed with ankylosing spondylitis of the lumbar region. M81.8—Other osteoporosis without current pathological fracture. M79.622—The patient has…

Rheumatology Coding Corner Question: Coding for Acute Flare of Idiopathic Gout

From the College  |  December 16, 2015

It has been two months since the implementation of ICD-10, so everyone has gotten a feel for the new code set. Let’s see how well you are doing in your diagnosis coding for rheumatology-specific conditions. A 55-year-old female patient presents for a follow-up visit of idiopathic chronic gout of multiple joints without tophi. She complains…

Understanding the Z Codes in ICD-10

From the College  |  December 15, 2015

Two months into the transition, the ICD-10 code set is still not exactly the most enticing reading material. But there is still so much to learn and apply, that it is necessary for physicians, coders and billers to stay abreast of the coding and billing guidelines. Although all of the guidelines and conventions may be…

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