CPT® code, 92504 binocular microscopy, (separate diagnostic procedure) may not be reported when the microscope is used to perform the minor ear procedures as described.
Use of an operating microscope, reported with Current Procedural Terminology (CPT) codes 64727 and 69990, is a reimbursable service in specified instances.
Prior to 2015 the CPT coding book available from the AMA referred to two different types of CPT codes for charges in electron microscopy. The first of these is "electron microscopy, diagnostic" (88348). The second of these was indented below the first, and had the name of "scanning" (88349). In 2015 the latter code (88349) was deleted.
CPT® code, 92504 binocular microscopy, (separate diagnostic procedure) may not be reported when the microscope is used to perform the minor ear procedures as described. Here is why! 92504 is a diagnostic procedure—as such the CPT® rules state that all surgical procedures include a diagnostic procedure
ICD-10 code R31. 29 for Other microscopic hematuria is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
ICD-10-CM Code for Encounter for preprocedural laboratory examination Z01. 812.
Z20 - Contact with and (suspected) exposure to communicable diseases | ICD-10-CM.
History of fallingICD-10 code Z91. 81 for History of falling is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Z12.11. Encounter for screening for malignant neoplasm of colon.
ICD-10 code Z51. 81 for Encounter for therapeutic drug level monitoring is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Inoculations and Vaccinations ICD-10-CM Coding Code Z23, which is used to identify encounters for inoculations and vaccinations, indicates that a patient is being seen to receive a prophylactic inoculation against a disease.
9: Fever, unspecified.
However, if COVID-19 does not meet the definition of principal or first-listed diagnosis (e.g. when it develops after admission), then code U07. 1 should be used as a secondary diagnosis.
However, coders should not code Z91. 81 as a primary diagnosis unless there is no other alternative, as this code is from the “Factors Influencing Health Status and Contact with Health Services,” similar to the V-code section from ICD-9.
ICD-10 Code for Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits- Z86. 73- Codify by AAPC.
Code F33. 1 is the diagnosis code used for Major Depressive Disorder (MDD), Recurrent, Moderate. It is a mental disorder characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities.
On January 16, 2009, the U.S. Department of Health and Human Services (HHS) released the final rule mandating that everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) implement ICD-10 for medical coding.
On December 7, 2011, CMS released a final rule updating payers' medical loss ratio to account for ICD-10 conversion costs. Effective January 3, 2012, the rule allows payers to switch some ICD-10 transition costs from the category of administrative costs to clinical costs, which will help payers cover transition costs.
CPT® guidelines disallows +69990 Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure) in addition to any procedure that includes microsurgical techniques as part of the code descriptor (e.g., 22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection; single interspace, cervical ). These “disallowed” primary codes are listed in a parenthetical note preceding the code and its descriptor in the CPT® Codebook.
Your best bet when reporting 69990 to Medicare payers is to check the National Correct Coding Initiative (NCCI) to be sure that use of operating microscope is not bundled to the primary procedure code. Author.
Aetna considers endothelial cell photography medically necessary for members with any of the following indications:
Endothelial cell photography (also known as specular endothelial microscopy, anterior segment photography, and corneal endothelial microscopy) involves the use of a specular microscope to determine the endothelial cell count. It is used by ophthalmologists to predict success of ocular surgery and other ocular procedures.
American Academy of Ophthalmology Preferred Practice Patterns Committee. Comprehensive adult medical eye evaluation. San Francisco, CA: American Academy of Ophthalmology; 2010.
Use of an operating microscope, reported with Current Procedural Terminology (CPT) codes 64727 and 69990, is a reimbursable service in specified instances.
The Centers for Medicare and Medicaid Services (CMS) Medicare Claims Processing Manual and the Correct Coding Initiative (CCI) state that CPT code 69990 is not to be reported in addition to CPT code 647 27.
Common areas of confusion include CPT code 63042. Re-exploration at a level with a recurrent disc herniation can only use CPT code 63042. It should only be used after the global period for the first disc surgery has expired. Repeat facetectomy and lateral recess decompression at a level with a prior decompression must use CPT code 63047 if no disc work is per-formed. The presence of a lumbar disc herniation (722.1) drives the CPT code.Another common misconception is code 63047. This code can be used unilaterally or bilaterally as long as the decompression involves the lateral recess and foramen. Posterior fusion codes that involve disc preparation (22630,22633) already take into account the decompression work. Using ad-ditional decompression codes (63005, 63012, 63030,63042, 63047) is not al-lowed.
The use of posterior fusion codes that encompass disc work (eg, 22630 and 22633) already take into account the removal of lamina, facets and ligamen-tum flavum. The interbody fusion codes also were written assuming bilateral interbody placement which requires bilateral decompression. In cases that require decompression plus fusion (L4-5 spondylolisthesis with central and lateral recess stenosis), only the fusion codes can be used.
2014 Common Coding Scenarios for Comprehensive Spine Care includes medical and surgical coding vignettes, key components to include in the procedure notes and proper coding of spine procedures for 2014.