Archive for The Day of June 10th, 2007

Archive for the Day of June 10th, 2007

Welcome to the medical billing blog archive for the day of June 10th, 2007.

Here you will find links to every article added to the Outsource Management Group web site during June 10th, 2007.

You can browse this day's archives by clicking the "More" button from any of the excerpts below.

Why it is Necessary to Demonstrate Medical Necessity

Some physicians and coders believe that CPT guidelines allow for reporting 99215 for any established patient based on a comprehensive history and examination, even if the MDM is low risk. By this reasoning, you may report 99215 for any E/M visit where the physician documents a comprehensive physical and exam, even if he or she only treats a minor problem. However, this is a myth. CPT E/M guidelines do not offer a legal loophole allowing them to ignore medical necessity. The nature of the problem for which the patient presents is the measure of medical necessity for E/M services. This is included for every level of service. If medical necessity

How Depth Affects Excision Claims

Depth is very important when choosing the appropriate code for coding excision claims. For example, a surgeon excises a lipoma from a patient’s back, and the excision measures 5.0 cm x 4.0 cm x 2.0 cm. In this situation, should you select code 21930 or code 11406 for the procedure that was performed? The key to deciding which code is the correct code is the depth of the excision that the physician performed on the patient. Assuming that the depth, in this example, is 2.0 cm (20mm), is much greater than the average thickness of the skin (2-3mm), so you are justified to report code 21930 (which is excision, tumor,

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