Modifier 58 vs Modifier 78: Modifier 58: Same underlying condition, planned or unplanned additional procedure. Modifier 78: New problem caused by the initial surgery (complication) requiring a return to the OR. Medical Coders often struggle to differentiate between modifier 58 (staged/related procedure) and modifier 78 (unplanned return to OR). Let’s break down the key differences […]
Make sure your facility is aware of all the Medicare policy changes that permit payment for expanded services. Telehealth as a healthcare delivery platform has been in existence since the late 1960s. It was first introduced through projects initiated by the National Aeronautics and Space Administration (NASA) and the Nebraska Psychology Institute. The declaration of […]
Arrive at the correct procedure code by breaking down the operative report. Even seasoned coding professionals occasionally find it challenging to assign the appropriate ICD-10-PCS codes from the operative report. Mastering the procedural coding system used in the inpatient hospital setting takes practice. Medical coders reporting inpatient services should start by reading the operative report, […]
The Centers for Medicare & Medicaid Services (CMS) has begun covering a portion of the device cost for Barostim Neo, a neuromodulation device for treating chronic heart failure. In late 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it would begin covering a substantial portion of the cost of implantable heart failure […]
NDCs will help you determine when to use 0094A and 91309. If you’ve been waiting for news on Moderna’s booster dose-specific COVID-19 vaccine for adults, check this out: The Food and Drug Association (FDA) revised the emergency use authorization (EUA) to include this booster as of March 29, 2022. Assign 0094A, 91309 for Booster Dose […]
Solidify your understanding of aortic valve disease and how to report this life-changing treatment. Transcatheter aortic valve replacement (TAVR) is a minimally invasive cardiac procedure to replace a diseased aortic valve in a person’s heart. The most common reason to undergo TAVR is aortic stenosis, which is an abnormal narrowing of the aortic valve opening […]
Spring brings Coding Clinic Guidance. Spring has sprung, and that brings the first American Hospital Association (AHA) Coding Clinic on ICD-10-CM/PCS issue of 2022. There are a wide range of topics and guidance. Now that we are receiving biannual coding updates, we begin April this year with some new codes, and some changes that are […]
Ten new HCPCS Level II codes for drugs and biologicals will be payable for Medicare, effective for claims with dates of service on or after July 1, 2019. HCPCS Level II codes is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT code set jurisdiction, such as […]








