CODING & DOCUMENTATION

 

Fam Pract Manag. 2018 Mar-Apr;25(2):41.

Author disclosure: no relevant financial affiliations disclosed.

TIME SPENT ON CHRONIC CARE MANAGEMENT VS. TIME SPENT ON E/M SERVICES

Q

Following an office visit at which I have obtained a patient's agreement for chronic care management services, I would like to have a nurse care coordinator begin implementing the care plan. Can the nurse care coordinator's time on the date of the office visit be counted toward the time of the chronic care management service?

A

Yes. In 2017, the CPT manual included the following instruction: “Do not count any clinical staff time on a day when the physician or qualified health care professional reports an E/M service.” However, an erratum to the 2018 CPT manual removed this instruction. As long as the same time is not counted twice, the Centers for Medicare & Medicaid Services allows the separate reporting of time spent on chronic care management services on the same date as an office visit for a Medicare patient. For more information, see “Frequently Asked Questions About Physician Billing for Chronic Care Management Services.”

ICD-10 CODING FOR BUG BITES

Q

What is the appropriate ICD-10 code for a patient who presents with a bug bite?

A

The first ICD-10 code you should report for a bug bite is typically a superficial injury code. Find the term “injury” in the ICD-10 index, go to the subterm “superficial,” and then find the site/body area of the bug bite. For each body area, “bite” will be an additional subterm. For example, under injury, superficial, abdomen, you will find the term “bite” and a reference to codes S30.871-, “Other superficial bite of the abdominal wall,” and S30.861-, “Insect bite [nonvenomous] of abdominal wall.” Add the appropriate seventh character to indicate an initial encounter (A), subsequent encounter (D), or sequela (S) such as scarring.

If the patient experiences a toxic effect from a venomous bite or sting, find

ABOUT THE AUTHOR

Cindy Hughes is an independent consulting editor based in El Dorado, Kan., and a contributing editor to FPM.

Author disclosure: no relevant financial affiliations disclosed.

WE WANT TO HEAR FROM YOU

Send questions and comments to fpmedit@aafp.org, or add your comments below. While this department attempts to provide accurate information, some payers may not accept the advice given. Refer to the current CPT and ICD-10 coding manuals and payer policies.

 
 

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