Recent content by alysenb

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    Wiki IPPE and Advanced Care Planning

    I am reading conflicting information. Can advanced care planning (99497) be billed with the IPPE (G0402)? I am reading that the patient costs is not waived when billed with IPPE but it is waived with the AWV. I understand time has to be documented to be able to bill 99497.
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    Wiki Pacemaker and ICD remote interrogation place of service

    Does anyone know if a remote interrogation can be done when the patient lives out of state? Example, we are in Missouri but patient lives in Florida. Place of service is 02, so I am thinking it does not matter where the patient lives. I cannot find any information on this topic.
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    Wiki cardiac sarcoid

    No it is not. You are better to have your primary code as a rhythm disorder, heart failure or cardiomyopathy diagnosis.
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    Wiki Documentation requirements for 90935/90937

    Does anyone have a link or information on documentation requirements for 90935 or 90937. CMS doesn't really have anything. UHC is denying after reviewing medical records so I need to know what is missing and you know they won't tell me.
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    Wiki Preventative visits and counseling and guidance

    Do educational handouts count toward education and guidance? If a provider documents that they gave the patient educational handouts or brochures, should that count as "guidance and counseling" portion of a preventative exam?
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    Wiki Savi Scout marker 19120 or 19125?

    I am having a discussion with a provider about a procedure they did. They performed a lumpectomy with a Savi locator. The office is saying it should be coded 19120 because there was no "wire" locator used. I believe it should be coded 19125. They have me really doubting myself on this one.
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    Wiki Ventricular Tachycardia Denials

    I had this issue because the payer was very delayed in updating their system with the new codes. They admitted it was their fault. My claims are finally being reprocessed.
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    Wiki Patient provided injectables

    Can a provider charge 96372 to administer an injectable that the patient provided? For instance, a patient has a medication that should be self-administered but they are unable to due to fear or physical ability, so they come to the office for a nurse to administer it. Can we bill 96372? I...
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    Wiki nuclear medicine 78451/78542

    For these I have always used the indication along with contributing factors. For instance, CAD as primary then secondary might be hyperlipidemia, diabetes, tobacco use, etc.
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    Wiki Preventative exam and FIT test

    I have a payer that is denying 99386 when billed with 82274. Denial reason is "non-covered services routine exam/screening". Right now there are no modifiers except QW on the 82274. Does anyone think we could get 99386 paid by adding modifier 25? I know there are no CCI edits for this, but I...
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    Wiki Screening codes

    Can someone help clarify something? Is a depression screening (G0444) and cardiovascular risk screening (G0446) included in AEV (G0439)? I am pretty sure the depression screening is but wanted confirmation.
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    Wiki Holter monitor dates

    We are having a discussion in our office about which dates are appropriate for Holter monitors. Example is 93225 and 93227. We hook the monitor up and interpret the results. Should we be billing 93225 on the date of hook up and then 93227 on the day we interpret the results? Or should both...
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    Wiki Help with CPT code for thallium nuclear stress test

    Question is did they do only stress images or did they do both resting and stress images? If they did both then you would code 78452. All other codes are correct.
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    Wiki 92928 and 93454

    I have a situation where I am billing 92928-LD, 92928-59-LC 93454-26-59 The insurance is denying 93454. I feel like there is an issue with the modifiers. Would I remove the -59 from the 92928?
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    Wiki Planing of Sesamoid

    Anyone know how to code this one? I was thinking 28315.52
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