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csperoni's latest activity
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Ccsperoni replied to the thread vulvar skin tag removal.The general guidance is to use a location specific code if it exists. If they are skin tags being destroyed or removed, that is not the same as removing a mass/lump/lesion to biopsy. I would use 11200 for skin tag removal from the vulva. 11200...
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Ccsperoni replied to the thread Wiki Telehealth Place of Service Codes 02 or 10.Located!! My MAC (NGS) came out with this fact sheet stating: "If the patient receives the telehealth service from a location that is not a facility they would normally receive care, such as their car or work, then POS 10 would be appropriate...
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Ccsperoni replied to the thread Wiki Telehealth Place of Service Codes 02 or 10.I would agree with POS 10. My personal opinion is the the descriptors of the POS codes can be misleading. POS 10 generally means not a facility. POS 10 would apply to anywhere the patient is living, in addition to workplace and a variety of...
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CHello, In regard to your question "Can we use the decision for that minor procedure in the MDM/risk for the office visit?" Please review the below link...
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Ccsperoni replied to the thread Wiki New patient.I don't think this would be billable as there is no medical decision making, no assessment, and no plan. Even if you determined it could be billed on time, in a situation like this, I would not bill.
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Ccsperoni replied to the thread Wiki OB global billing.I agree with @mmckibbin. Almost all my carriers would want this split billed to new insurance 59426 7+ antepartum 59410 vaginal delivery with postpartum care
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CBilling will depend on the insurance company guidelines. Some say if over X visits it will be global no matter what. Most will be split billed because you already started care and billed 2 other visits with a different insurance company.
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Ccsperoni replied to the thread Wiki Billing audit for an 11 clinician Primary Care Clinic/s.This is a community forum. If you are asking AAPC to perform an audit, you need to contact them directly. https://www.aapc.com/business/audit-services
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Ccsperoni replied to the thread Wiki Preadmission Testing via Telehealth.If you don't know the scenario, then no one can answer this for you. Just about any common PST testing (EKG, CXR, bloodwork) I could think of can't be done when the patient is at home. If you would like to provide that information, then others...
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Ccsperoni replied to the thread Wiki Post op visits - one doctor performs the surgery & another doctor.If both clinicians are the same group, same specialty, you would code for the typical surgery code. There is no reason to split the coding with -54/-55, as from a coding perspective and insurance perspective they are in exactly the same group...
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Ccsperoni replied to the thread Wiki 2 DIFFERENT SURGERIES 2 DIFFERENT PROVIDERS.Depending on how extensive the surgery itself is, you might consider that not opening and not closing the patient is resulting in reduced work and -52 MIGHT be a consideration. If it was a 6 hour intensive surgery, then maybe not. If it was a...
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Ccsperoni replied to the thread Wiki Board certification for Hand specialty.Exactly. As @CBLENNIE explained, the key is how the provider is credentialed. I will add that while most carriers use taxonomy, others (namely Medicare) use a shorter list of 2 digit specialty codes that does not contain as many subspecialties...
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Ccsperoni reacted to CBLENNIE's post in the thread Wiki Board certification for Hand specialty with
Like.
I have a few questions about your question. Do both providers have the same taxonomy code, or are they different? If the providers have the same taxonomy code, most payers are going to consider the hand specialist as the same specialty as the... -
Ccsperoni replied to the thread Wiki Modifier needed for inpatient.By coding rules, different providers of different specialties should not require a modifier for that reason alone. There is a modifier -AI for the initial inpatient visit which goes on the admitting physician's claim. Other than that, this must...
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CACOG has guidelines for an NST, and in general, you would not begin testing until 32 weeks gestation. The diagnostic value of NSTs before 32 weeks varies and has high false-positive rates due to the immaturity of the fetal heart. This means that...