Recent content by csperoni

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    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 even states "any area".
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    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 based on this description provided by CMS in the...
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    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 others. There was a FAQ or additional reference...
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    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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    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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    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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    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 can give advice.
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    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 practice. If this is a frequent occurrence and...
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    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 typical 1 hour procedure that only took 25 minutes...
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    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 as taxonomy. "Hand Surgery" is given it's own...
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    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 be a carrier rule/guideline. Perhaps their...
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    Wiki Preadmission Testing via Telehealth

    Some additional context could be helpful here. I'm not certain how you could perform "testing" via telehealth. Where is the patient and where is the provider?
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    Question Post-Signature Addendums in EHRs/EMRs?

    In any EMR, when there is an addendum, the change may be sort of "behind the scenes". The EMR is required to track who/what/when the change was made, but often the initial view or printed view is a "prettied-up version." I know our EMR displays what the current signed version is, and you have...
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    Wiki new vs established.

    What reference are you using that states a new patient requires a physical examination?
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    Wiki Subsequent visit and discharge same day

    In many practices, if the intent is that the patient will have all her postpartum care with the same provider who delivered, we would hold the billing until at least the first office postpartum occurs, and then bill for delivery + PP. However if you are not providing the PP, then as indicated...
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