iowagirl77's latest activity

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    iowagirl77 reacted to amyjph's post in the thread Wiki A coder's job duties and workflow with Like Like.
    They will change their mind when the revenue drops and takes 3x (or more) as long to come through requiring extensive appeals and corrected claims. Then audits will start coming in too. I have seen this tried and failed in the past. If it is...
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    iowagirl77 replied to the thread Wiki Dermatology Post Operative Wound Check (No Global Period-Mohs).
    If there is no global period, you can bill an E/M as long as documentation supports it. You may check with your practice though, in case there is some reason they don't. In some cases, providers may not be aware of which services are 90/10/0 day...
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    iowagirl77 replied to the thread Wiki LCD clarification.
    It can differ from one LCD to the next- you really have to read the instructions closely to understand why they are separating CPTs, HCPCS, and dx into different groups. For A59105, it appears that the group 1 diagnoses are the off-label use...
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    iowagirl77 replied to the thread Wiki 64635 and 64636.
    Was this preauthorized, and if so, for how many units? It could be as the response above states, and they want you to bill the second level with bilateral modifier. Did both 64635 and 64636 deny? Since it also denied for N674, you might see if...
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    iowagirl77 replied to the thread Wiki Excision of lesion.
    If your quote under the gross description is stating the patient's name and DOB, PLEASE REMOVE IT IMMEDIATELY!! You should be using the excision size noted in the procedure note (1 cm) to select your code, not the dimensions noted in a pathology...
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    iowagirl77 replied to the thread Wiki 28090.
    Hi Felice. Can you please supply a little more information? What was the diagnosis? The FHL runs from lower leg to phalanx. This doesn't state at what level this was at, but perhaps it is stated elsewhere in the report? Was there another...
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    iowagirl77 replied to the thread Wiki 11420 Medicare denial for frequency.
    The note starts out fairly specific on size and quantity, but devolves from there. 2 x 1.5 cm 1 x 2 cm 3 additional areas were noted, but no size was mentioned. It is unclear how the provider came up with 9 total, so I can see why only 6 total...
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    iowagirl77 replied to the thread Wiki PRP injection.
    These codes are used for two separate things- do not bill them together. Bill only the appropriate code for what was performed. Reference...
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    iowagirl77 replied to the thread Wiki how many modifiers?.
    Each charge that is within the global of the first procedure will need a modifier, not just the highest RVU. Requiring a modifier on each charge allows you to identify any procedure within global that could be for a different reason, such as...
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    iowagirl77 replied to the thread Wiki 93970.
    If it was performed twice on the same day, I'd bill the second line with either a 76 (same provider) or 77 (different providers) modifier. If the additional one denies, you may need to appeal with records to show that it was necessary to do both.
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    iowagirl77 reacted to amyjph's post in the thread Wiki LT and RT with C1762 and C1763 with Like Like.
    Oh yeah, good point lol. I read it that they were getting denials for NOT having it. If you are adding it to those and it's denied then take it off for sure lol
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    iowagirl77 replied to the thread Wiki Modifier 76 & global period.
    You might further research this- everything I can find specifies that modifier 76 is for repeat of a procedure on the same day only...
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    iowagirl77 replied to the thread Wiki LT and RT with C1762 and C1763.
    Are you getting denials because you added a laterality modifier, or because you didn't add one? Unless the payer specifically wants it, I wouldn't add it. I'd consider it a supply code, and since it can be used universally (not a specific version...
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    iowagirl77 replied to the thread Wiki POS.
    According to this list, UHC doesn't allow 45100 in office: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/attachments/reimbursement/Procedure-and-Place-of-Service.pdf Is the CPT correct? It wasn't performed with a scope?
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