Recent content by Jbeck@karuk.us

  1. J

    Wiki COVID testing for asymptomatic Medicare patients

    Here is an updated link to the Coding Clinic Advisor doc that Amanda posted on 6/24 - they have deleted question #16 and replaced it with questions #38 & #39, as of 8/5/2020. They have clarified that with asymptomatic patients for whom the results of the test are not known Z20.828 is the...
  2. J

    Wiki Billing modifier 59 on 36415

    Would you use a 59 mod for another draw done the same day, or a 51?
  3. J

    Wiki Wellness visit coding with immunization administration codes.

    What if there was no counseling documented for your vaccine admin? That code (90471) is not age specific.
  4. J

    Wiki Pediarix Billing/Coding

    Normally they would only be giving the injection of one vaccine in one spot. Our clinic documents the components in exactly the same way; the MA is supposed to make sure they use the same location for all components. If they pull out the needle and put it back in somewhere else (I have never...
  5. J

    Wiki Billing pediatric vaccine codes

    If you are using the admin codes without counseling, the 2nd and 3rd vaccines would use the 90472 code.
  6. J

    Wiki Traumatic wound repair - delayed care requiring debridement

    A patient presented to our clinic with a 5 day old wound (4 cm long) of the left index finger he had gotten from cutting himself while dressing out a deer. The wound was infected at this point, and the delay in seeking medical care meant that the wound required sharp debridement of the...
  7. J

    Wiki Clarification on occipital block

    64490 is a paravertabral facet injection with image guidance. Did they perform that?
  8. J

    Wiki Knee Articular Sensory Diagnostic Nerve Block

    My codebook says 64405 is for an occipital nerve block. Maybe 64450??
  9. J

    Wiki Glucose Monitoring (CGM)

    I believe you can only bill those 'A' codes if you are a DME supplier - HCPCS book says they are not priced separately by Part B. So if you are billing under Part B for sensors owned by your practice, you would only use 95250 and 95251. Does this help?
  10. J

    Wiki 95250 and 95251

    CPT book states not to bill more than once per month. We are using the Libre Pro, and the material I have says CMS will cover the office supplied sensor. Or are you asking about a personal sensor RX'd directly to the patient?
  11. J

    Wiki Continous Glucose Monitoring (CGM)

    You need the printed report from the sensor (usually scanned to your EHR) in order to report the 95250 (placement of sensor, download of at least 72 hours of data, and removal of sensor) for equipment owned by the office. 95251 is the interp & report of the downloaded data, which is usually...
  12. J

    Wiki Qualifying DX codes for 95250/95251?

    I am trying to find out whether there are any guidelines on diagnosis codes that CMS accepts for CGM codes 95250/95251. I have searched the NDC/LCD database and have not been able to find anything. Will any diabetes diagnosis code work? If someone could point me in the right direction, I...
  13. J

    Wiki Eversense

    95250 is the placement, calibration, patient training, downloading of at least 72 hours of data, printout of data recording, and removal of a sensor owned by the medical practice. My understanding is that all elements must be performed in order to bill this code, so the date billed should be...
  14. J

    Wiki another 95251 question -- different from below

    Billing 95251 I had this question as well, although I did find some guidelines in this webinar...
  15. J

    Wiki Medically indicated circumcision

    Our provider did a circumcision on a 4 mo old patient at the recommendation of the urologist after an episode of urosepsis. Z41.2 would not be an appropriate dx code in this case, but I am having difficulty figuring out what code(s) should be used. Someone suggested Z40.8 (Encounter for other...
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