Recent content by Karalea88

  1. K

    Wiki Transitional Care claim DOS

    I have received conflicting information on when to the report the DOS for TCM's. I have read that the DOS should be reported with a DOS 30 days after discharge and also read that we do not have to wait until 30 days post discharge. Is it appropriate to report DOS when face to face is done or...
  2. K

    Wiki Office E/M with modifier 25

    If someone could help with this scenario...... Patient in cardiology office for 1 year follow up and echo regarding hypertension, cad, stenosis( echo was scheduled the same time as the 1 year follow up). Echo was done same time as encounter and reviewed, medically appropriate history and exam...
  3. K

    Wiki Modifier 54 and 55-- help

    Thank you both for your feedback :) This helps make it clear!!
  4. K

    Wiki Modifier 54 and 55-- help

    Can same group providers with same Tax ID report modifiers 54 and 55 on procedures with 90 day global? Should the surgery be billed as global?
  5. K

    Wiki DECISION FOR SURGERY

    I understand that if procedure was done the same day as visit then we would not give credit for MDM but is it necessary for the provider to include the list of risk factors in the note itself or can they just document "Risk and benefits discussed' for outpatient/inpatient surgery?
  6. K

    Wiki DECISION FOR SURGERY

    Yes, decision was made during visit to perform injection that day. Provider wants to bill 99214 but I suggest 99213. 68 year old patient with MODERATE problem, minimal amount and/or complexity of data, and low risk factor since documentation does not support any co-morbidities or conditions...
  7. K

    Wiki DECISION FOR SURGERY

    If a provider documents "We discussed the risks and benefits of a corticosteroid injection" does this meet the documentation requirement for Decision for minor surgery with risk factors? OR does the provider need to include the risk and benefits in the documentation to support decision for surgery?
  8. K

    Wiki 25 modifier

    Is it appropriate/necessary to bill modifier 25 with E/M code when CPT 36415 (lab drawn) is done during the visit? Or is the it not necessary?
  9. K

    Wiki Drug Therapy monitoring documentation help????

    For Drug Therapy requiring intensive monitoring what needs to be documented? Do providers need to specify what they are monitoring for? Below is example of documentation and I am not sure if this would qualify since specific monitoring is not documented. Provider is seeing patient for 4 mnth...
  10. K

    Wiki standing order

    Can providers receive credit for review on a standing weekly CBC order that they ordered? Example-- patient has blood work on 1/12 (standing CBC order) and has a follow up appt on 1/13, provider reviews with patient at follow up.
  11. K

    Wiki Test order/reviewed and interpretation of test help!!!!!

    Thank you for helping clear this up!
  12. K

    Wiki Test order/reviewed and interpretation of test help!!!!!

    I have a provider that is questioning the credit for test order and/or reviewed and interpretation of test. I will provide a scenarios. 1. He sees patient and will have patient return to office in 1 year with EKG. He does not count the order of EKG with this visit. When patient follows up...
  13. K

    Wiki Medication Refills

    Thank you. Only stating continue current therapy/medication would be treated the same way since medication needed to be continued is not documented, correct?
  14. K

    Wiki Medication Refills

    Patient sees provider, meds are reviewed and one prescription has been discontinued but it does not state if the provider was the one to discontinue the medication. Would this still count as prescription drug management since discontinued medication is listed under plan? Or would this be...
  15. K

    Wiki 99203 or 99204????

    Thank you for your response. If cast was treatment, would this make it a low risk, since the physician has to make sure cast is applied properly or would it still fall under minimal risk?
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