Recent content by mattie7632

  1. M

    Wiki 97124 - professional charges

    Yes, it does, IF the payer requires Medicare modifiers on PT codes.
  2. M

    Wiki Qutenza Questions

    The admin code is likely 64632 though I've seen providers us 64640 as well. Insurance will only reimburse you YOUR cost of Qutenza ($3600 apprx for 4 patches, 2 each foot) so be sure the patient pays their portion!! Yes, Medicare will pay for it.
  3. M

    Wiki JW/JZ modifer

    If Specialty Pharmacy supplied the medication, you don't bill for it, the pharmacy did.
  4. M

    Wiki Billing PIP Personal Injury Protection

    You bill for it the same way you would bill any commercial insurance; however you have to obtain all the necessary information from the patient about this claim so that all the accident fields can be populated and the claim will go through. ie Medical claims billing address, medical adjustor...
  5. M

    Wiki PRP injection with Euflexxa

    Isn't your provider alternating the PRP / Euflexxa ? For example, Patient begins care and has his series of Euflexxa injections, in 3-6 months he has PRP to same location, 3-6 months later Euflexxa. (HA is repeated every 6 months). This is how our provider does it and we've never had issues such...
  6. M

    Wiki G0283 to Horizon

    G0283 is the Medicare code for 97014 -EMS. Some BCBS plans do require the Medicare codes and modifiers for PT; however, so you'd have to be sure what Horizon wants first. Also, 97014/G0283 reimburses very little ($5-$10) so keep in mind even if you are successful having the claim corrected using...
  7. M

    Wiki Billing for drugs when the administration code is bundled.

    What is the drug?
  8. M

    Wiki Botox injections

    The admin code is 64616 if you are injecting Botox for Cervial dystonia/spasmodic torticollis. Also if you are buying and billing the Botox, be sure the payer reimburses your actual cost for the product, as some will not to push you to Specialty Pharmacy.
  9. M

    Wiki Sanexas

    The Sanexas machine is NOT covered by Medicare and it will only be a matter of time before CMS and the OIG go after you if you start billing for this. They aren't messing around in their pursuit of offices engaged in this. Some commercial payers will pay for it. The coding is complex if you are...
  10. M

    Wiki GP Modifier for W/C claims

    I've done chiro including WC for 20 years now, and thus far they are not requiring the GP modifier on PT codes.
  11. M

    Wiki What CPT code should I use for Fluidotherapy?

    Yes, use the unlisted modality code. This is assuming you mean hydratherapy, ie the water bed? If you mean fluid flow....this is a different procedure and has it's own codes.
  12. M

    Wiki Massage Chair Code

    No, there is no CPT for this. You could use the unlisted modality CPT code and see if some payers will reimburse after they request notes.
  13. M

    Wiki EM MDM - unique tests

    Thanks, you're absolutely correct. I double checked with our compliance company and they reiterated what you said. Needless to say, the doctors are disappointed lol
  14. M

    Wiki CPCO Exam? - Anyone here CPCO Certified

    Ahhhh!!! They've cancelled the exam twice now due to Covid and I'm supposed to sit for it on March 6 leaving me just 4 weeks now to prepare. These comments have me scared! I thought I had a good understanding of this but jeez my time is up and I have to pass as my year is about up and there are...
  15. M

    Wiki EM MDM - unique tests

    If a chiropractor does a Kemp's test (also interprets and documents), or x-rays including the read and report, can these qualify as data points for MDM? In a discussion with my providers, most of them agreed that they sometimes do spinal exams that do not include the ordering and performing of...
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