Recent content by mgarcia400

  1. M

    Wiki help with appropriate modifier

    Yes, this is what the physician did for the patient. I'm really having a hard with what modifier they're wanting.
  2. M

    Wiki help with appropriate modifier

    I've been struggling with a getting a procedure paid. This was done at a family practice. DX L02.415- Abscess of lower right extremity cpt 99213- 25 27301 They've paid office visit but keeps denying 27301 stating "service code inconsistent with reported modifier or required modifier is...
  3. M

    Wiki Medicare "G" code for shingrix admin

    Hello all. I bill for a Family Practice. Is the a specific "G" code to bill Medicare plans for the administration of Shingrix- 90750? I know for flu it's G0008 and pnuemoccal G0009.
  4. M

    Wiki Diabetic Retinol Eye Exam

    Hello all, I bill for a Family Practice and we're going to start doing Diabetic Retinol eye exams. Does anyone else bill for this at their practice that are not an ophthalmologist? Codes that I have been finding seem to be for specialists. What cpt code range would you use?
  5. M

    Hello Sharon, You've answered some of my questions in the past. I have posted on the forum but...

    Hello Sharon, You've answered some of my questions in the past. I have posted on the forum but have yet to receive a response to my new questions. Hoping you can help me? I bill for a Primary Care Family Practice. We are starting to do In-house X-Rays but they are being read outside of the...
  6. M

    Wiki X-Ray billing

    Hello all, I bill for Primary care family practice. We are starting to perform X-rays in office, but they are being read out of office. Can anyone clarify the correct way to bill for when X-rays are read outside office. I know to apply the appropriate CPT code for actual X-Ray, but what...
  7. M

    Wiki Child wellness or adult annual preventative?

    Is listing a pediatric BMI code going to conflict with Z00.00 since that's adult or should it be Z00.129 for child?
  8. M

    Wiki Billing 96372

    We give testosterone shots at our practice, patients provide their testosterone. We bill J code with 96372, insurance pays the injection for it.
  9. M

    Wiki Child wellness or adult annual preventative?

    Hello all, I bill for a family practice. We had a new patient come in for their annual physical along with an immunization. Billed was Z00.00 (patient is 18yrs old) with 99385, also adult Z68.20 (adult BMI). The claim was denied "invalid diagnoses code with patient's age and/or gender."...
  10. M

    Wiki Ear lavage and E/M payment

    Hello all, I work for a Family Practice and have been having trouble getting E/M visits as well ear lavage 69209 both paid. I submitted a claim as follows: 1. H61.23 Bilateral Impacted Cerumen 99213-25 Linked to 1 69209- 50 linked to 1 Blue Care Network paid 69209 (a very small amount) but...
  11. M

    Wiki Durolane Injection coding

    Thank you for the info. So office visit wouldn't be separately payable if though it was the provider who saw the patient and gave the injections?
  12. M

    Wiki Durolane Injection coding

    Hello all, I work for a Family practice and we recently started giving Durolane injections in the knee. We had patient recently have the injection in both knees in one office visit. My question is am I coding this correctly? I recently submitted a claim to Medicare Plus Blue (MI) as follows...
  13. M

    Wiki Medicare G0438 and G0444 denial

    Thank you! Very helpful!
  14. M

    Wiki Medicare G0438 and G0444 denial

    I work for Family Practice. I billed G0438 for patient as well G0444 for depression screening. I have seen G0444 on the preventative list for Medicare. G0444 was denied for "combination not compatible with another procedure or procedure/modifier provided on same day according to NCCI". Can...
  15. M

    Wiki Medicare G0402 and EKG

    Thank you for the response and information!
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