Recent content by pclaybaugh

  1. pclaybaugh

    Wiki CPT 96127

    Another tidbit, for ADHD – this can be counted more than once if completed by different parties (e.g., parents and teacher), scored and documented by the provider.
  2. pclaybaugh

    Wiki H&P visit vs Comprehensive visit

    Please supply more context to the question. History and Physical, a component of an E&M, is the most formal and complete assessment of the patient and the problem and should be in most encounters. The E&M Guidelines is a great place to start.
  3. pclaybaugh

    Wiki Additional Dx Codes

    Thanks in advance for any answers. Patient is seen for back pain due to a fall, injected with Toradol. The diagnosis codes are clear but only used one diagnosis code. I am inclined to suggest the provider also add the Dx codes that were addressed (bold font). Happy to accept any input. The...
  4. pclaybaugh

    ED Workload Credit

    Hoping for some expert advice on good documentation to give the hardworking staff in the ED credit for their cognitive workload. Assume the symptoms the patient presents with are not active and there are no findings. Say 5 labs were ordered and counseling was completed for return precautions...
  5. pclaybaugh

    Wiki Counseling patient on options for pregnancy

    Hi, as you state the patient isn’t sure, perhaps leave off the Z-code for the unwanted pregnancy. This appears to be a confirmation of pregnancy visit, so Z32.01 seems appropriate.
  6. pclaybaugh

    Wiki Assistance with Hysterectomy Codes

    That’s a great tip. Thanks!
  7. pclaybaugh

    Wiki Assistance with Hysterectomy Codes

    Hello, many thanks, I will take a closer look. I have just found a Coding Clinic to help me along.
  8. pclaybaugh

    Wiki Assistance with Hysterectomy Codes

    Greetings, I code mostly OB deliveries and am revisiting Gyn Coding and have the following op report. Forgive the length. I have coded this with 58552. Please, am I missing something? A sterile speculum was placed in the patient’s vagina and the cervix was visualized. A single tooth tenaculum...
  9. pclaybaugh

    Wiki OB code sequencing - we're having a debate

    Well. just back into coding OB, but I place the condition codes just below those as in example B. Thanks for posting this as a debate and look forward to others responses.
  10. pclaybaugh

    Wiki Audiologist

    Hello, I am going down the audiology rabbit hole as well. Am reading an article as follows: https://www.audiologyonline.com/articles/evaluation-and-management-code-use-11371 Perhaps this will be helpful in some way.
  11. pclaybaugh

    Wiki Wart or Lesion Count

    Thanks, agreed. Whilst the location is evident, the count is not specific, rather as stated with a click.
  12. pclaybaugh

    Wiki RESECTION KELOID EAR

    Looks like the code I would use except for the fact that the codes 11441 - 11446 are based on length. I don't think you need a RT modifier.
  13. pclaybaugh

    Wiki What needs to be done for 31231?

    Hi, this is the CPT Asst. take: Introductory Text Key Changes The introductory text was expanded to further define the components of a diagnostic nasal endoscopy. A complete diagnostic nasal endoscopy (31231) includes visualization of the nasal cavity interior, the middle and superior meatus...
  14. pclaybaugh

    Wiki Wart or Lesion Count

    Good morning, all the items were addressed other than the actual count of warts, lesions, etc. Hopefully an answer with guidance will be forthcoming. Many thanks for your response.
  15. pclaybaugh

    Wiki Wart or Lesion Count

    Hello again, Please weigh in on whether there is a requirement or recommendation to indicate exactly how many lesion/warts areremoved. I am looking at documentation that appears to have a click box, >15 for wart numbers treated. My thoughts are the an amount should be forthcoming in order to...
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