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rthomas@impcna.com's latest activity
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rthomas@impcna.com posted the thread Wiki EPIC in Physician-Owned Primary Care Office in General Discussion.We are a Physician-Owned Internal Medicine & Pediatric Primary Care office. We looking into switching our EHR & PM to EPIC since both of the major hospitals in our area are on EPIC. Looking for input, pros & cons, and advice. I am the billing... -
rthomas@impcna.com replied to the thread Wiki G0180 equivalent for commercial insurances.Yes, that is correct.
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rthomas@impcna.com replied to the thread Wiki G0180 equivalent for commercial insurances.You can bill CPT 99374, Care Plan Oversight for your commercial patients.
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rthomas@impcna.com replied to the thread Wiki TOAD status.Yes, you are correct, these need to be coded every year.
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rthomas@impcna.com replied to the thread Wiki Physician Assistant.Make sure the physician assistant been credentialed with Highmark. When our PA sees patients we do not attach a supervising provider.
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rthomas@impcna.com replied to the thread Wiki G0444.We use the PHQ9 and the provider has a brief discussion with the patient regarding depression.
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rthomas@impcna.com replied to the thread Wiki Tricare and G2211.Tricare for Life isn't even picking up Medicare's deductible or coinsurance for G2211. It would be interesting to know why Tricare is paying on pediatric claims since they state in the news letter that it's on their No Pay list.
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rthomas@impcna.com replied to the thread Wiki Diagnosis Code for Weight Checks.Can you query the provider to see why the patient was to come back in a week for weight check and have then amend the note? Our providers are really good at indicating why the want the patient to come back whether is be due to feeding problems...
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rthomas@impcna.com replied to the thread Wiki Wart or Lesion Count.If you can look at note in see that 5 lesions removed from left forearm, 2 removed from right thigh then it is not necessary to indicate a total of 7 lesions. In our practice when it comes to removing warts/molluscum (17110 & 17111) we do have...
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rthomas@impcna.com replied to the thread Wiki Wart or Lesion Count.Procedure documentation needs to indicate location, what was used to perform procedure, how procedure was performed, did the patient tolerate procedure or were there complications?
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rthomas@impcna.com replied to the thread Wiki 20610 - Different area, same side - Help!.For line # 4 I would have used modifier 51 to indicate multiple procedures them list 59 to indicate separate site 20610-RT-51-59.
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rthomas@impcna.com replied to the thread Wiki WHO IS NUMBER ONE?.Most companies use the birthday rule to determine who is primary when it comes to a child's coverage. Example: Mom's birthday is in June and Dad's birthday is in March. Since dad's birthday falls first in the year his coverage would be primary...
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rthomas@impcna.com replied to the thread Wiki E/M & AWV.Yes, Medicare allows you to bill AWV & E/M same day. You need to make sure that all the AWV requirements are in your note as well as documentation to support E/M. We have a nurse dedicated to doing the AWVs that way the provider can focus on the...
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rthomas@impcna.com replied to the thread Wiki Medicaid billing & immun administration codes.Medicaid doesn't reimburse for additional components. 90461 is for any additional components of the vaccine. If the provider is an EPSDT provider and enrolled in the Vaccine For Children program then you can bill for 1 component per vaccine...
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rthomas@impcna.com replied to the thread Wiki BCBS Claim Rejections.We have had this issue before and it was due to the subscriber & relationship being entered incorrectly. Some insurance cards will have the patients name on them and not the subscriber. Example: My husband Anthem BCBS and my daughter in on his...