Recent content by TJAlexander

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    Wiki Understanding Workers Comp

    Please HELP! I really need help understanding the whole workers compensation process when it comes to medical billing. I understand that if the WCIC is owned by a commercial carrier (Aetna, UHC) then we are FORCED to abide by contractual obligations because our contract supersedes any state...
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    Wiki POS Home Sleep Study

    Maybe it's the wording of the CPT code saying 'unattended'. I thought that the test itself was a 'G code.
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    Wiki Filing Complaint with state insurance board

    I've filed a few claims with the state commissioner's office in GA. Because the plans were self-funded they didn't have jurisdiction however, once the state contacted the payer I usually heard from someone who was able to help me with the issue.
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    Wiki PT Timed Units

    Hey guys, What are you guys doing when you get denials for timed exercises for PT? Our therapist uses WebPT so there is a daily note and a flowsheet. If the flowsheet doesn't list the minutes for the timed exercise but the daily notes lists the exercise and the number of units, doesn't that...
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    Wiki NDC Denials

    Hi! Thanks for responding. So they only mentioned the NDC which is taken directly from the box the injections were shipped in so I'm confused as to how it can be invalid. The payer rep on the phone wasn't helpful but I think I read somewhere (it may have been here somewhere...) that payers use...
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    Wiki NDC Denials

    I'm curious if anyone else is having this issue. Last year we started receiving denials for our viscosupplementation claims saying that the NDC number was invalid. I was confused because the NDC was listed on the CMS website and I was taking the number right off the package in the 11-digit...
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    Wiki Personal Injury

    This is for anyone with experience treating PI patients; specifically surgery. We are new to the PI business but it has been somewhat seamless since we primarily see patients via telehealth. However, we have a patient that requires surgery and everything blew up. Somehow the hospital our...
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    Wiki HELP! 2 surgeries on the same day...

    My gut instinct tells me that this is correct. I advised our clinical staff to schedule separate surgeries to avoid any complications with reimbursement. This job gets complicated enough with regular surgeries!!!
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    Wiki HELP! 2 surgeries on the same day...

    We have an established patient that has a new WC comp injury for which he will need surgery (wrist) and another long-standing issue (shoulder) that he also needs surgery on. The surgeries CAN be performed during the same operative session but are we able to bill 2 different payers? He wants...
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    Wiki POPTS/PT Billing/Coding Resource

    I was told to use place of service 11 when billing. Is this correct? I thought place of service 62 indicated physical therapy.
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    Wiki Physical Therapy Billing

    Thank you!
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    Wiki Physical Therapy Billing

    Hello, Our practice just acquired a new location that includes physical therapy. I've never billed for PT before and am curious as to whether the DPT can bill under our MD's NPI.
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    Wiki PRP and Stem Cell

    We determine the pricing based on cost, the number of joints treated, and provider work. Like Amyjph, the only time we've been paid by insurance for PRP was workers comp.
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    Wiki Appropriate reimbursement

    Thank you for that!
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    Wiki Appropriate reimbursement

    Reddit has a forum called AITA; for those of you that know, then you know. Anyway, I need to know if I'm just a horrible coder and biller. The surgeon I work for is an orthopedic surgeon who sometimes works on professional athletes that are hurt during play. The claims for the injuries are...
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