Recent content by TThivierge

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    Wiki Modifier needed for inpatient

    Hi Debellis59,:) I suggest trying these modifiers to define the different clinical providers. Check it in the HCPCS manual Appendix 2. The modifiers you may seeking could be ... AE Register dietician,, AF Specialty Physician , AG Principal physician, AH Clinical Psychologist, AJ Clinical...
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    Wiki Help! NCCI edits

    Stacia 70, Standard treatment programs in acute rehabilitation include occupational, physical, and speech therapies (OT, PT, and ST, respectively). You need to ensure document minutes, have consult plan of treatment, and body area give treatment. Add modifier 96, 97, GO GN GP depending on...
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    Wiki Rookie Questions about getting labs covered in ambulatory setting

    Hi Krauttermedica I use notations for doc's order to guide me but at times the name of the lab is what the physician is looking for. Also if person has complex illness like type of cancer and it is current most labs will coordinate with such serious illness. Also do not forget to code in lab...
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    Wiki 2 visits on one day--what modifiers should be used in ED?

    Hi Nikki I would try using modifier 27 on 2nd visit to ED on same date. I hope this data helps you Lady T
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    Wiki dietitian billing: Hi i need help with some dietitian billing. any experts? what are the proper cpt codes for billing a dietitian visit?

    Hi Dravekar You can bill CPT 99211 not CPT 99212 for this staff person .Add referring physician or provider on claim. Some payers want modifier AE for dieticians. If do phone call can use CPT 96886 series add minutes in documentation and discussion for established patients. I hope this data...
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    Wiki G2211 FQHC Medicare

    Hi Heather Well I got this data from the journal listed. However are the Dx code billed as unspecified diagnosis? Payers not covering unspecific dx as much. Or it could be when billed Z codes as primary dx. Most Z dx codes are not primary dx codes. Years ago I use to work at a FHQC facility...
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    Wiki G2211 FQHC Medicare

    Hi There HGILHAM The HCPCS code G2211 add on code is not to be billed with outpatient and clinic but for a long term care problem and must be complex. Public feedback has not been good on this HCCS code so made modify conditions on it and budget constraints. Try and visit https://www.cms/.goc...
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    Wiki Personal History of Cancer-- Invalid principal diagnosis?

    Hello Toria Some of the Z codes listed above should NOT be first listed or principle Dx. code on claims per the ICD 10 manual These are not first listed dx codes such as: Z34, Z76, Z99, Z40,andZ42.You can use these as secondary or last dx on claims per documentation. As stated in ICD10 manual...
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    Wiki CCM

    Hi VNorman Yes if want to bill have them do the CYB (cover your behind) in completing proper documentation. Lady T
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    Wiki Need some advice on these three codes...., 90833, 90836, & 90838 Thank you!

    Hi Brad Yes can bill these CPT codes add modifier 95 if video or telehealth. Add modifier 93 if phone call. Ensure put amount of minutes on medical documentation for that day of treatment, describe problem, care, meds using and current dx codes. Ensure the patient name Etc on record & ,add...
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    Wiki 95165 UHC Continuous Denials

    Hi Seraphine8519,🐜🦋 I would use another CPT it states it CPT 95165 is for professional service for preparing multiple doses of insect bugs antigen . Maybe should use CPT 95115-95125 linked with problem..allgery on skin or breathing or mold or Etc. Other factors...CPT Codes 95115 and 95117 -...
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    Wiki CCM

    Hi V Norman They should be aware or able to verify patient, mode of treatment listed is video, phone call or face to face, add minutes talk with patient, get list of current vs past medical histories and last time inpatient & problem. Review meds but also about current visit of the assessment...
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    Wiki Testosterone testing

    A total testosterone test CPT 84403measures free testosterone and testosterone that's attached to proteins. This is the most common type of test. A free testosterone test CPT 84402 measures only the "active" form of testosterone. This test is less common, but it may be useful for diagnosing...
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    Wiki incomplete colonoscopy due to blockage

    Hi Shaughnessy Bill the gastro CPT code chosen- 45380 then use definitive dx for Rectum mass, and dx Z12.11 last on claim. If lab results states rectum cancer is positive from results add that on claim first then Z dx code..Please note digital finger exam is bundled in, Provider cleaned out &...
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    Wiki Peripheral Arterial Disease Coding – Lower Limb Thrombosis

    Hi XXXPAragon To read more about the MPFS search tool, go to the MLN® booklet, How to Use The Searchable Medicare Physician Fee Schedule Booklet (PDF) . See reference https://www.cms.gov/medicare/payment/fee-schedules/physician/lookup-tool. You put in CPT code and list dx associated with...
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