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  1. K

    Wiki What would you say to someone considering becoming a medical coder?

    I lucked out at getting my first coding job back in 2007. The thing is, I applied for front desk and during the interview, the office manager noticed my CPC-A. So, she decided to hire me as a Coder (I only worked 21 hours a week and got paid minimum wage) with no experience. I lasted over a...
  2. K

    Wiki DME Billing

    I work for a DME company. The providers send us the orders to set up the patients and we bill for the supplies under the ordering provider's NPI.
  3. K

    Wiki Should I take another certification?

    Try applying with your Health Department. You never know where that might lead. As for AAPC, every time you call, note the date and the time and who you speak with. I have learned to do that and if you haven't already, get forceful with who you are talking with when appropriate. I don't know...
  4. K

    Wiki Who usually does medical coding/billing for a Health Dept?

    I have both CPC and CPB certificates. I briefly worked for my Health Department as an ASA II. The position was scheduling and registering patients. I then got pulled in to do the Billing, which mostly was for Family Planning. We did get paid for STD Services, but only if they drew blood for...
  5. K

    Wiki Medicare is not paying for A7045

    Medicare keeps denying A7045: Exhalation port with or without swivel used with accessories for positive airway devices, replacement only. I have tried the following modifiers: NUKX and just NU and then no modifier. I looked up the following LCDs: L33718 and L33800. They offer no guidance on...
  6. K

    Wiki Hospice Coding for a Vent Patient

    I work at a DME company and have a vent patient in Hospice. The Hospice company is not paying for the Vent with the Diagnosis of G12.21. I was told by the Hospice company that ALS is not covered diagnosis code by Hospice. I was told that the claim needs to be refiled with a Modifier not...
  7. K

    Wiki BCBS Denying for Family Planning Office Visits at Health Department

    Thank you for your help and very insightful information on this matter.
  8. K

    Wiki BCBS Denying for Family Planning Office Visits at Health Department

    I see the BCBS Remits and it just says Maximum allowed benefits has been reached and no further explanation on the Remit or on BCBS website.
  9. K

    Wiki BCBS Denying for Family Planning Office Visits at Health Department

    Procedure code is usually a 99213 or 99214 and the Diagnosis code is Z30.9 for the most part. I don't see the actual claims being entered, I just follow-up after they have bee either paid or denied by the Insurance.
  10. K

    Wiki BCBS Denying for Family Planning Office Visits at Health Department

    I work at a Health Department as a part-time biller. Recently, BCBS started denying several patients visits due to the Max benefit being reached. BCBS did pay for the annual and maybe one follow-up visit, but started denying the visits after those two. Patients come here for their Depo shot 4...
  11. K

    Wiki Viva Health Claim Denial

    Never had a chance to get this corrected.
  12. K

    Wiki Altering Paper Medical Orders??

    Thank you for your guidance with this matter.
  13. K

    Wiki Altering Paper Medical Orders??

    Is it okay to alter paper medical orders for a DME company? My billing supervisor erased something that the doctor wrote on the order and replaced it with something else before the paperwork was submitted to Medicaid. I just don't know what is right and wrong in this situation. Another thing...
  14. K

    Wiki Hypothetical Question Concerning a Signature Date on a Medical Order

    Thank you. As for the order in question, it's a paper order.
  15. K

    Wiki Hypothetical Question Concerning a Signature Date on a Medical Order

    I submitted a Medicare Redetermination, and it was denied because the signature date on the Oxygen CMN was outside of the allowed 30 days after the face-to-face visit. Then all of a sudden, the signature date was changed from September to July to meet the 30-day signature date requirement for...
  16. K

    Wiki E2325 Keeps Denying by Medicare because of Invalid Modifier

    Has anyone ever gotten E2325 (Sip and Puff Accessory for a Wheelchair) paid by Medicare? It has been submitted with RR, but still denying for Missing, Invalid modifier. It's being billed as a Capped Rental. The LCD is not helpful either.
  17. K

    Wiki WellCare of Georgia

    Has anyone ever dealt with WellCare of Georgia? Where do they get their Fee Schedule from?
  18. K

    Wiki E0483 Recert PA for Alabama Medicaid

    Has anyone ever submitted a Recert PA for E0483 to Alabama Medicaid and if so, how was it done?
  19. K

    Wiki ABA billing with no Auth (cross posted)

    I do DME billing for Medicaid and we need a PA before the claim can be billed, otherwise, it will get denied for no PA, and can't retro the PA to cover those claims. I don't know if it is the same for ABA services, but it might be.
  20. K

    Wiki DME Billing Webinars / Workshops

    I was wondering if there are any Webinars / Workshops that help with DME Billing. Thank you.
  21. K

    Wiki Question on the EPSDT Requirement

    Say a patient is 20 years old, does this patient still need to get an EPSDT for Alabama Medicaid?
  22. K

    Wiki The Sad Hunt as a CPC-A

    I got my CPC-A back in 2010 and was given the break of coding for a GI Doctor after interviewing for a receptionist position for that office. Was laid off a year later and took a hospital scheduling position but moved on due to many changes in that department. Took a temporary Maternity...
  23. K

    Wiki Alabama Medicaid Suspends Claim after adjustment of that claim

    Thank you.
  24. K

    Wiki Alabama Medicaid Suspends Claim after adjustment of that claim

    When trying to fix a claim on the Alabama Medicaid portal, after correcting the claim and then clicking Adjust, the claim is put in Suspended Status. Why is this?
  25. K

    Wiki Supply Code Denying by Medicare

    Medicare is denying A4483 (disposable moisture exchanger) because it's bundled into another code. How can I find out what code it is bundled into. Thanks.
  26. K

    Wiki wellcare/sunshine merger coding rules

    Sunshine of Florida bought out Wellcare of Georgia, correct? I deal with them for DME.
  27. K

    Wiki Charge Admit/Discharge On Day Patient Expired

    I have a physician who is charging the Admit code only and the patient expired on the same day they were admitted. Do I charge an Admit or let the provider know that a discharge code needs to be used for this service. Thanks for the help, Bethany K. CPC, CPB
  28. K

    Wiki Viva Health Claim Denial

    I have a claim where Viva Health is denying due to: diagnosis(es) billed are inappropriate for pos. The given diagnosis for this date of service is: I10,E78.5,E03.9,I63.9,E55.9,J02.9 and R73.09. The patient came in for an office visit and then had a flu shot same day. Why would this claim be...
  29. K

    Wiki Hospital Charge

    I have a provider who saw a patient in the hospital and charged a discharge visit on 1-3-19 (99239). The patient wasn't officially discharged from the hospital on 1-4-18 and the same provider came back and charged a hospital visit (99232). Do I go ahead and bill out the discharge visit, since...
  30. K

    Wiki HIV Coding in Alabama

    I have question concerning a patient being seen by the clinic that I work for and the provider is assigning B20. However, this patient is not being treated for the HIV or any related symptoms of the HIV. It states in the chart that the patient is coming in for a follow-up of abdominal pain or...
  31. K

    Wiki Administration Code Denying for Medicare

    Thanks for the help
  32. K

    Wiki Administration Code Denying for Medicare

    Is anyone out there getting denials from Medicare when a patient comes in for an office visit and has an injection the same day. The office visit gets the modifier 25, but then Medicare is turning around and paying only for the administration (96372...) service and drug and not the office...
  33. K

    Wiki Updating Patient Information

    Thank you for the clarification.
  34. K

    Wiki Updating Patient Information

    When a patient comes in at the beginning of the year, is it the right thing to collect the patient's new insurance and updated demographics to scan into the chart? Also, every time the patient comes in after that visit, the front desk should always make sure that policy is still the same and if...
  35. K

    Wiki Guidance on Coding Podiatry

    I'm new to coding for podiatry. I have a patient come in for an office visit and the provider does two procedures at that same visit. However, there are only two diagnosis codes given for that visit. I would still charge the office visit with a 25 modifier along with the two procedures...
  36. K

    Wiki Billing Ultrasound Not Done by Delivering Doctor

    I have a patient who had an ultrasound done at a doctor's office before transferring to the delivering doctor. The delivering doctor didn't do an ultrasound once she transferred to that doctor. This is a global package for delivery, anesthesia, office visit and lab work all done by the...
  37. K

    Wiki CPC Looking for Coding Postition

    At this current time I am a scheduler and have been in this position for over four years. I assist the various medical offices with choosing the correct diagnosis codes to ensure compliance guidelines. My postition as a scheduler has allowed me the opportunity to be exposed to the the fields...
  38. K

    Wiki CPC-A in Anniston, AL Looking for Externship Volunteer Opportunity

    I am recently Certified Coder-Apprentice looking for an externship opporunity in the surrounding area of Anniston, AL. If any one knows of any medical offices that might be interested, please let me know. Thanks, Khartoum1900nile
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