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    Wiki Local Coverage Articles

    My understanding is that Local Coverage Articles are 'further explanation' of an LCD. So if a state does not have an LCD for a CPT or HCPCS code, we do not need to research further and read any Articles that apply when the same code has an LCD for a different state. For example, J9035 does not...
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    Wiki Axillary Graft for Bypass During Arch Grafting

    Hello, If a graft is placed in the axillary vein to use for CardioPulmonary bypass during a total arch replacement--do we code the creation of the axillary graft? I'm thinking it is included in the primary procedure which requires bypass but I would like confirmation. After informed...
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    Wiki US Guidance 76937

    Hello, I saw another thread on this but am interested in 2019 resources or guidelines. I have read Dr. Z and the code description and would like to know how others are deciding there is enough documentation to support billing for the guidance on Heart Caths. francine cahoon, cpc, cpma, ccc, copc
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    Wiki Has anyone taken the Certification exam recently?

    I am taking the cert exam in 2 weeks... just wondered if there were any suggestions from recent test takers. I have coded ophth for 5 years. francine
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    Wiki Do you agree with my Codes??? Provider doesn't

    Under roadmap imaging after double flushing, the Envoy catheter was advanced into the proximal cervical right internal carotid artery where it was used for 3-D rotational right carotid cerebral angiography. The Envoy catheter was then connected to heparinized pressurized saline flush using a...
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    Wiki When do YOU code from a path report?

    I am looking for documentation stating when you can use the path report for diagnosis coding. I am finding things that **hint** that you can do this but I need something documented and reference-able. Any help or direction would be appreciated.
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    Wiki Mesh used as a prevention to Hernia--can I code it?

    Hi, I have a surgeon documenting that they placed mesh over the colostomy site as a prevention to hernia. Any ideas on coding for this? 49568 is for mesh during an actual hernia operation which is not what is being corrected here. Thanks in advance!
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    Wiki Billing for refractions-92015

    I know most payers do not reimburse for refractions. I also know the cpt description for 92015 doesn't clearly state if the patient is given the RX. My EncoderPro states the RX is given to patient. Does anyone bill the 92015 if the RX IS NOT given to patient? What is your rationale for...
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    Wiki Conscious Sedation

    Has anyone found documentation clarifying the maximum (if there is one) of time to bill for CS? Last months magazine had a graph in it that said 83 minutes OR LONGER would be 99152 and 99153 X 5 but I'd like some type of concrete policy to back me up. Thanks!
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    Wiki Estimated Coding Productivity

    Hello, I am a coding supervisor for a large healthcare system in the mid-west. We have 41 coders for over 500 providers. We are trying to come up with a range of productivity standards for all specialties. We are up to our armpits running reports and performing all kinds of mathematical...
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    Wiki NP's and treadmill stress tests

    Question has come up today.... can an NP bill for a stress test?
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    Wiki ERG or 92275 help

    I am trying to find definitive documenation that ERG's cannot be billed bilaterally. Any ideas?
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    Wiki Risk required for a 99245 eye consult

    I have a provider who is billing a 99245 yet his risk tops out at 'prescription drug management' for eye drops. He is not understanding my explaination. Does anyone have examples of what would constitute a level 5 for risk? I know urgent surgery on the eye would count, but any others?
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    Wiki 92002,92004,92012 and 92014

    I am looking for clarification on whether or not dialation is REQUIRED for 92004 and 92014. For example, my Glaucoma prividers do not dialate to do a fundus exam, yet bill a comprehensive visit. I read the cpt definition as they have done a comprehensive exam. Any comments or help is greatly...
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