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Wiki Testicular Lymphoma

What is the correct coding for testicular lymphoma -- I am torn. I have always been told to code any reproductive organ cancer to the disease site. But I am unsure when it comes to lymphoma. This is Diffuse large B-cell lymphoma. I have referred to the official guidelines, and can't find any...
- dkb6126
- Thread
- Mar 28, 2024
- Replies: 1
- Forum: Diagnosis Coding
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Wiki 10555-10557- OPTUM DENIALS!!

I can't even find a CPT 10555 or 10557 - are you sure these are the correct cpt codes you want to use?
- dkb6126
- Post #2
- Mar 28, 2024
- Forum: Payer/Health Plan
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Wiki Skin Excision vs Lipoma Excision (114xx, 2155x)

I would always code a "mass" to soft tissue - which should be the 21556-59 and 21554. You can only bill for the repair if it was a complex repair.
- dkb6126
- Post #2
- Mar 28, 2024
- Forum: General Surgery
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Wiki Bilateral 11042 and Medicare

agree with CodingKing. You can't use a -50 or RT or LT on that code. Sum the surface is correct.
- dkb6126
- Post #3
- Jan 7, 2020
- Forum: Medical Coding General Discussion
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Wiki AS and 62 together?

I agree with Thomas
- dkb6126
- Post #3
- Nov 20, 2019
- Forum: Modifiers
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Wiki Radiation Weekly Management charge 77427 - Humana PPI audit

We have been getting PPI audits from Humana that are recouping payments for the 77427 (weekly mgmt charge) because we bill it on the first of the 5 days of treatment. Humana is saying it has to be billed on the 5th day of treatment - but they also require a date span, which our software won't...
- dkb6126
- Thread
- Nov 20, 2019
- Replies: 1
- Forum: Billing/Reimbursement
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Wiki Neuroendocrine of the Pancreas?

So - Neuroendocrine carcinoma and carcinoid's are not exactly the same things. We usually code the neuroendocrine carcinoma of pancreas to C7A.8 (or possibly C7A.1 depending on path). I would only code it to the C7A.094 if the pathology said "carcinoid". "Both carcinoid tumor (carcinoid) and...
- dkb6126
- Post #3
- Nov 14, 2019
- Forum: Hematology/Oncology
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Wiki Pathology

We wait for the pathology (we are an oncology practice), unless the path is taking an exceedingly long time (like over 10 days).
- dkb6126
- Post #2
- Nov 14, 2019
- Forum: Diagnosis Coding
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Wiki Billing 99232 to Cigna with Reading of US

We have had the same problem with Cigna --- bundling our physician claims to the hospital claim - even though we bill with the modifier-26 on a CMS-1500 and they bill on a UB04 (which implies the -TC so it doesn't have to be on the claim).
- dkb6126
- Post #3
- Nov 14, 2019
- Forum: Billing/Reimbursement
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Wiki Pilar Cyst Excision

They may be denying it because it is not needed. None of these codes look like they bundle. Each excision should be coded separately, and they only need a modifier if you bill the same cpt more than once.
- dkb6126
- Post #2
- Nov 14, 2019
- Forum: Medical Coding General Discussion
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Wiki Series billing chemo

Does anyone out there bill their OP chemo on series accounts (monthly billing). It doesn't meet the CMS requirements, but you can bill it that way. I'm curious what it has done as far as reimbursement. Also curious on the denial rates - and if it seems to affect cash flow. We currently bill...
- dkb6126
- Thread
- Nov 14, 2019
- Replies: 0
- Forum: Outpatient Facilities
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Wiki Surgical documentation question

I have a situation where two physicians performed a complex surgery. One was the primary surgeon, the other is the assistant surgeon. My problem is the only operative report was done by the assistant surgeon. He does list himself as the assistant surgeon in the dictation. There is no...
- dkb6126
- Thread
- Aug 14, 2018
- surgical documentation
- Replies: 3
- Forum: General Surgery
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Wiki ICD-10 Superbills

Anyone have a ICD-10 superbill they would share -- specifically looking for Surgical Oncology. Please and thank you.
- dkb6126
- Post #34
- Sep 24, 2015
- Forum: ICD-10
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Wiki Humana capping 77300 - radiation oncology

Anyone else have issues with Humana capping dosimetry charges at 6 units per course of treatment? When we do Vaginal HDR dose calcs are done with each insertion but they only want to pay for 6 total????
- dkb6126
- Thread
- Mar 25, 2015
- Replies: 0
- Forum: Billing/Reimbursement
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Wiki 19301 multiple times same breast

You really should use the modifier -76 (repeat procedure by same physician) in this case, not the -59. If they don't pay with that change - appeal with medical records.
- dkb6126
- Post #2
- Aug 11, 2014
- Forum: General Surgery
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Wiki Dx sequencing??

If the lung is what you are treating at this visit it should be the first listed diagnosis.
- dkb6126
- Post #3
- May 16, 2014
- Forum: Hematology/Oncology
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Wiki Interoperative Frozen section - 88331

Looking for some advice on billing the 88331 (interoperative frozen pathology). Our surgeon (oncology) will often have to send a specimen to review during the surgery. Is this CPT 88331 billable by the surgeon, or is it only billable by the pathologist. We are getting denials, asking for a...
- dkb6126
- Thread
- May 16, 2014
- Replies: 0
- Forum: General Surgery
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Wiki 77300 - humana capping units??

Does anyone have an opinion on the fact that Humana's new policy caps the dosimetry charges (77300) at 10 units total in a 58 day period? Our Rad Onc's usually bill this twice - once with the initial course, and again on the boost (when we do a separate plan). We are getting a lot of denials...
- dkb6126
- Thread
- May 16, 2014
- Replies: 0
- Forum: Hematology/Oncology