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  1. Brandy0618

    Wiki WebPt help.

    Good afternoon. I am seeking assistance, direction or tips from anyone that has worked with or is working in Webpt EMR and Webpt billing. I am a CPC and CPB. I have worked in healthcare for a long time but I have never struggled with software like I struggle with this software. 100% of it is...
  2. Brandy0618

    Wiki Physical Therapy compliance with EMR.

    Good afternoon. I do not have much experience with Workers Compensation. However, I think this is a question not only for Workers Comp but for guidance in correct patient EMR charting. On a patients initial evaluation our therapist always include the date of Injury/Onset under the date of...
  3. Brandy0618

    Wiki Physical therapy/Workers Comp.

    Good afternoon. I do not have much experience with Workers Compensation. However, I think this is a question not only for Workers Comp but for guidance in correct patient EMR charting. On a patients initial evaluation our therapist always include the date of Injury/Onset under the date of...
  4. Brandy0618

    Wiki Physical Therapy ETP Incentive reconciliation direction.

    Good morning. Can anyone help guide me with how you reconcile ETP Incentives on an ERA. We are processing paper claims due to a software conversion. We are on Webpt and Webpt billing. I just do not understand how to correctly reconcile the incentive payments. This carrier is Ash (Cigna)...
  5. Brandy0618

    Wiki Physical Therapy.

    Good evening. Has anyone heard of codes for chart review? Or maybe completion of charting. Referring to physical therapist reviewing the PTA documentation? Our administrator has asked me about this. I was unsure and was not aware of any. He believes there are. I also wanted to know about...
  6. Brandy0618

    Wiki Chart Review codes for Physical Therapy.

    Good evening. I was approached by my administrator with a question about possible CPT codes for chart review. I work in physical therapy. Has anyone heard of this? I believe he is referring to completing charts after hours? He also had a question for me about our therapist being able to...
  7. Brandy0618

    Wiki Copay, Co-Ins, Allowable, Billed?

    Good afternoon. I am a CPB in addition to a CPC. I have primarily held coding jobs until now. I am now in a billing position and I need a refresher in the equation of copay + insurance payment should = the allowable? Correct? The paid amount from the carrier + the adjusted amount should =...
  8. Brandy0618

    Wiki Are we able to bill Labs for Pre Pellet if blood draw was in office?

    Good afternoon. Does anyone out there bill for labs when testing for the HRT male and female Pre Pellets? Are we allowed to bill the carriers for the lab draws in office to send to Labcorp for example 80050, 84402, 82670? If we bill these CPT codes in office what codes do the Lab bill out for...
  9. Brandy0618

    Wiki Labs for Pre-Pellet.

    Good afternoon. Does anyone out there bill for labs when testing for the HRT male and female Pre Pellets? Are we allowed to bill the carriers for the lab draws in office to send to Labcorp for example 80050, 84402, 82670? If we bill these CPT codes in office what codes do the Lab bill out for...
  10. Brandy0618

    Wiki Clarification with POS 02, 10, 11. (Telehealth).

    Good day. I am requesting clarification to the end to PHE where modifiers 02, 10, and 11 are concerned. I am so confused. What does it mean when it is described as "Medicare has told practitioners to use the place of service (POS) that would have been used if the patient was seen in person...
  11. Brandy0618

    Wiki Help with Telehealth visits and modifiers 02, 10, 11.

    Good day. I am requesting clarification to the end to PHE where modifiers 02, 10, and 11 are concerned. I am so confused. What does it mean when it is described as "Medicare has told practitioners to use the place of service (POS) that would have been used if the patient was seen in person...
  12. Brandy0618

    Wiki Requesting MIPS help.

    First of all I apologize for asking for help in understanding and reporting MIPS. I am a CPC and CPB but I have never worked in a practice until now that accepts Medicare and I am uncertain of how this is reported yearly, quarterly. Can someone please explain this workflow to me, please. I am...
  13. Brandy0618

    Wiki Help with understanding MIPS.

    First of all I apologize for asking for help in understanding and reporting MIPS. I am a CPC and CPB but I have never worked in a practice until now that accepts Medicare. Can someone please explain this workflow to me, please. I am basically an infant with this process. I also am asking for...
  14. Brandy0618

    Wiki LCD for 11102-11107 (Biopsy)

    Can anyone help point me in the right direction of where I can obtain the LCD for biopsies? I cannot find this. We are having a difficult time with denials with biopsies when reported with R21 (Rash). Our providers obviously have no idea what the rash is. This is why they are submitting the...
  15. Brandy0618

    Wiki 11104 biopsy with diagnosis code R21 Rash.

    Does anyone have information or guidance on how our providers can get reimbursed when submitting 11104 with R21? These are rashes in question. Not neoplasms. I am at a loss as when our providers are trying to rule out or prove one rash vs another. Obviously, we cannot use a diagnosis of...
  16. Brandy0618

    Wiki Billing for supplies in addition to Mohs procedures.

    Good morning ALL. ;) I have utilized the "Search field" for information on being able to bill out supplies in addition to Mohs procedures. I was unable to find any threads on this subject. Can anyone tell me if you we are able to bill for supplies in addition to the Mohs procedure itself...
  17. Brandy0618

    Wiki New suture removal code 15853

    Good morning. I am wanting to load this code(+15853) into out PM. I have tried to find RVUs in order to attach a fee to this code but I cannot locate anything. Can someone help me? Suture removal is very common in Dermatology and I was wondering if anyone can lend some information on whether...
  18. Brandy0618

    Wiki Reimbursement for gender identity laser hair removal?

    Has anyone had experience with billing for 17380 (Electrolysis epilation), F64.9? This is services for a male transitioning into a female seeking laser hair removal before surgery. We are having TriWest tell us with a prior authorization our Esthetician can bill under our MDs credentials. This...
  19. Brandy0618

    Wiki MOHs surgery and BX different site practices.

    If a MOHs surgeon performs surgery on a site that has been previously confirmed BCC or SCC (from dermatologist/dermatopathologist in the practice) and during this surgery he decides a separate site needs to be biopsied and sends this specimen to an outside lab, is this billable to the MOHS...
  20. Brandy0618

    Wiki LHR (electrolysis) for gender dysphoria.

    I was wondering if anyone has had experience in billing and reimbursement for 17380 (electrolysis epilation) with a referral from TriWest carrier? We received a referral from Triwest on behalf of a patient to perform LHR on the beard area as the hormone medications are not helping to remove...
  21. Brandy0618

    Wiki Kenalog conundrum. HELP. :(

    Good morning. If our provider reports Kenalog intralesional given at 2 separate sites same mg same volume, do you combine the two and report a total? Our provider is reporting the same dosage on 2 separate lines. If different dosage on 2 separate sites you would report two different lines...
  22. Brandy0618

    Wiki Kenalog mg combined?

    Good morning. If our provider reports Kenalog given at 2 separate sites same mg same volume, do you combine the two and report a total? Our provider is reporting the same dosage on 2 separate lines. If different dosage on 2 separate sites you would report two different lines? Correct...
  23. Brandy0618

    Wiki 54056 cryo simple vs 54065 extensive?

    Can anyone help answer what constitutes simple vs extensive between these 2 codes? I have researched and researched and receive many different answers. Our provider removed 8 papules from the penis via cryosurgery. When queried he questions what constitutes simple vs extensive? Thank you.
  24. Brandy0618

    Wiki Cryosurgery for removing foreign body.

    Has anyone in the derm world ever coded method destruction cryo for removing a splinter? Our provider states the skin will bubble and it will force the splinter out. Would CPT 17110 be appropriate for this? Thank you.
  25. Brandy0618

    Wiki 87070?

    Good morning. Can anyone help answer the question of, can we report 87070 if the provider performs the C+S Aerobic Bacterial culture with 99212? This is sent to the lab but the provider performed the collection of the culture. Or, is this considered bundled into 99212. Thank you. :)
  26. Brandy0618

    Wiki Cigna requires medical records with E/M?

    Has anyone else in the derm world heard that Cigna will require medical records will all E/M when filed with a procedure starting 8-2022? Thank you.
  27. Brandy0618

    Wiki PTP and MEE's?

    I am not new to coding. However, 6 months of dermatology coding can make you feel new every day. :cry: Can anyone help me understand how to best code and get reimbursed for 17110 with 17000? 11301 and 17000? Both combinations are with 99213. Some carriers will reimburse with XS applied to...
  28. Brandy0618

    Wiki Do carriers reimburse for Dermtech?

    Good morning derm world. Can anyone tell me if carriers reimburse for the Dermtech adhesive tests? Thank you so much. :)
  29. Brandy0618

    Wiki May we use patients "words" for coding EMR?

    Good afternoon. I would like advise on whether we are able to code (attach diagnosis code) the patients words in CC/HPI in the clinical note? For example, if a patient tells the MA, LVN who rooms the patient that they are experiencing pruritis but the provider does not include pruritis in...
  30. Brandy0618

    Wiki Diagnosis R21 with 11104.

    May I ask if anyone has issues with reimbursement when you report 11104 and attach R21 (rash)? Via the EMR our provider reports Biopsy-Punch R/O: Tinea Versicolor vs Hailey hailey. This would be before we have a path report. Thank you to any advise. :)
  31. Brandy0618

    Wiki Kenalog one line or two with 96372 and 11900?

    Good day. ;) I am not new to coding just rather new to dermatology since December. I might be asking a dumb question and I will apologize ahead of time. Our provider performed two injections 96372 (IM) and 11900 (IL). Both Kenalog. Would I combine the kenalog and file on one line or does each...
  32. Brandy0618

    Wiki Can you report an intermediate closure with a punch biopsy?

    Good morning. Can you report an intermediate closure with a punch biopsy? Our provider performed a punch biopsy. There was a significant hole that remained. He performed an intermediate closure on this wound. I have read per CPT guidelines simple closure is included in the service. But I...
  33. Brandy0618

    Wiki Advice on reporting Hyperhidrosis (botox).

    I am seeking advice on submitting correct documentation for treating hyperhidrosis via botox? Will carriers even honor this for reimbursement? If so, what is the necessary documentation for reporting this procedure? Thank you in advance for any help. :)
  34. Brandy0618

    Wiki How to report 54050 x 3?

    I am not new to coding but new to dermatology. I need advice on how to report 54056 x3. My provider states we should be able to report 3 cryo areas that he preformed destruction on. All 3 areas of destruction were on the scrotum. Can we report this x3? Or can it be reported on 3 line items...
  35. Brandy0618

    Wiki Can you be reimbursed for dressings in dermatology?

    Good afternoon. I have spent the last week looking for this answer to no avail.:cry: We have a provider (dermatologist) that wants to know if she can be reimbursed for dressings applied in the office setting? I have looked everywhere for an answer. With no luck. I have found some Medicare...
  36. Brandy0618

    Wiki Reporting saline for lipoatrophy?

    I am searching for assistance in being able to file and injection of saline when 11900 is used to administer saline due to lipoatrophy (buttocks)? This was after they patient received a steriod injection 6 mo prior. To me this is cosmetic. I am new to dermatology. The provider has filed only...
  37. Brandy0618

    Wiki Advice on waiting for pathology or not to report diagnosis?

    Good afternoon. One of our physicians has posed a good question. One that I do not have the answer for. How do we wait and report a pathology diagnosis to apply to the original encounter when that pathology diagnosis will not line up with the original encounter note? If an area is excised...
  38. Brandy0618

    Wiki Advice on correct Kenalog reporting.

    Good afternoon. I have read many posts about the subject of Kenalog on the forums. However, I am confused with how Kenalog actually is dispensed in the vial? Does Kenalog come in 10mg vials and 40mg vials? The reason I ask is being compliant with reporting 2 separate NDC codes for each. If...
  39. Brandy0618

    Wiki Has anyone else had a problem with bulging fontanelles?

    We are struggling to find an appropriate ICD-10 for bulging fontanelles. Has anyone else had this challenge? Thank you for any advice.
  40. Brandy0618

    Wiki Help with filing NDC codes for J0696 when your nurses order from a diff manufacturer

    I am super confused! I am a CPC and I code for an individual pediatric practice. I am confused as to how I file our Rocephin injections (via NDC#s) when our nurses order from different manufacturer's? When our nurses place an order, if they are out of Rocephin with the manufacturer we last...
  41. Brandy0618

    Wiki Help with ADHD diagnosis?

    We have always used the diagnosis code 314.01 in reference to ADHD follow up. The child has been diagnosed and is followed every 6 mo while on medication. Until yesterday (after reading my pediatric newsletter on supercoder) it states that we are to be using V58.69 for follow ups to ADHD. It...
  42. Brandy0618

    Wiki 82962?..if with E/M modifier?

    This is crazy. I posted this in Path and Lab but apparently either everyone already knows the answer or the opposite (no one knows)...hummm. Our pediatrician completed an E/M in addition to 82962 glucose stick and my question is that I do not think this would warrant a modifier but it is...
  43. Brandy0618

    Wiki Help with 82962, modifier with E/M

    I guess I am asking a question that is so simple everyone knows the answer or I just can not find anyone who knows? If our physician completed an E/M and also completed 82962, would I attach a 25 to the E/M or not? With 25 the last sentence states "on the same day of the procedure or other...
  44. Brandy0618

    Wiki In all Forums "no" help for this. PLZ HELP

    I am a CPC in a Pediatric office. Today our Dr. asked for my help and advice with an issue that has been a "FIRST" in our office, however I thought in all the Pediatric forums I would find someone else that has encountered this and could help via a diagnosis code. Our Dr. saw 2 sets of parents...
  45. Brandy0618

    Wiki Asking more advanced group since

    Im now asking the same question I asked in the pediatric section of the forum, however I can not get anyone to answer. Im assuming this means that the answer is not out there? I have filed a claim with Tricare 3X with one of those times including medical records. Tricare will not pay for our...
  46. Brandy0618

    Wiki Help with screening diag code for tricare

    Tricare has denied our flu tests that we filed as they will not accept anything but a screening diagnosis. I can not locate anything that will specify a screening code for our flu tests. Has anyone had this issue? Thank You
  47. Brandy0618

    Wiki Requesting venipucture and modifier 25 advice

    I am still really confused with a ton of information that I have on whether or not I am to attach a modifier 25 to venipuncture or not? (36415) Some coders say yes, some say no. Most always in our office (pediatrics) the children don't come in with intentions of a blood draw. Its only during...
  48. Brandy0618

    Wiki Please HELP with NDC question.

    I would welcome any help on the correct way to enter and file J0561 (bicillin) using one code (J0561) but indicating that we are using 600,000 or 1.2 million units? This is the same code but how do i indicate whether i am using 600,000 or 1.2 million units as they both have different NDC CODES...
  49. Brandy0618

    Help with 99173

    Our medical software has given me a warning that in coding 99213 with 99173(vision test) I am unbundling. My question is..this patient came into our office for a follow up to encephalitis and while in the room with the dr, she decides she needs to ck her vision, as her vision could be affected...
  50. Brandy0618

    Wiki Please help with proper injectable drug guidelines.

    We received a letter from a carrier reporting that claims are required to be submitted based on (HCPCS) units, not the dosage administered. As I research this I am more confused that when I started. The example in the front of HCPCS explaining that if one ostomy pouch is used it should be...
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