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  1. jocarter

    Wiki Obesity vs. Morbid Obesity

    Good morning. I have been taught that if the BMI is above 40, but the documentation only states the patient is "obese", then we can not capture the "morbid obesity" code E66.01. I am getting push back on this and I can not find documentation to support a clear message to the provider that...
  2. jocarter

    Wiki Critical Care and FS Modifier

    I can't find guidance on this specific scenario: First provider is a Physician and documents 35 minutes of critical care, second provider is mid-level and documents 74 minutes of critical care. Would you combine all of the time and bill the 99291 and 99292 under the mid-level provider (since...
  3. jocarter

    Wiki Need guidance - exploratory laparotomy with evacuation of hematoma, bleeding control

    New to coding for surgery and totally lost on this one: I am interpreting this a 2 separate procedures- first re-opening the pfannenstiel incision and removing the hematoma I was thinking 35840 for that portion, but further down it reads that they made a completely separate incision where blood...
  4. jocarter

    Wiki super glues eyes shut? Help with ICD-10

    Recommendations needed for what ICD-10 code/codes to use for a patient seen for eyes super glued shut? I am baffled on this one! Nothing seems to fit this scenario Thanks, Jolene
  5. jocarter

    Wiki G0390 with 99291 Trauma Billing- Help

    Does anyone use the G0390 on professional claims? It is in the HCPCs book and per what I can find online it needs to be billed with Level 1 Trauma activation, but only if critical care is performed. Our billing dept is saying the G0390 is only billed on the facility side? Any help would be...
  6. jocarter

    Wiki general surgery workshop/conference

    Anyone going to the workshop below in February? I always attend the AAPC conferences but I am looking for something more in depth for the general surgery piece. Betsy Nicoletti is one of the presenters for this... https://www.karenzupko.com/wp-content/uploads/ACS_Brochure.pdf...
  7. jocarter

    Wiki pre-operative visit within a global period for related procedure

    If the patient had a partial removal of colon with colostomy and is still within the 90- day global period, can/should the same physician bill for the pre-operative visit prior to the colostomy reversal? It feels like this should just be a 99024 post op visit but another coder is telling me...
  8. jocarter

    Wiki HELP-suspensory ligament release for penile lengthening

    This is an interesting one I have been researching and can't figure out an answer to. The provider will be doing a suspensory ligament release for penile lengthening due to decreased length of penis after priapism. There is no other procedure being performed, just the release of the...
  9. jocarter

    Wiki multiple endoscopic injections to different sites -NEW UROLOGY CODER NEEDS HELP

    I am new to Urology coding and an getting stuck on a record. I would greatly appreciate any recommendations on this. The provider did a cystoscopy, detrusor injection of botulinum into the bladder and then also did periurethral submucosal prostatic injection of Macropastique. in my mind we...
  10. jocarter

    Wiki A/R question about writting off claims that are being appealed

    Is it a normal practice to adjust off a balance at 90 days, even if the claim is pending an appeal/redetermination? I am finding multiple examples where documentation clearly supports the charges, so we should be getting payment. Any feedback on this would be greatly appreciated. Merry...
  11. jocarter

    Wiki Medical nutrition therapy-Time requirements

    The Cpt book states: 97803-Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes If the provider does 28 minutes of counseling, can we bill 2 units? or does the provider have to submit a full 30 minutes to bill 2 increments of...
  12. jocarter

    Wiki E/M & Procedure same day- Auditor Opinion Needed

    Deleting post
  13. jocarter

    Wiki Sigmoidoscopy and New Patient Visit same day

    I am new to reviewing charges for a Colo-Rectal office, so I am questioning why we would schedule a patient for a sigmoidoscopy prior to seeing the patient for the first time... I questioned the provider and was advised that depending on the reason for the visit, 90% of the patients will be...
  14. jocarter

    Wiki Allergy Testing for Lidocaine?

    Any recommendations on what cpt code to use for intradermal administration test for lidocaine allergy? The testing was done over a period of many hours, injecting lidocaine every 30 minutes. Our office can't seem to agree the proper code and I can't find anything about this specific test...
  15. jocarter

    Wiki New Patient Paperwork and EMR

    We have patients fill out new patient paperwork for Review of Systems and Histories, then a Medical Assistant takes the information from the forms and inputs it into an EMR system and then destroys the origional copies.... Should we be scanning in the paperwork the patient is filling out? What...
  16. jocarter

    Wiki Cardiologist-billing for weight loss counseling???

    I have a Cardiologist who is asking about billing 99401 for 15 minutes of weight loss counseling. Documentation is clear that different weight loss methods were discussed and the effect the patient's BMI has on his conditions.... But if the physician is already billing an office visit...
  17. jocarter

    Wiki Modifier 62 Co-surgeons- Oklahoma Medicaid

    Per CPT book: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons...
  18. jocarter

    Wiki Critical Care & Discharge Same Day?

    I have a physician who provided critical care 99291 and then later the same day the patient passed away. The physician feels he should be able to bill the discharge 99238 for the pronouncement of death and paperwork.... I can not find any good clear infomation that states you can or can not...
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