Search results

  1. RebeccaWoodward*

    Wiki Global or not?

    Patient has had breast reconstruction due to breast CA. The implant has ruptured and she has developed a "sunken" breast. Would you consider the follow up visits for the ruptured implant as global? I'm sitting on the fence on this one.... Thoughts...
  2. RebeccaWoodward*

    Wiki Event Monitors

    Still getting my feet wet in cardiology... 1) Am I correct that when billing the technical charge, you report the date of service of the "hook up"? 2) The date of service reported for the interpretation is the date of the actual interp.
  3. RebeccaWoodward*

    Wiki Loss of credentials???

    Curious..... If you don't renew your membership, you lose your credentials?? I thought you would lose credentials if you did not keep your CEU's up to date!!! I received an email from the AAPC stating otherwise.... WHAT'S THE DEAL???
  4. RebeccaWoodward*

    Wiki Fragil X with PCR Reflex??????? (Infertility)

    First time for me... What would be the CPT codes for this? Research has lead me to 83891, 83898, 83900, 83912, 83909(x2) but I'm not sure. Any thoughts? :confused:
  5. RebeccaWoodward*

    Wiki New versus new for 2012????

    Have you read the definition of a new patient beginning 2012? "Solely for the purposes of distinguishing between new and estab. patients, professional services are those face-to-face services rendered by a physician and reported by a specific CPT codes(s). A new patient is one who has not...
  6. RebeccaWoodward*

    Wiki 93306/93351

    I am very new to cardiology and would like to pick your brain. I have been doing some research on the above CPT codes and found a Q/A on the American Society of Echocardiography. I'm aware that CCI edits bundle these two codes but if the documentation does support two, different clinical...
  7. RebeccaWoodward*

    Wiki Medicaid question

    I was informed today that, supposedly, our Medicaid carrier processes CPT codes from the bottom up. My concern is that we post our charges in descending, monetary order. If this is true, is this affecting reimbursement/modifier usage? Can anyone confirm if your Medicaid carrier does this...
  8. RebeccaWoodward*

    Wiki RN/LPN Performing AWV

    Does your carrier have a policy on this??? This seems so strange to me... Question: Can a Registered Nurse (RN) or Licensed Practical Nurse (LPN) perform the entire AWV? Answer: Yes an RN or LPN can perform the visit. They need to be under the direct supervision of a physician and the state...
  9. RebeccaWoodward*

    Wiki Change in global period for 12001-12018

    As of January 1, 2011, the global days for simple repairs (12001-12018) has changed from 10 global days to 0. I've gotten some feedback that there is a possibility that we can charge for a suture removal for Medicare patient's...yes, I said Medicare. I'm still researching this but wondered if...
  10. RebeccaWoodward*

    Wiki Auditing OBGYN records

    For those that audit OBGYN records, are you using the 97 guidelines? Or is there another tool in the OBGYN world that you use? Do you find that the 97 DG fit easily into this specialty?
  11. RebeccaWoodward*

    Wiki JACHO Documentation Requirements

    Does anyone have a copy that they are willing to share? Or a link? I've searched the JACHO site and can't locate this information. I have "The Universal Protocol" but looking for something more in depth. TIA!
  12. RebeccaWoodward*

    Wiki Revision w/ new Lami

    63664? Or 63655/63685 since this was placed at a different level? Or something different? Any and all opinions are welcomed- PREOPERATIVE DIAGNOSIS: Spinal cord stimulator malfunction. POSTOPERATIVE DIAGNOSIS: Spinal cord stimulator malfunction with malfunction of lead and extension...
  13. RebeccaWoodward*

    Wiki WC Impairment rating

    I'm trying to locate some information for my surgeon regarding impairment rating for vocal cord paralysis. This is a W/C injury that took place a year or so ago. I found the rating guide on the NC Ind. Commission but I don't see anything that sticks out for this type of injury. The surgeon...
  14. RebeccaWoodward*

    Wiki I am Confused! NCS and 64450

    Am I reading this correctly??? There are edits placed against 95900/95904 and 64450. 95900/95904 are bundled into 64450 and can not be overridden with a modifier. But here's my problem... 64450 was performed on the left side of the arm and 95900/95904 was performed on the right... Obviously...
  15. RebeccaWoodward*

    Wiki The “Compendium of Unimplemented Office of Inspector General Recommendations”

    Even though these are currently unimplemented, it provides insight on what the OIG/CMS are currently looking at for 2010. I found the "incident to" recommendations interesting (amongst others)... Recommendations: (1) CMS should seek revisions to the “incident to” rule. The rule should...
  16. RebeccaWoodward*

    Wiki Emg

    Patient was scheduled to have NCS/EMG. The physician was not able to complete the entire procedure and had the patient return approx. one week later for an additional EMG. Rather than reporting 95860 twice, I think we should combine the two extremities and report 95861 with the final report...
  17. RebeccaWoodward*

    Wiki Prescription Mgmt?

    This is a first one for me. New patient to our Pain Mgmt practice. Patient has a BKA due to diabetes/HTN. The current prosthesis is worn, cracked, etc. Physician writes a new script for prosthesis. Credit RX Mgmt? Leaning towards "no"... Thanks!
  18. RebeccaWoodward*

    Wiki Hand surgery

    :confused: Any thoughts on the CPT codes for this? :confused: POSTOPERATIVE DIAGNOSES: 1. Left index finger amputation through the distal phalanx with disruption of the flexor digitorum profundus attachment. 2. Amputation through the left long fingertip through the distal phalanx without...
  19. RebeccaWoodward*

    Wiki 2010 Webinars w/ free CEU's

    http://www.medtronicsofamordanek.com/spineline/registration/
  20. RebeccaWoodward*

    Wiki Finding Answers

    I agree and you could address your questions to them but for an additional fee or required membership...normally. That's why I'm so hard pressed about quoting an authoritative souce such as CMS, CPT Assistant, or a medical society (AAOS, AANS, etc.) Even then...there's usually an additional...
  21. RebeccaWoodward*

    Wiki Final Rule/CMS

    http://edocket.access.gpo.gov/2009/pdf/E9-26502.pdf Ok...Consultations start on page 31
  22. RebeccaWoodward*

    Wiki AI Modifier for Consultations

    Looks likes this modifier was accepted... http://www.cms.hhs.gov/apps/ama/license.asp?file=/HCPCSReleaseCodeSets/Downloads/10anweb.zip AI= PRINCIPAL PHYSICIAN OF RECORD, Principal physician of rec Open the excel spread sheet
  23. RebeccaWoodward*

    Wiki CMS Press Release

    For Immediate Release: Friday, October 30, 2009 Contact: CMS Office of Public Affairs 202-690-6145 CMS ANNOUNCES PAYMENT, POLICY CHANGES FOR PHYSICIANS SERVICES TO MEDICARE BENEFICIARIES IN 2010 The Centers for Medicare & Medicaid Services (CMS) today announced final changes to policies...
  24. RebeccaWoodward*

    Wiki Ortho opinions....PLEASE!!!

    Ok…I’m going to try to explain this without confusing you or for that matter…myself. Patient was seen 10-12 for consult and reduction of radial fracture and bimalleolar reduction. Both were closed reductions Consult and reduction 10-12-09 I discussed the patient's case with Dr ***, and he...
  25. RebeccaWoodward*

    Wiki 95904 as 12 units

    Our physician performed 12 units of 95904. I know that Appendix J of the CPT code has a recommendation of 6 units for bilateral CTS testing. I wanted to seek some opinions and see if anyone was using modifier GD. GD="Units of service exceed medically unlikely edit value and represents...
  26. RebeccaWoodward*

    Wiki 2010 OIG Workplan

    FYI... http://oig.hhs.gov/publications/docs/workplan/2010/Work_Plan_FY_2010.pdf
  27. RebeccaWoodward*

    Wiki Dural Leak/Modifier 22?

    I know that dural leak that occurs during a spine procedure is inclusive to the procedure; however, the defect was already present…likely due to corticosteroids. I know that you could possibly report modifier 22 for the dural repair if the repair required additional bone removal for exposure...
  28. RebeccaWoodward*

    Wiki Wrist-Open reduction

    The provider coded this visit with a deleted code (25620). I think this should be 25607 and 25652. Can you guys take a gander and check behind me? PREOPERATIVE DIAGNOSIS: Displaced, unstable left distal radius and ulna fracture. POSTOPERATIVE DIAGNOSIS: Displaced, unstable left distal...
  29. RebeccaWoodward*

    Wiki Another Knee Question

    Please provide your opinion on this op note…… PREOPERATIVE DIAGNOSIS: Right knee pain secondary to medial and lateral meniscal tears. POSTOPERATIVE DIAGNOSES: Right knee pain secondary to medial and lateral meniscal tears; chondromalacia involving the medial and lateral femoral condyles and...
  30. RebeccaWoodward*

    Wiki Code-A-Round

    I, for one, am happy that the AAPC has created an inexpensive way for us to gain some of our specialty CEU's. Code-A-Round Code-A-Round is an online coding simulation that mimics a real-world coding experience. Coders view actual patient notes on screen and are then asked to input the correct...
  31. RebeccaWoodward*

    Wiki CPT code 77071 -HELP-

    Ok...I'm stumped When is it appropriate to bill for CPT code 77071? Medicare has denied this charge and I'm searching everywhere for information on this code. Help........ ***I just realized I posted this in the wrong forum....geezzz.....***
  32. RebeccaWoodward*

    Wiki Medicaid Provider Enrollment Fee

    I just gotta know....... Am I reading this wrong?? Misunderstanding?? Has anyone else experience this with your Medicaid carrier? :eek: Provider Enrollment and Re-credentialing Fee Session Law 2009-451 mandated that DMA begin collecting a $100 enrollment fee from providers upon initial...
  33. RebeccaWoodward*

    Wiki FYI- OIG August 2009 Report (Incident to)

    Thought I would pass this along if you didn't already have it.... http://oig.hhs.gov/oei/reports/oei-09-06-00430.pdf
  34. RebeccaWoodward*

    Wiki Ingenix discrepency!

    Something was just brought to my attention this morning. Ingenix 2009 Neurosurgery/Neurology Coding Companion has a 90 global period assigned to CPT codes 63650, 63685, 63688. I rarely use this book since I have a preference for other coding material; however, some of the providers use this as...
  35. RebeccaWoodward*

    Wiki Crani Case

    Preop dx- 1-multiple facial and skull fractures 2-Rt frontotemporopatietal epidural or subdural hematoma w/ severe mass effect & midline shift 3-Traumatic brain injury w/ rapidly declining neurological status Procedure- 1-Rt. Frontotemporopatietal craniotomy 2-Evacuation of rt...
  36. RebeccaWoodward*

    Wiki Crani help

    Preop dx-Cranial defect; hyperostotic skull lesions x 3 Procedure- 1-Rt frontoparietal cranioplasty, using patient specific implant cranioplasty plate. 2-Excision of hyperostotic skull lesions x 3 The area over her prior incision and the areas over the 3 hyperostotic lesions were shaved...
  37. RebeccaWoodward*

    Wiki What do you see? (Spine)

    I'm a little torn on this one. The fusion codes/instumentation aren't the issue. I'm looking at the diskectomy that was performed but I also see a pars defect. 63012? 63030? I'm leaning a little towards 63012...what do you think? PREOPERATIVE DIAGNOSES: L3-4 grade I spondylolisthesis with...
  38. RebeccaWoodward*

    Wiki ICD-9 290.9 denial

    Medicaid has denied ICD-9 code 290.9 on a 47 yr. old male. Denial states diagnosis and age are not compatible. I've reviewed the ICD-9 book and it clearly indicates "A"...which equals=Adult Age (15-124). I've confirmed his true DOB and this does match what is indicated on his Medicaid card...
  39. RebeccaWoodward*

    Wiki Spine anyone?

    Below was coded as 63056 and 63030. There aren't any NCCI edits against these two codes. The carrier has denied 63030 as inclusive into 63056. The surgeon feels strongly that these are separate, billable codes. I would really appreciate any input….Thanks! PREPROCEDURE DIAGNOSIS: Right...
  40. RebeccaWoodward*

    Wiki Oarsman's wrist Dx

    Looking for a diagnosis code. I'm looking at 726.4 Any thoughts?
  41. RebeccaWoodward*

    Wiki Opinions for Scoring Chart Reviews

    Hello to all~ I need some feedback from those of you that perform chart reviews (AKA audits). Currently, we have a procedure in place to conduct chart reviews every three months. Within these three months, a certain amount of random charts are pulled. When I'm reviewing these charts, I am...
  42. RebeccaWoodward*

    Wiki Did I miss this or Is this part of the update?

    Sometimes, I click on individuals names to check out their credentials or any other information about an individual. Has anyone else noticed the changes in the format? I see several new features....
  43. RebeccaWoodward*

    Wiki Crediting 3 Chronic Conditions

    I'm curious what your view is on this... I know that you can achieve an extended HPI if the provider documents the status of as least three chronic or inactive conditions. Here's my question. Let's say, for instance, the physician is somewhat vague in the HPI section. However, at his...
  44. RebeccaWoodward*

    Wiki Spinal procedure-Need Opinions

    There is difference of opinion on how this needs to be coded...... A midline incision was made and carried down to the lumbodorsal fascia. Bipolar cautery was used for hemostatis. The fascia was opened on both sides of midline. Fluro was again brought into use to confirm the levels. The...
  45. RebeccaWoodward*

    Wiki Knee procedure

    I'm feeling somewhat out of my comfort zone. Can you help me with this op note? Procedure-Arthroscopy left knee w/ partial lateral meniscectomy; debridement of inflamed fat pad and plica Inflow cannula was introduced through a superomedial portal and the irrigant contained epinephrine per...
  46. RebeccaWoodward*

    Wiki Ortho Consultant

    Hello..... We are in the process of seeking the expertise of an Ortho consultant. I have recommended Margie Vaught. Recently, we had Karen Zupko and Assoc. provide some services for our Neuro physicians. Has anyone used Margie Vaught? If so, what was your experience...good/bad? We also want...
  47. RebeccaWoodward*

    Wiki 27193 description-Confused!

    27193=The physician treats a pelvic ring fx or dislocation. The displacement or dislocation is less than 1 cm. No manipulation is required. Treatment typically is bed rest and crutches. (Per CDR) For those of you whose physician has charged for this...what was actually done? This charge has...
  48. RebeccaWoodward*

    Wiki BCBS Appeal Process

    I have a surgical claim that denied for lack of medical necessity. The claim was appealed with a provider resolution form. It was submitted by our billing department with hopes to overturn the denial. Without going into details of the appeal itselt, it was not successful. Now...here's the...
  49. RebeccaWoodward*

    Wiki Spine procedure

    This is a very lengthy op note so I'm only going to provide the "meat" and hope it's enough. Extensive right L4-5 Foraminotomy and removal of disk herniation and decompression of L5 nerve root. (63030) Bilateral L5-S1 facetectomies, diskectomies, removal of abnormal pars defects and...
  50. RebeccaWoodward*

    Wiki E Prescribing for your physicians

    Hi eveyone, I received this information today and thought some of your providers might find this of interest. It offers CME's for the providers. All course materials and exams are offered free of charge per site...
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