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    Wiki Excision of masses-Path shows one is lymph node

    Hello, I'm hoping someone can help me with this case. 1. The patient had multiple scalp masses bilaterally, however, the patient wanted to have only the wound on her left side remove. The ones removed were #1 midline parietal area measuring 6 x 3 x 2 cm, the second was midline occipital...
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    Wiki 99291 in Neonatal Care

    Just wondering if anyone knew if there were any other scenarios that CPT 99291 might be billed by a neonatal intensivist besides when transferring a critically ill neonate to another hospital?
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    Wiki New OB Provider

    I am not very familiar with OB/GYN coding. We just recently hired a new OB/GYN and she asked me a few questions that I did not know the answer to, and that I couldn't find any information on. Could someone please answer these for me? 1. Can you bill separately for a paracervical block with...
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    Wiki Critical Care

    If a doctor provided critical care services to a newborn for only 45 minutes, and then the newborn is deemed a normal newborn again, should a 99291 or a 99468 be billed? Also, would it be incorrect to also bill for normal newborn services in addition to the above? Thank you!
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    Wiki Needle Flexor Tenotomy of Toe

    How would you code a flexor tenotomy done with an 18-gauge needle? I have included the procedure note. I was thinking the unlisted code since no incision was done, or 28010/52. 5 mL of 1% lidocaine plain was utilized to anesthetize the toe. After anesthesia, an 18-gauge needle was utilized...
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    Wiki Diagnosis for Open Wound of Lower Abdomen?

    Can anyone please tell me how I would code a diagnosis of "open wound of the mid lower abdomen"? Can I only use the S31.109? Thanks!
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    Wiki Diagnosis/Management Options

    If someone comes in for a follow-up of 3rd, 4th, and 5th trigger fingers, would you count only one point under Diagnosis/Management Options or 3? Thanks! Chelsea Barry
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    Wiki Measurements for Lesion Excision

    I might be overthinking this, but if a doctor says that a lesion is .5cm in size, and that is was excised using a 1cm elliptical excision, what would you use for the total excised diameter for CPT selection? Does this indicate the margins were .25cm? Thanks!
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    Wiki Using Dx from E/M for Same Day Procedure

    We have recently had trouble with our physicians leaving out the diagnosis/indications for procedure in their OP reports. They were thinking that we could use the H&P's diagnosis that was performed the same day. I know you can combine two E/M notes when they are on the same day, can you do...
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    Wiki Causal Relationship between CKD and Anemia?

    I have read recently that according to the ICD-10 Guidelines, there is a causal relationship with DM and comorbidities since they are linked with the word "with" in the alphabetic index. Does this same rule apply with anemia and CKD? It shows up like this in the alphabetic index: anemia in...
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    Wiki Neonatal Critical Care/Prolonged Services

    I am a certified E/M coder, but do not have much experience with Pediatric hospital billing. Could you help me with a couple of these questions? 1. Are you allowed to bill the Initial neonatal critical care code (99468) and the prolonged service code (99356) for the same day? 2. And am I...
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    Wiki Help with Injection Procedure

    How would you code the following? This was for Morton's Neuroma. A alcohol injection consisting of 1.5 cc of a mixture of dehydrated alcohol and 1% Lidocain plain was infiltrated in 3rd interspace b/l around the symptomatic area. Thanks in advance!
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    Wiki Help with Injection Procedure

    How would you code the following? This was for Morton's Neuroma. A alcohol injection consisting of 1.5 cc of a mixture of dehydrated alcohol and 1% Lidocain plain was infiltrated in 3rd interspace b/l around the symptomatic area. Thanks in advance!
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    Wiki Comprehensive Exam

    I was just wondering if you guys would count this as a comprehensive exam in 95 guidelines. CC: Abdominal pain. Vital signs: Stable. He is afebrile. Cardiovascular: Reveals good respiratory effort. Pulses are regular. Abdomen: Soft. RUQ pain to palpation. Extremities: No cyanosis...
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    Wiki Comprehensive Exam?

    I was just wondering if you guys would count this as a comprehensive exam in 95 guidelines. Vital signs: Stable. He is afebrile. Cardiovascular: Reveals good respiratory effort. Pulses are regular. Extremities: No cyanosis, clubbing, or edema. No calf tenderness. General: He is alert and...
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    Wiki Modifier for HT Revision

    What modifier would you use if a patient initially had a hammertoe repair, and then two weeks later had to go back into the operating room for a revision due to implant failure? I had 3 in mind, but am not sure which one to use. I was thinking maybe modifier 58 (probably not), 76, or 78. Any...
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    Wiki Medical Necessity for Critical Care

    We have been outsourcing one physician's Intensivist charges for several years. Just recently, we have been getting documentation returned and down coded stating: "Documentation does not support medical necessity for critical care. Provider's physical exam states "Patient in no acute...
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    Wiki Detailed or Comprehensive PE?

    I was hoping someone could help me determine how you would break this exam apart, or even if you can? Physical Exam: Vital Signs: Temp 36.2, pulse 82, resp. rate 24, BP 158/102, pulse ox 96%. General: 45 yo white male, appears stated age. Well developed, well nourished. Slightly obese...
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    Wiki Routine Foot Care Question

    State of Kansas If a patient has a systemic disease (Such as DM), but doesn't meet any of the class findings, does the patient still meet medical necessity if they have mycosis of the nail and pain in bilateral feet? The diagnoses would look something like this: B35.1, M79.674, M79.675, E11.9...
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    Wiki PVD/Atherosclerosis

    I have several providers that used the term PVD/Peripheral Vascular Disease and I believe they are under the assumption that this means Atherosclerosis. Is this the same thing? Am I able to code atherosclerosis when the provider is only putting PVD? Thank you!
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    Wiki Diabetic Foot Ulcers

    Just wanted to see how you guys would code this diagnosis. This is exactly how it was written: "DM, Neuropathy, G2 ulcer RT dorsum" Thanks!
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    Wiki Debridement Modifiers

    Medicare patient-which modifiers would you use in the following scenario? Pt has a LT heel ulcer (12cm2) debrided to include Sub-Q tissue: 11042 Pt also has a RT heel ulcer (12cm2) debrided of fibrin and slough: 97597 This might be a beginners question, but I just had a provider start trying...
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    Wiki Trauma Wound

    Just wanted an opinion on how you guys would code "trauma wound rt pretib." Thanks!
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    Wiki Insufficient Documentation

    I am having problems finding enough information in one of our wound care doctors' documentation to pull a diagnosis code. Does anyone know if it is okay to use written diagnosis codes that a provider has signed off on, even though the actual notes from the provider don't support them? Thanks!
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    Wiki Open Wound

    Can anyone tell me how they would code the dx of "open wound of Lt toe" They said it was not traumatic, therefore, this makes me think the L97.52_ codes. It is okay to assume the ulcer in non-traumatic wounds documented like this? Otherwise insurance companies want accident information. Thanks!
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    Wiki Place of Occurence-Feedyard

    Anyone have any suggestions on what place of occurence code to use for an accident at a feedyard? I was thinking either Y92.79-Other farm location or Y92.89-Other specified places. Thanks!
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    Wiki Newborn of Gestational Diabetic Mother

    What diagnosis code would you use for an infant who is being tested and monitored for Newborn suspected to be affected by Gestational Diabetic mother, but is found to be perfectly fine? The two I was looking at are P01.8 and P70.0. Thanks in advance!
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    Wiki E/M for Wound Care

    There has been a huge controversy at our wound care center about when doctors can and cannot bill for an E/M service when they do a debridement the same day. I had attented the online webinar for wound care coding and specifically asked the moderator if you could charge for an E/M the same day...
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    Wiki EKG Interpretation After Death

    Our practice is getting caught up on billing from about 9 months worth of EKG reads after switching systems. I am getting a lot of denials for Date of Death Precedes the Date of Service. The provider read the EKG the same day that the patient died. I know you are supposed to bill by the date...
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