Search results

  1. N

    Wiki Employee assistance program- billing Preventive medicine CPT codes for therapy appts

    Does anyone have experience with employee assistance programs using Preventive medicine CPT codes (99404) for therapy services instead of the therapy CPT codes 90834-90837?
  2. N

    Wiki Telehealth Place of service

    Can someone clarify what place of service (02 or 10) you should use if the patient is seen via telehealth, but they are not physically located in their home? They may be at their work, in their car, etc.
  3. N

    Wiki supervision rules for LPCC, LISW, LPC, LSW, LFMT

    Does anyone bill for these types for providers and do you know if supervision agreements need to be in place? If you have any information to share on these types of providers, it would be much appreciated - what setting are you billing these services, what cpt/hcpcs codes are you using...
  4. N

    Wiki G0425-G0427 vs 99446-99449

    Help! Does anyone know what the difference is between these codes?
  5. N

    Wiki Buckeye Ohio - denial code M44

    Is anyone familiar with this denial code? It means - Missing/incomplete/invalid condition code. Its denying on a bunch of newborn services (99460, 99462). I can not find anything, anywhere.
  6. N

    Wiki Procedure performed same day as neonatal and pediatric critical care

    The CPT code guidelines state procedures that are included in the critical care codes and not separately reported. Is it possible to bill a procedure performed on the same day as the critical care if the provider is from a different group? Example Group A bills 99468 and Group B bills...
  7. N

    Wiki LPCC

    Can anyone tell my what CPT codes an LPCC can bill?
  8. N

    Wiki Follow up phone call after discharge - billable?

    Can a provider bill for a follow-up phone call to the patient after discharge - answering any medical condition questions, prescription questions and providing education. Also confirming patient's follow-up appts. I have searched and searched and cant seem to find anything. Wouldn't it...
  9. N

    Wiki Telehealth E/M services

    Does anyone have verbiage from CMS on how you are to choose a level of service (99201 - 99205 & 99212 - 99215) when the providers are unable to do a hands on examination other than note the general appearance of the patient? Do you instead choose your level based mostly on the medical decision...
  10. N

    Wiki medical team conference 99367

    Does anyone know if you can bill CPT code 99367 (medical team conference with patient or family NOT present) and an E/M code on the same day? Or would you instead combine both services and use the time spent during the conference as part of your E/M level?
  11. N

    Wiki 90791 vs 90792

    What CPT code is best to use when the patient is seen in the ER and is given prescription meds at the time of service to stabilize them? They may not necessarily be given a prescription when discharged.
  12. N

    Wiki consultation with POA over phone

    I would appreciate any guidance on this question! Can you bill an E/M service done with a POA for a patient that is done over the phone vs face to face? The service would be billed based on counseling/coordination of care guidelines. If the service was medically necessary for the patients care...
  13. N

    Wiki Palliative Care visit same day as Hospice enrollment

    Can you bill and be paid for a palliative care visit that is done on the same day the patient enrolls into Hospice? The provider is not employed by the Hospice. Any help would be appreciated.
  14. N

    Wiki Arobella debridement

    Does anyone know the most appropriate CPT code to use for debridement with Arobella? I am confused on whether 97597/97598 or 97602 is the better choice? Any thoughts/comments would be appreciated!!
  15. N

    Wiki how would you code this?

    Corpack placement - Corpack placed at 75 cm at nose, confirmed placement with KUB. Timeout prior to insertion and consent obtained. No complications.
  16. N

    Wiki counseling and/or coordination of care over phone with family member

    Can you bill an E/M service based on time (coordination of care) when the conversation is with a family member acting as decision maker for the patient but its over the phone instead of face to face? I cannot find anything helpful on CMS's website. Thanks.
  17. N

    Wiki Palliative Care Consult and Hospice admission on same day

    Does anyone know if you can be reimbursed for a palliative care consult on the same day the patient gets admitted to hospice? The provider is not employed by the hospice. any information would be helpful. thanks.
  18. N

    Wiki Coordination of Care - Inpatient

    Can anyone give me an example of what would fall under coordination of care for an inpatient (trying to bill based off of time)? I know the guidelines state the time doesn't have to be face-to-face and can occur on the floor/unit. But, does a face-to-face with the patient ever have to occur...
  19. N

    Wiki smoking cessation - done in a group

    Does anyone know if you can bill smoking cessation done in a group setting?
  20. N

    Wiki 90471 in 22 place of service

    has anyone else had problems getting reimbursed for vaccine administrations done in an outpatient setting (22 place of service)?
  21. N

    Wiki 99211 or 96372

    What's the most appropriate way to bill for a depo shot administered by an NP in an outpatient hospital facility (POS 22)? Any comments are helpful. :)
  22. N

    Wiki Assisted Living - Annual exam

    How would you code an annual physical being done in an assisted living facility? do you use well visit codes with V70.0 as the diagnosis and 13 as the place of service? or do you use an assisted living CPT code? any help is appreciated!
  23. N

    Wiki 96150 & 99408

    If an LISW is doing a Health & Behavior assessment and also Substance Abuse counseling on the same day, could you include the time doing both pieces into CPT 96150? Since you for one can not report both CPT codes on the same day and could not report 99408 if done by an LISW anyway since its...
  24. N

    Wiki prolonged care and procedure

    Here's the scenerio. The physician is called to place an IV. They are unsuccessful after multiple attempts. They document in their note that they spent 45 minutes with the patient. Would it be wrong to code an e/m service based on their documentation and then also bill a prolonged service...
  25. N

    Wiki 90805 & 90806 same day

    Is it appropriate to bill a 90805 (provided by a CNS) and a 90806 (provided by a LISW) on the same day? Or could the CNS and the LISW combine their time and bill (one code) a higher psychotherapy code???
  26. N

    Wiki ICD-10 and payors

    Will all other payors be required to transition over to ICD-10 by October 1, 2013 as well? Also, are they allowed to start using ICD-10 prior to the effective date?
  27. N

    Wiki 90801 in ER setting

    Does anyone know if cpt code 90801 (psych diagnostic interview exam) is only specific to certain places of service. Can you bill this code with the 23 pos when its done in an ER setting? I cant seem to find anything that says you can only use in certain settings. Thanks in advance to anyone...
  28. N

    Wiki attendance at delivery

    The CPT code guidelines for 99464 state --Attendance at delivery and initial stabilization of newborn. What do you do if the physican doesnt make it into the room prior to the baby being born but instead arrives at just a few minutes of birth. They are being requested by the delivering...
  29. N

    Wiki well visit and counseling

    (coded as 99401 and 99394) The provider writes--40 minutes was spent face-to-face. Over 50% of this time was spent in counseling and education with mother and patient, as well as patient separately. I know we cant use the 99401-99404 because its included in the well visit. But, could we...
  30. N

    Wiki new vs est

    :confused: Here's the scenerio-please help!! Patient is seen in the ER for a work injury and is NOT seen by one of our providers even though we do do billing for the hospital (just not ER). A week later, the patient follows up with an outpatient clinic we do billing for as well and IS seen by...
  31. N

    Wiki 99463- it appropriate

    Is it appropriate to bill 99463 if the provider does the h&p and discharge on the same day but the baby was born the day prior to these services being done?
  32. N

    Wiki IV start

    Hello. Can anyone tell me what the difference is between the CPT code 36000 and 36410. The company that i work for has always coded IV starts as 36410. Im wondering if we may be wrong. Thanks:)
Top