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    Wiki Contract coding on the side

    So.. I have a full-time medical coding job but I wanted some part-time work on the side- maybe contract. Does anyone know where and how to find these positions?
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    Wiki Adjustment

    IF you have Dr A pediatrician saw a patient for gastric issues and the Dr B pediatrician sees the patient for pain management. One or the others claims denies and you are are asked to please review as BCBS will not cover both providers need to adjust. What should I do? I'm loss.
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    Wiki 96372 for admin vaccines

    Does anyone have a link or any information bill 96372 for admin vaccine for adults with Medicaid? Getting an error to remove the admin code and replace with 96372.
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    Wiki Comparison code 0435T

    Could anyone provide any information for comparison code for 0435T/0436T? Thanks in advance.
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    Wiki Fee Schedule

    My office is having a difficult time getting CPT 19260 paid due the code not on the SC Medicaid fee schedule. See the comment I am getting from AR department: I just checked SC Medicaid fee schedule - the 20601 NOR the code Amanda changed it to (the 19260) are on the SC Medicaid fee schedule...
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    Wiki Detorsion of right ovary

    I need help with a comparison code for an unlisted lap oviduct/ovary procedure(58679) for detorsion of right ovary. Any suggestions?
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    Wiki ED

    My office and I are having a difficult time getting ED visit approved. Here is the situation: The patient came into the ED(POS 23) and was seen by hospitalist code used was 99284; on the same day m provider(peds surgeon) for H&P. My provider billed a 99219 but I change it to 99204. Should I...
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    Wiki MINIMALLY INVASIVE PECTUS EXCAVATUM REPAIR WITH CRYOBLATION THERAPY

    Need advice. My provider performed a pectus repair with cryoablation therapy. The codes used are 21743 & C2618... I have not seen this before. I wanted to know if the cryoablation therapy is part of the surgery? See Op note. Procedure: The patient was identified and placed in the supine...
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    Wiki Change of Chait Appendicostomy with Fluoroscopy

    I need some advice on a code. My provider performed a change of Chait appendicostomy with fluoroscopy and the code that is being used is 49450. I think there should be an unlisted code 44979. See op note below. Procedure: The patient was identified and placed in the supine position on the...
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    Wiki M144 (denial pre/op Op include in allow 4 surg)

    I need some guidance the denial for M144(pre/op Op incl in allow 4 surg). So we billed 99219 & 99225 and according to BCBS State they have denied the 99225(pre/op include in allow for surgery). Should we not bill the 99225 since BCBS state see that 99219 is the only code to use before the surgery.
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    Wiki LAP REPLACEMENT/REVISION, CSF SHUNT, OBSTRUCTED VALVE/DISTAL CATHETER IN SHUNT SYSTEM

    Could someone help me with the scenario below? Patient was taken the operating room for distal shunt revision/replacement but done laparoscopic. Should I code unlisted lap code (49329) or the shunt revision/replacement (62230)?
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    Wiki Repair of high imperforate anus with bladder fistula, combined laparoscopic (abdominal) and sacral approach

    Could someone help me with a code? The code that is used by my provider is 46742 but I could not find a code for the lap. See Op note. Also procedure was performed by two surgeons. OP note #1: Recto-bladder neck fistula identified, divided, and repaired laparoscopically. Mobilization of the...
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    Wiki CPT 99220

    Need some advice. Say a patient came to the ED and was put under observation status(99220) and a procedure done (I&D-which was not performed by my provider) on Monday and discharge the same day. The patient returns three days later with complication and needed another I&D(which is performed by...
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    Wiki rectal exam under anesthesia with nasal speculum used

    I need some advice to what code to use for the procedure below. I was thinking of 45990 but there is nothing stating diagnostic. Findings: Two separate superficial 1cm lacerations on either side of midline posterior to the anus and terminating just inside the anal mucosa. 　There was no...
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    Wiki Repair of sacral hernia

    Does anyone knows what CPT code to use for repair off sacral hernia? Without mesh?
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    Wiki Enterolysis vs twisted distal bowel

    Does anyone have any suggestion for the situation below? Provider is using 44005 but the patient had a twisted bowel. Procedure: Midline laparotomy incision was made through the existing incision going through the umbilicus and the dissection was carried down through the skin and soft tissues...
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    Wiki Procedure note within the attestation

    Is there any guidelines regarding procedure note within the attestation? My provider did a g-tube replacement procedure while the patient was seen in the ED but did the note within the attestation. Is this ok to bill or should I ask my provider to do addendum? Attestation signed by MD...
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    Wiki Tunneled CVC and reposition of peritoneal dialysis catheter

    Could someone help with a code for the reposition of peritoneal dialysis catheter after Tunneled CVC catheter was placed? The only code I can use is an unlisted code 49999.
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    Wiki Chest x-ray for Broviac catheter placement

    Is there a code for chest x-ray to confirm a position of Broviac catheter? CHEST XRAY FINDINGS: 　　　　　LUNGS: Expiratory chest x-ray. 　The lungs are grossly clear HEART and MEDIASTINUM: Normal and unchanged 　　　　　PLEURA: No pneumothorax or pleural effusion 　　　　　SKELETAL...
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    Wiki Silo replacement w/ modifier

    Need some advice. Should a 58 modifier be applied for a replacement of the second silo performed on the same day? See op notes. 1st placement of silo(49605): Weighing 1.3 kg, the patient is significantly small making reduction of the abdominal contents untenable. The abdominal wall defect is...
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    Wiki Enterostomy with foreign body

    Need some advice on the patient with enterostomy with foreign body. Patient swallow a BB and thought to have lodged in throat; after EGD was done the BB was located in the walls of jejunum. Procedure: Multiple enterotomies in the small bowel from intraluminal magnet　adherence. 　All the...
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    Wiki Enterectomy resection w/ enterostomy; g-j tube convert to g -tube button

    Could anyone give some advice on what code to use for the conversion of gf-tube to g-tube button? Also, the enterectomy resection? See Op note below. Findings: Roux-en-Y jejunostomy performed 20 cm beyond the ligament of Treitz with a 14 French MIC tube in the jejunostomy stoma. 　The...
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    Wiki Ingrown nail on both big toes

    I need some advice with ingrown nail. My provider performed a partial removal of nail both great toes. Code used is 11750; what modifier could be applied? Location: Foot: R big toe (Right & left big toes) Pre-procedure details: Skin preparation: Betadine Preparation: Patient was prepped and...
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    Wiki Closure of scrotal wound

    Could anyone help me? Need I code for closure of scrotal wound. See Op note Findings:　The left hemi-scrotal wound was 50% dehisced with exposure of the testicle. 　The right hemi-scrotal wound edges were mildly separated for the length. 　No evidence of infection. Indication:　patient underwent a...
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    Wiki EXCISION OF LEFT PRE-AURICULAR CYST

    Small　(6-8mm)　fibrotic mass in the subcutaneous tissues with possible cartilage. Indication: 14-year-old girl who has a cystic mass of the left pre-auricular space that occasionally enlarges. It is consistent with a first branchial cleft remnant. Procedure: 　The patient was placed in the...
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    Wiki Partial splenectomy for excision of splenic cyst

    Help!! Patient had a cyst on spleen and provider excise cyst. I need help with coding ; my provider use 38120. See OP note. Description of Procedure: The patient was brought to the operating room laid in the supine position. After induction by anesthesia, the patient was placed into a...
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    Wiki Exchange of G-J tube to G-tube

    I need advice to what to code for exchange of G-J tube to G-tube. Should the G-j tube removal be coded and then the placement of G-tube? Any suggestion will be helpful? PROCEDURE NOTE Diagnosis:　Gastrointestinal dysmotility Procedure:　Exchange of G-J to a G Findings:　New gastrostomy tube...
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    Wiki Division of abdominal fascia for relief of ischemic bowel and temporary closure of gastroschisis with silo.

    Need advice for division of abdominal fascia for relief of ischemic bowel and temporary closure of gastroschisis with silo. My provider used 49605. Patient had the placement of silo on 8/7 and temporary closure with silo on 8/8. Just trying to figure if I code a post-op visit or 49605 with 58...
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    Wiki Lysis of adhesion and enterostomy

    Need some advice on the following procedure below. My provider want know if he could bill lysis of adhesion and enterostomy. Codes used 44620, 44180 & 44005. Thanks advance. ICD-10: * Bowel perforation (HCC) [K63.1] * Altered bowel elimination due to intestinal ostomy (HCC) [K94.19] *...
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    Wiki Resection of mesenteric mass

    Could some one give me advice on the procedure for resection of mesenteric mass? Procedure: Resection of mesenteric mass Dx: Left lower quadrant abdominal mass [R19.04] The patient was placed in the supine position. 　Adequate anesthesia was initiated. 　Antibiotics were administered. 　The...
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    Wiki Peritoneal drain placement

    Could so give me some advice to find a code for peritoneal drain placement for 25 week infant? Procedure:　Peritoneal drain placement Indications:　Patient is a 25-week infant now 8 days old who presented with large amount of pneumoperitoneum on radiograph, abdominal wall discoloration and...
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    Wiki Hernia repair

    Patient had right inguinal hernia repair back in June 2019 and later was seen for a follow up. During the follow-up patient noted to have left inguinal hernia. Should a 58 modifier be applied to the second hernia repair? Any suggestions would be greatly accepted.
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    Wiki Replacement of J-tube with change of non-balloon device

    Needing some advice on the following procedure. Findings: Contrast injection into the jejunostomy tube revealed a dilated segment between the balloon and skin, but that contrast proceeded rapidly and normally through the roux-limb. 　The tube was switched to a non-balloon device - 14Fr 1.2cm...
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    Wiki Excision of granulation tissue

    Does anyone know what code(if there is code) for excision of granulation tissue?
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    Wiki Coding resolve problem for new patient visit

    Patient(pediatric) was referred to my office as new patient for swollen scrotum and once the patient was seen the problem was resolved. My provider used Z71.1; which is not a supportive DX code for insurance. Do anyone have any suggestion for what ICD-10 code to use?
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    Wiki Exicision of Keloid and injection of Kenalog

    Procedure: The patient was placed in the supine position. 　Adequate anesthesia was initiated. 　The position was changed to prone. 　The upper back and neck were prepped and draped in a sterile fashion. 　An elliptical incision was made to incorporate the entire lesion, leaving a very small rim of...
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    Wiki Placement of a Suprapubic Catheter

    Procedure: Assessment of the bladder revealed that it was remarkably distended despite having a urinary catheter in place. 　Therefore, a suprapubic catheter was placed. 　Through a small incision in the midline just above the pubic bone, the bladder was entered with cautery. 　A Cook silicone...
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    Wiki ED codes

    I need clarification..... if a patient came through the ED on Monday and the provider uses 99283, the next day my provider uses 99283. Could I code the ED code for my provider for the next day? The provider are not in the same department.
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    Wiki POS 23

    I need clarification for POS 23. If a patient is seen in the ER and the provider uses a observation code(99218-99220). Doesn't the provider needs to use a ED code?
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    Wiki Excision mass of subcutaneous tissue

    I'm in need of second an opinion of a excision-mass of subcutaneous tissue. The code used is 21920 but there are measurement of the mass. But I questioning that is the correct code. Can someone help me? Findings: 8x8mm fibrotic mass Procedure: The patient was placed in the supine position...
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    Wiki Is there a Penrose drain cpt code?

    Is there a code for Penrose drain? Patient is 23 week old diagnosis with Pneumoperitoneum, likely SIP. Procedure: The right abdomen was prepped and draped in a sterile fashion. A small right lower quadrant incision was made. Upon entering the peritoneal cavity, air, fluid and meconium was...
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    Wiki Granulation tissue cautherzation during global period

    If a patient has a G-tube placement(43653) and later comes into the office for a nurse check. During that visit the nurse noticed that granulation tissue has developed around the G-tube, so the office decides to cauterization the granulation tissue. Isn't the cauterization of the granulation...
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    Wiki Nurse visit and office procedure

    My office is wondering why I do not bill the nurse visit(99211) with office procedure(granulation tissue removal). I explain that it is a NCCI edit. My office would like to have documentation stating why. I tried looking the NCCI website for further clarification. Do anyone know where I could...
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