Search results

  1. S

    Wiki Tricare consultation s

    Could someone please help settle an argument? A coworker insists that you can bill a consultation code to tricare prime patients, but not tricare select patients. Has anyone else heard of this?
  2. S

    Wiki Modifer Question

    Could someone please help answer this one? For example, J3262, Actemra, it has multiple NDC codes. I know for UHC, they require modifiers Kp and KQ on them. Does anyone know of any other payers requiring the same modifiers?
  3. S

    Wiki 1 or 2 units of 96372

    Could someone please help me? I know that I have seen that if a patient gets two injections of a pre-filled syringe of any medication, that you only bill 1 unit for the injection code. Does anyone have a link that supports the using only 1 unit? This goes for meds like Evenity, Xolair, Cimzia, etc.
  4. S

    Wiki Missing/incomplete/invalid diagnosis code

    Is anyone else having issues with getting denials for the use of M06.89 or L40.59 as primary diagnosis codes on office visits or injection services, mainly Toradol?
  5. S

    Wiki Actemra ndc for UHC

    Is Anyone else having issues with United Healthcare denying Actemra infusions for an invalid NDC? We have the denials that they are saying it is the NDC but the NDC is valid.
  6. S

    Wiki Hepatitis Panel

    Is anyone else having issues to get the hepatitis panel paid by Tricare? We are using Z01.89 and they do not want to pay it. I would appreciative anyone's help. Thank you!
  7. S

    Wiki Modifier XP

    Here is my situation. A patient comes in for their scheduled infusion for their RheumatoidArthritis. They see the nurse practitioner for a follow up on their gout while they are here. Would you use modifier XP on either encounter? The infusion is billed under the physician and the follow up...
  8. S

    Wiki Ceus

    Where does anyone go to get their ceus for their CPCD?
  9. S

    Wiki Ceus

    Where does anyone else go to get their ceus for their CRHC? I have them for my cpc, but need them for crhc and cpcd.
  10. S

    Wiki Benlysta Waste

    Is anyone else having issues with BCBS recouping the reimbursement they receive for Benlysta waste? It is billed out correctly with the modifier JW on the waste. EviCore is a third party company that they have auditing Benlysta waste. We use the correct number of vials to have the least...
  11. S

    Wiki Documenting the use of CBD Oil

    Could you please give me your opinions on the documentation of the use of CBD oil in a physician's office note in Texas, where the use of Marijuana is illegal? Should the physician stay neutral and not mention it at all, or document that the patient uses it?
  12. S

    Wiki Documenting the use of CBD Oil

    Could you please give me your opinions on the documentation of the use of CBD oil in a physician's office note in Texas, where the use of Marijuana is illegal? Should the physician stay neutral and not mention it at all, or document that the patient uses it?
  13. S

    Wiki Documenting the Ue of CBD Oil

    Could you please give me your opinions on the documentation of the use of CBD oil in a physician's office note in Texas, where the use of Marijuana is illegal? Should the physician stay neutral and not mention it at all, or document that the patient uses it?
  14. S

    Wiki Documenting the Use of CBD Oil

    Could you please give me your opinions on the documentation of the use of CBD oil in a physician's office note in Texas, where the use of Marijuana is illegal? Should the physician stay neutral and not mention it at all, or document that the patient uses it?
  15. S

    Wiki Remote Coding

    I have been considering going to work as a remote coder working from home. What are the dependable companies that offer benefits?
  16. S

    Wiki Medically Unlikely Edits

    Does anyone have the medically unlikely edits saved to their computer or in their documents? I am needing to verify how many times 72291 could be billed in 2014.
  17. S

    Wiki Mue - Could someone please tell me where

    Could someone please tell me where I can find last year's medically unlikely edits? I need to verify on some codes but can only find 2015 MUE's.
  18. S

    Wiki Bimalleolar fracture

    Could someone please help with this one and give me your opinion? PREOPERATIVE DIAGNOSIS: Left bimalleolar fracture. POSTOPERATIVE DIAGNOSIS: Left bimalleolar fracture. OPERATION PERFORMED: Open reduction and internal fixation with syndesmosis screws, left bimalleolar fracture. ANESTHESIA...
  19. S

    Wiki Multiple Embolectomies

    Could someone please give me a second opinion on the coding of this report? I believe that it is 35302 and 34201. PROCEDURE: 1. Exposure of the right common femoral artery and right superficial femoral artery and right profunda artery 2. Embolectomy of the infrarenal distal aorta. 3...
  20. S

    Wiki Groin exploration with debridement of foreign body

    Could someone please help with coding the below report. I am having difficulties with this one. The patient was brought to the operating room. He was placed in supine position. He underwent endotracheal intubation and general anesthesia. He was prepped and draped after appropriate...
  21. S

    Wiki Seminars-I am planning on

    I am planning on going to the STS coding seminar in November, but does anyone know of any other cardiovascular thoracic coding seminars before that? My boss is wanting me to go to one ASAP.
  22. S

    Wiki Multiple Surgical Assistants

    Does anyone know where I could get a list of what procedure codes are payable for multiple surgical assistants?
  23. S

    Wiki Mitral Valve Repair

    Could you please help? I am in a discussion with the performing physician on this case on what should be billed. Could you please tell me what you would code? PREOPERATIVE DIAGNOSIS: Severe mitral valve regurgitation. POSTOPERATIVE DIAGNOSIS: Severe mitral valve regurgitation. PROCEDURE: 1...
  24. S

    Wiki Seminars

    Could anyone please tell me of some good cardiovascular thoracic seminars to attend?
  25. S

    Wiki JP Drain Removal

    Could someone please help me out with the below report? Please give me your input on if this is still included in the primary surgery or if it is billable. If it is billable, what CPT would you use? PREOPERATIVE DIAGNOSIS: Retained surgical foreign body (JP drain). POSTOPERATIVE DIAGNOSIS...
  26. S

    Wiki Syndesmosis Repair with ORIF lateral malleolus

    Could someone please advise me on this? I have been billing the 27829 for the syndesmosis repair as well as the ORIF of whichever bone is fractured as long as the syndesmosis screws are not inserted through the plate used for the ORIF. Another coder has told me that that is incorrect and that...
  27. S

    Wiki Help!!!!!!

    I need some help settling a disagreement in my office. I have a surgeon that periodically forgets to dictate his assistants on his operative reports. I have had them added to the op-notes through transcription before. Now transcription will not add them. They are requiring the physicians to...
  28. S

    Wiki Help - with this surgery

    Could someone please help me with this surgery? The physician and I are having major differences of opinions over how this should be coded. He coded it as 61684, surgery of infracranial AV malformation; infratentorial and 69990. I was looking at either 61510 and/or 61518 with the 69990...
  29. S

    Wiki Skin Lesion removals

    Could someone please tell me if a physician performs a lesion removal or biopsy, should I will out with skin lesion as the diagnosis code, or should I wait until I get a path report back for final diagnosis? If I should wait, could you please tell me where I could find this documented?
  30. S

    Wiki Removal of Carotid stent with CEA

    Could someone please help me with this? I am thinking that the stent removal is included in the CEA, but not sure. The stent was partially placed by a cardiologist the day before this procedure and this CV surgeon was called in on the case when it did not fully deploy. Any and all help is...
  31. S

    Wiki ommaya reservoir removal

    Could someone please verify what they would bill out for the following op report........ POSTOPERATIVE DIAGNOSIS: Lymphoma; retained neurologic device (Ommaya CSF reservoir). PROCEDURES: Removal of neurologic device. PROCEDURE: He was brought to the operating room and placed under general...
  32. S

    Wiki Help

    I have the following report that our bariatrics surgeons performed that turned into a gastric surgery. Could someone please help????? PREOPERATIVE DIAGNOSES: 1. Morbid obesity. 2. Hypertension. 3. Hyperlipidemia. 4. History of Cushing's syndrome, status post resection of pituitary adenoma...
  33. S

    Wiki hip necrosis excision????

    :eek::confused::eek:Could someone please help me with the coding of this op report? The codes that the surgeon is saying to code with are 27301 with diagnosis code 998.1. Could I please get your opinions on this? PREOPERATIVE DIAGNOSIS: Status post left total hip wound hematoma with skin...
  34. S

    Wiki Patient in coma

    I have a report on a patient for a consult/E M, but the patient is in a coma. The neurosurgeon visited the patient three times that day, but did not document the total time spent. The question is that the surgeon cannot get any type of history or review of systems from the patient and there...
  35. S

    Wiki wound closure

    I am needing help. I have a ptatient that had a CABG 8/1. The patient's heart was too swollen to close the sternum, so the surgeon did a patch closure. He took her back in 8/8 and removed the packing material and did an irrigation of the chest. Should this be a no charge due to this being...
  36. S

    Wiki non payable codes for mid level providers

    I was wondering if anyone can help. I did have a list of procedure codes that are not payable for mid-level providers to bill to Medicare. In the process of moving my office, I have misplaced it. Would anyone possibly know where I can find another copy of it? I have been searching...
  37. S

    Wiki catherter/aortic root vent

    Could someone please tell me if the following can be bill in addition to a CABG or if it is bundled? If it is billable, what code would you use for it? Cannulation sutures were placed in the ascending aorta and right atrial appendage. The patient was cannulated with a 21 French wire...
  38. S

    Wiki pericardial effusion/hemopericardium help

    Could someone please help me with the CPT coding on the following report? I am having problems finding the correct codes. Thank you in advance. PREOPERATIVE DIAGNOSIS: 1. Cardiac tamponade, pericardial effusion /hemopericardium. 2. Cardiogenic shock. 3. Coronary artery disease status post...
  39. S

    Wiki Orthopedic specific exam

    Does anyone know where I could get a template or the guidelines for an exam specific for orthopedics? I am looking for the bullets on an ortho exam.
  40. S

    Wiki Cms - Is anyone else having difficulties

    Is anyone else having difficulties getting onto the CMS website? I have been trying to get into the NCCI edits since Friday and still cannot get onto the CMS site at all.
  41. S

    Wiki Billing for discharge

    I have a question. Here is an example: Specialist admits to the hospital for surgery and discharges three or four days later. Do you bill for the discharge or is it included in the global? They dictate discharge summary notes.
Top