Search results

  1. V

    Wiki G2211 with PHQ2 and TCM

    Thank you for clarifying Rachael. I just realized that it is specific for the Office/Outpatient E/M. It is all over the article. Guess it's one of those days for me!lol. Adding here for everyone's reference :"All medical professionals who can bill office and outpatient (O/O) evaluation and...
  2. V

    Wiki G2211 with PHQ2 and TCM

    Hi Kimoy, "Can we bill G2211 along with TCM" - Were you able to find additional details on this?
  3. V

    Wiki TCM coding 99495, 99496 for Cardiologists

    Hello everyone, Checking to see if anyone has been submitting the TCM service CPT codes 99495, 99496 for Cardiology specialists? On my research it says Specialists can provide these services. But I am unable to find further details except for this one from AAPC ...
  4. V

    Wiki Assisted Living Facilities

    Hello everyone, I just posted a question in this group on coding for the Palliative care. I am looking for the Codes and the POS for palliative care services provided at the assisted living facility. Appreciate any inputs...
  5. V

    Wiki Prolonged Modifiers

    Hello, I am new to coding Palliative care services and urgently looking for the details for 2024.Our provider is looking to provide these services in an assisted living facility. Can one of you confirm if the below information is correct? 1. POS will be 12 2. CPT codes are New (99341- 99345)...
  6. V

    Wiki G2211

    Hi, I am just curious to know on why you are not considering it. We have patients coming into our Cardiologist office with issues of HTN, CHF and other Venous insufficiency and much more for which they have been followed up on a regular long-term basis. Would that be sufficient enough for us to...
  7. V

    Wiki G2211- HELP!

    Anyone billing this for Specialists? (I am looking for Cardiology, Nephrology in specific) Can you elaborate a little more on this? - "Documentation for each visit must meet the requirements for the code, The documentation must clearly show that the patient/provider relationship meets the...
  8. V

    Wiki Claim denial modifier assistance

    Hello, did you get this resolved? We are currently having issues with both A9555 and A9502.The tests are performed at office and being billed with the codes below. But having problem with one Payer (Banner Medicare) who is denying just the A9555 stating that " CPT A9555 is denied as Separately...
  9. V

    Wiki A9500 Noridian denials

    Hello, we did face the same issue and I hope this helps for everyone looking for this info :) All you have to do is enter the cost of A9500 as per your invoice in 1500 claim form - either under box 19 or just above the date of service, where you list the code- as " A9500 - Invoice price - $...
  10. V

    Wiki Question regarding Holter Monitors in Primary Care

    Hello Berry, If you are hook up the device at office and your physician reviews - you bill only 93225 and 93227.The third party who does the analysis of the report bills the 93226. In other words, you do not get to bill the global code 93224, if part of the service is done by a different...
  11. V

    Wiki VenaSeal CPT 36482 - second kit reimbursement

    Hi everyone, I am looking for details on how to bill for the second kit used for VenaSeal ablation at office. The first catheter was completely clotted inside the lumen of the catheter due to difficult anatomy and our provider had to use a second kit to complete the procedure. We submitted...
  12. V

    Wiki MAC Vs Moderate Sedation Vs Conscious sedation

    Thank you, Kyles, for getting back on this. Let me review the anesthesia sheet notes and check if all details are available a. " intraservice time" - Attached AAPC document for future references. Learning quite a bit on sedation documentation here! Appreciate your guidance. Vid
  13. V

    Wiki MAC Vs Moderate Sedation Vs Conscious sedation

    Thank you both for your responses. I just reviewed the guidelines, and it does state that MAC doesn't include moderate sedation. So, my final takeaway : Our surgeon has to mention the conscious sedation instead of MAC With a supportive documentation - " Conscious sedation administered under...
  14. V

    Wiki MAC Vs Moderate Sedation Vs Conscious sedation

    Hello experts, Hope one of you can help me with my confusion. My surgeon sent the above OP note, performed at an ASC facility, which states Monitored anesthesia care( MAC) but told us that she provided the conscious sedation. Monitored anesthesia care includes Moderate or Conscious...
  15. V

    Wiki MDM

    Hello everyone, I have a follow up question. If a patient is seen at Cardiology office, patient being followed up for 4 month follow up for ONE chronic stable illness (say HTN) and pacemaker device check, provider is not making any medication changes, and the documentation states this, Blood...
  16. V

    Wiki 93620 or ??

    Thank you for correcting Jim :) I missed paying attention to this documentation for the 93612 - "From the right ventricular apex and RV base, up to triple extra-stimulus pacing at 600ms and 400 ms"
  17. V

    Wiki NP billing for loop implant procedure?

    Hi Jim, thank you for your response. We usually bill this for the physician. I am checking to see anyone's experience in billing this service for a NP. I do have this information below but posted here to check if anyone is already doing this :) Please refer page 39...
  18. V

    Wiki NP billing for loop implant procedure?

    Can anyone guide me on this? Please share your experience in billing criteria in such scenarios.
    • vidraj
    • Thread
    • 33285 loop impalnt np billing
    • Replies: 2
    • Forum: Cardiology
  19. V

    Wiki 93620 or ??

    Check with your surgeon if you can submit 93456- 59, 52 (RHC with reduced services) and the 93618 (Induction of arrhythmia by electrical pacing - if this was not done this code allows modifier 52 as well). This is better than not getting reimbursed at all. If done at a facility, include the...
  20. V

    Wiki EKG and Cardioversions not bundled together

    If it is the second EKG performed during the same day, did you try adding the modifier 76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional) for the second one? I am not sure on before and after the CV in specific, but if a second EKG done by the same...
  21. V

    Wiki Coronary Shockwave Lithotripsy - CPT code?

    I would like to know more on this response. Yes, there is no specific CPT code for Intravascular Lithotripsy, and it leads to an unlisted code. When our cardiologist performs this procedure in a facility, we cannot bill the HCPCS code for him. Have you had any success by submitting 92933 in such...
  22. V

    Wiki Code help please for SBO

    Hello, I am looking for the CPT code details for ABThera wound vac to bill our surgeon for a hospital claim. Can we use the 97608 ? Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate...
  23. V

    Wiki Skin Grafts- Q4116-Alloderm per square centimeter

    Hello, I am looking for more information on the reimbursement of Alloderm implants for ASC facility billing and noticed this post. Can you please share the knowledge gained over the years? Or any ASC facility coders out there - how does your facility get reimbursed for the Alloderm used for...
  24. V

    Wiki New to inpatient coding 99231 or 99024--help please

    Thank you for this. This clears up all the confusion I had :)
  25. V

    Wiki New to inpatient coding 99231 or 99024--help please

    Thank you, Thomas. This definitely helps. Is there anyone who doesn't bill these post - op subsequent encounters (4/16 - 4/20) at all, as anyways they will be denied as inclusive under surgical package?
  26. V

    Wiki New to inpatient coding 99231 or 99024--help please

    Hello everyone, Posting this to get more clarity on the original header of this thread - Inpatient coding 99231 or 99024? I am coding for our surgeon for the below scenario. Our Surgeon performed a major 90-day procedure on 4/15/23. And he did inpatient subsequent follow up encounters...
  27. V

    Wiki Modifier GC

    Thank you. very helpful details:)
  28. V

    Wiki More than two ECG readings on the same day by the same provider. How to code

    Hello, Have you tried billing the 3rd or 4th ones with the same modifier 76? Please check the scenario 2 given here: https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00094712 Let us know if it worked out!
  29. V

    Wiki Use of “we” for modifier 80

    Thank you for this. Will share it with my providers:)
  30. V

    Wiki Modifier GC

    Hi, I am a newbie for the teaching facility coding and need some help. Our surgeon is an attending physician for a teaching hospital, and I see a variation in the inpatient follow-up notes. 1. The visit note is written by the resident and has a the PGY1-4 verify/add an addendum on updated...
  31. V

    Wiki Use of “we” for modifier 80

    Hello, I have a follow up question on your response above. I am a newbie to the teaching facility procedures, and you had mentioned, "I assume you are talking about non-teaching facilities "- Are the guidelines different for teaching hospitals? I am currently debating on the documentation. We...
  32. V

    Wiki TEE Documentation

    Yes, to bill 93312-Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report, they do need to be stated under procedure description. After noticing a few denials, we...
  33. V

    Wiki G2066

    Hello everyone, I am looking for details on any other alternate code for G2066, as Medicaid California does not reimburse for this code. How do you all bill for this service for an individual practice provider for this payer?
  34. V

    Wiki CCC exam - reference material

    Hello, I recently took AAPC's program. https://www.aapc.com/training/ccc-online-cardiology-coding-training.aspx I did take the review material - CCC Specialty guide with me just for additional reference. But CPC book, ICD - 10 and HCPCS book is all that is needed. What really helped me...
  35. V

    Wiki Time or MDM

    Thank you, Amy, for taking time to give a detailed response. I have noted down all the key points, and the links are super helpful to share it with the providers. One of our providers asked me the same exact question when I was updating her on the 2023 E/M changes and "TIME" factor. "An...
  36. V

    Wiki Time or MDM

    Thank you both for your quick responses.
  37. V

    Wiki Time or MDM

    Thank you, this is very helpful. I have a follow up question, What if we have a visit with low MDM, but MD documented the time spent as 35 or 50 minutes. Does that qualify to code it higher as 99232 or 99233?
  38. V

    Wiki How to bill a post op fever?

    Thank you both for this. I will query the provider.
  39. V

    Wiki How to bill a post op fever?

    Hello all, I am debating over a claim where to code it as inpatient consult or a post op follow up. Below is the scenario and I hope one of you can give me your thoughts. This patient had a major procedure by our general surgeon and is under 90-day global period. Patient called the next day...
  40. V

    Wiki Modifier 25 Changes?

    Thank you. You are right, I am unable to tell if it's the complication of the initial procedure. Will have to check with the provider. So, if the visit note supports a service which is "unrelated" both to this previous day's decision to drain the abscess and to the previous surgery - I can...
  41. V

    Wiki Modifier 25 Changes?

    Hello everyone, I am new to pro-fee coding on the general surgery specialty, and I am looking for some answer. Hope one of you can help me with the scenario below. Patient is under 90-day global period - post Open abdominal surgery, Patient came back to ED with abdominal pain and our surgeon...
  42. V

    Wiki Proof needed - lesion excision

    Thankyou for your response :). I was debating to code as is, as I couldn't find any specific guidelines anywhere regarding this, to explain the surgeon. My thought when I posted this was - if a neoplasm is excised, and the operative description states the size of the lesion along with the...
  43. V

    Wiki Proof needed - lesion excision

    Hello, I am facing a different issue. For excision procedures, our surgeon is documenting the overall size of the lesion as below. Procedure: Excision of the 5.7cm lipomatous multilobulated left posterior thorax sub fascial tissue neoplasm Preop diagnosis: 5.7cm deep subfascial soft tissue...
  44. V

    Wiki ASC Billing - Same day - EGD and Colonoscopy .Need your inputs.

    Hello everyone, I am new to ASC coding and wondering if someone can help me with this. 1.Does ASC facility get paid for both the same day EGD and Colonoscopy ? 2.Do you bill both under one claim or submit as separate claims ? 3.And any modifier required as they are totally separate...
  45. V

    Wiki Coronary Shockwave Lithotripsy - CPT code?

    https://shockwavemed.wpenginepowered.com/wp-content/uploads/2022/06/cIVL-Physician-Reimbursment-Guide-SPL66945-Rev.-A.pdf Thank you. I am a profee coder for the Cardiologist. Do I still need to use this code +0715T? I thought it is only billed by the hospital. Can you please confirm?
  46. V

    Wiki Coronary Shockwave Lithotripsy - CPT code?

    Thank you.
  47. V

    Wiki CPT code 33274 claim denial requiring anatomical modifier?

    Hi, We append KX modifier for the leadless PM. Since you have mentioned it as Anatomical Modifier denial, 1. Considering the description for the CPT 33274 - " Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg...
  48. V

    Wiki Can you code Multiple Anatomic Modifiers for Percutaneous Coronary Intervention codes (92920-92979) & (93571-93572)?

    Hi, 1. For your question: if I'm able to append more than one modifier for CPT 92928, ,92929, 92950? In my experience, - apart from LC, LD, LM, RC, RI - I have used modifiers 59 to show they are distinct and - 26 for 93571 and 93572. 2. Does the anatomic modifiers apply to access point...
  49. V

    Wiki Coronary Sinus Venography

    Hi, I was looking for this earlier too. I think it is bundled with the Ablation procedure and we donot code it separately.
  50. V

    Wiki Holter monitor dates

    Hi , you didn't mention who does scanning analysis of the report for this monitor. If this is done externally, then yes you code for the service done separately as others suggested above. If it is done at your office , then you need to consider the global code 93224, 93241 or 93245 based on...
Top