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    Wiki lab question

    thank you both! Shena Betts
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    Wiki lab question

    I don't see forum specific to lab so I'm posting here. Our lab does a CBC w/ automated diff WBC (85025) however if something potentially abnormal is seen they also do a manual diff (85007). I'm wondering the best way to code these. Per CCI edits, 85025 & 85007 can't be billed together however...
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    Wiki Obtaining Experience with IVR Coding

    I've been coding IR for almost 15 years. To start out I received training from someone in our company that was already doing it. Back then IR was not as extensive as it is these days. I started out with easier things like biopsies, picc/mediport placements and basic vascular procedures. Over the...
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    Wiki nipple sparing mastectomy w/implant removal

    the surgeon did a nipple sparing mastectomy (which he coded 19303) and at the same time he removed the existing implants (which he coded 19328). Since there is a CCI edit for these codes together, I'm assuming it's not appropriate to report the implant removal separate from the mastectomy when...
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    Wiki touch preps with multi stains

    hi all, If a touch prep is done (88333) and multiple cytologic stains (pap & diff quick) are employed, can you report 88162 with 88333? thanks! Shena Betts, CPC
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    Wiki Help !! 11601/12001 denied

    did you try modifier 79?
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    Wiki Billing 76376 and 76377 alone?

    interesting.... i wonder why they are not designated as add-on codes then.
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    Wiki Billing 76376 and 76377 alone?

    They are not designated as add-on codes so I think you can.
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    Wiki inpt transported to physician's office

    hi all, An inpatient was transported by ambulance to the pain mgmt physician's office. He did a new pt visit and an epidural steroid injection and billed for all services with his office location. We received a call from the hospital telling us that because the patient was an inpt we need to...
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    Wiki PPD administration

    hi all, It's my understanding that code 86580 includes the PPD serum and you would not bill separately for it. The practice just did a lot of PPD admins in which the PPD serum was supplied to the office for free. Can the provider still report code 86580 if there was no cost to them for the...
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    Wiki follow up visit

    thanks! I knew Medicare would deny because of the same diagnosis so i wasn't sure if they would pay on appeal or consider it part of the global package.
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    Wiki follow up visit

    Hi everyone, Here's the scenario... the surgeon did procedure 19110 (90 day global) with a diagnosis of breast cancer. Apparently when the pathology came back there was more extensive disease than originally thought so the patient was called back in to discuss the findings and counseling was...
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    Wiki thoracic lymphadenectomy

    another question.... if he had removed all the lymph nodes required for a lymphadenectomy, he still would not be able to report 38746 with 32098. How would you report it? Unlisted? thanks again!
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    Wiki thoracic lymphadenectomy

    thank you for your reply and the reference!
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    Wiki thoracic lymphadenectomy

    hi, The surgeon did a thoracotomy with a pleural bx (32098) and removed a large aortopulmonary lymph node. Frozen section came back as mets so he then removed lymph nodes from stations 8 and 9. He coded the lymphadenectomy as 38746 however that is an add-on code and the primary procedure...
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    Wiki endarterectomy iliofem, com fem, SFA

    hi, If a long segment of occlusive plaque is removed from iliofemoral artery, common femoral artery and superficial femoral artery, can all 3 codes be reported? (35355, 35302, 35371-59) There is a CCI edit for the common fem endarterectomy with the other 2 codes. In the report, the surgeon says...
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    Wiki rib resection part of surgical approach

    hi all, Frequently the surgeon will resect the rib "so as to allow for easier visualization of the pleural cavity, so as to minimize skin incision, and so as to minimize the chance of iatrogenic injury to cephalad and caudad ribs with rib spreading." He has been coding 21600 for this however...
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    Wiki coding guide for thoracic surgery

    Thanks for the info! I only see a 2011 edition. Do you know if there is a 2012 available?
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    Wiki coding guide for thoracic surgery

    hi, I'm new to thoracic surgery coding. Can anyone recommend a good book to use as a reference when coding? thanks! Shena Betts,CPC
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    Wiki thoracic surgery lung cancer

    I'm new to coding thoracic surgeries and would appreciate any input on how to code the following case. (condensed report) Pre-op diag: Known right lower lobe, nonsmall cell carcinoma lung; questionably involved mediastinal lymph nodes and/or left lingular nodule (PET/CT findings) Due to PET/CT...
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    Wiki different specialties same group practice

    Pam, Our Medicare manual says the global surgical package includes: complications following surgery, includes all additional medical or surgical services required of the surgeon during the post-op period of the surgery due to complications that DO NOT require additional trips to the operating...
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    Wiki different specialties same group practice

    Hi, We have a group of 2 pulmonologists who are considering adding a thoracic surgeon to the practice. Currently, when there are pulmonary complications (such as pneumonia, emphysema, bronchospasm) from his thoracic surgeries he refers patients (or requests consults) to the pulmonology group. As...
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    Wiki Overread CPT code 76140 vs Original CPT code

    according to Clinical Examples in Radiology, Spring 2009, in a situation in which a referring physician requests a formal second opinion of a previously reported CT exam, upon exam of the CT, the consulting physician provides his or her opinion to the referring physician in a written report, the...
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    Wiki visit to patient in LTC facility

    hi, If the urologist goes to the long term care facility and does an E/M on his established patient, would this be billed using a nursing facility code (99304-99310)? If not, how would this visit be coded? thanks, Shena Betts, CPC
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    Wiki open removal of suture knot

    Hi all, could I get some opinions on how to code the following? Diagnosis: painful foreign body (suture knot) of abdominal fascia Procedure performed: debride/excise painful foreign body Description: the patient was supine, the surgical scar beneath the naval was incised, which was carried...
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    Wiki biopsy intra-abdominal/iliac lymph node

    thanks for your reply. Somebody else suggested 49321. It's not in the lymph node section of CPT but I guess that code would probably work too.
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    Wiki biopsy intra-abdominal/iliac lymph node

    Hi, If this was an open bx would it be coded 38500? If done laparoscopically how would it be coded? I only see code 38570 for a lap bx but that is for a retroperitoneal lymph node. thanks, Shena Betts, CPC
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    Wiki 88162 with 88313

    Is it ok to bill these 2 codes together? I asked the pathologist for an example of when both would apply to a case and he said: "these almost always occur with skinny needle biopsies. Touch imprints are prepared and stained with Diff-Quick (immediately) and PAP (later) stain. Code 88333...
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    Wiki hernia repair, infected patch removal, abscess drainage

    thank you for responding. What about code 49402 for the infected patch removal? Shena
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    Wiki hernia repair, infected patch removal, abscess drainage

    Hi all, Could anyone help me with the following report please? This was all done laparoscopically. Once the abdomen was entered, the adhesions were taken down until the midline was approached. A fibrotic mass was noted, felt likely to represent the posterior pseudocapsule around the...
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    Wiki partial colectomy x 2 ?

    Hi, the patient had a cecal volvulus w/ stricture to right ascending colon and a sigmoid volvulus. This is an open procedure and this is a condensed version of the OP note. A right hemicolectomy was accomplished by dividing the terminal ileum with a GIA stapler and the transverse colon just...
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    Wiki surgeon E/M in the emergency dept

    Thank you! Rebecca, that is exactly what I was looking for. Shena
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    Wiki surgeon E/M in the emergency dept

    I don't know, would it? The actual service took place before the patient was admitted. Do you know if there is a guideline from Medicare on this specific scenario? thanks, Shena Betts, CPC
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    Wiki surgeon E/M in the emergency dept

    A patient comes to the ED and the general surgeon on call is called down to evaluate the patient. The surgeon decides to admit the patient for surgery. Would it be correct to code the surgeon's E/M with an ED code (99281-99285)? Thank you! Shena Betts, CPC
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    Wiki breast abscess

    Hi, I would not code for the 2nd attempt. I don't see why you can't bill separately for the core biopsy. This report doesn't include the detail that you normally see for breast core biopsies but if it was done I would code it. Shena Betts, CPC, RCC
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    Wiki Limited Breast Ultrasound

    limited breast ultrasound Hi, 76645 is correct. If he feels it's a "limited" study, you could add modifier -52. Shena Betts, CPC, RCC
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    Wiki osteopathic manipulative treatment

    Hi everyone, Does anyone out there have experience billing for OMT, specifically for a drug referred to as P2G? P2G is a drug cocktail that includes phenol, glycerin and glucose. If anyone has experience with this, how are you billing for this drug? thanks, Shena Betts, CPC Physicians'...
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    Wiki mastectomy closure

    Hi everyone, I could really use some help on the following scenario. We bill for a surgeon that uses the term 'mastopexy' for what he's doing after the breast is removed (same operative session as the mastectomy) but I don't think it's really a mastopexy (breast lift). The following is how his...
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    Wiki Shoulder Arthrogram Coding

    Hi, You would code 73040 if a radiographic study is done after the joint is injected. Our docs normally do internal and external rotation views but it could be other views. You would code 77002 (instead of 73040) when they use fluoro guidance to inject the joint and only a spot film is taken...
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