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  1. M

    Wiki G2211 Primary Care First

    Oops you are correct. I must've misread G2212 as G2211. Thank you.
  2. M

    Wiki G2211 Primary Care First

    I've been researching G2211. Our practice is part of Primary Care First. Last year G2211 was included in the PBP. This year it has been removed from the PCF Payment & Attribution Methodologies. Does anyone have more information with billing G2211 while participating in an alternative payment...
  3. M

    Wiki G2211 Primary Care First

    I've been researching G2211. Our practice is part of Primary Care First. Last year G2211 was included in the PBP. This year it has been removed from the PCF Payment & Attribution Methodologies. Does anyone have more information with billing G2211 while participating in an alternative payment...
  4. M

    Wiki Depression screening G0444

    Unlike other timed codes depression screening is payable if 1 or more minutes is documented. Be sure the documentation also includes the screening tool used, the results, who performed the screening, the results were discussed with the patient and a plan even if it's no further plan. This has...
  5. M

    Wiki EPIC Medicare question

    When I submitted a ticket EPIC stated it was a feature that would need to be turned on for our practice. Once it was the claims would go to claim edit to add that information. I ended up using our clearing house because when unlisted codes are submitted, they get rejected for more information...
  6. M

    Wiki CPC looking for a job

    Emailed you.
  7. M

    Wiki hospital telehealth visit billable

    Right now during covid this isn't considered telehealth if it's hospital and under the same roof. You'd bill it as if they saw the patient face to face.
  8. M

    Wiki Working in Compliance

    It's a group within my company. My manager created it to stay compliant and make decisions on coding/processes/policies that are vague.
  9. M

    Wiki Working in Compliance

    I forgot to mention what I audit. The audits I do are to detect fraud, waste and abuse. If it's identified by me I work with my manager, cpc team and other teams on corrective actions like refund projects and re-education to prevent it in the future. We have a separate chart auditor which was...
  10. M

    Wiki Working in Compliance

    I am a quality auditor and coding researcher. I also am part of our CPC group that meets weekly to discuss compliance. Compliance actually saved my desire to work in this field. I was previously a claim recovery team lead that took my CPC and passed as magna cum laude. My manager let me code...
  11. M

    Wiki New Patient Office Visit Denials?

    Our practice refuses to let insurance companies control how we care for patients. The question is, is modifier 25 and the new patient office visit appropriate. Many procedures require the physician to evaluate the patient. If the patient was scheduled for that exact procedure ahead of time or...
  12. M

    Wiki E&M level decision making?

    Our practice the doctors chose the levels and the coders scrub the claim for modifiers, remove any unaddressed diagnosis and insurance rules. We have a chart auditor that makes sure the physicians are educated in choosing the right level based on documentation. At the end of the day they're...
  13. M

    Wiki Remote work

    When we were in the office it was a lot easier to hire students and train. Now that we're remote we are only accepting experienced coders/billers. It's so hard to train and supervise remotely. However if you knew our system and worked in scheduling/authorizations previously my manager would...
  14. M

    Wiki No CCI Edit Tool given to this Surgery Coder-Compliance Issue?

    They're all over the place but if you Google and familiarize yourself it will get easier over time. If you click the edit you're looking for the spreadsheets are usually linked at the bottom. Like I said a tool is great but I've found info in these our tools didn't have. Like exactly what...
  15. M

    Wiki No CCI Edit Tool given to this Surgery Coder-Compliance Issue?

    I don't think there is guidance stating you must use a tool but I am still studying. There is guidance on unbundling and correct coding if that's what's or what's not happening. However CMS's edits are accessible to everyone on their NCCI website. It's not as easy as a tool and you have to read...
  16. M

    Wiki Medicare AWV from Year to Year

    Our MAC WPS lets us bill subsequent AWV's after a full 11 months has passed. Therefore, if a patient received one on 5/18/2021 they're eligible on 5/1/2022. Advantage plans may vary. WPS's portal shows the exact dates the patient is eligible.
  17. M

    Wiki 87635 & 99211

    Thank you.
  18. M

    Wiki 87635 & 99211

    Thank you!
  19. M

    Wiki 87635 & 99211

    Hello, we are looking to start a drive by covid testing center. We have the CLIA waived tests 87635. If a patient comes specifically for the testing (no e/m) may we bill 99211 & 87635QW? From what I am gathering I would say yes if documentation supports the assessing, screening of the patient...
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