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    Wiki Same Day Admit and Discharge Codes

    Patient was admitted and discharged on the same date by general surgeon. On same day patient had appendectomy. Would I bill an initial H & P (99221 - 99223) with the surgery or would it be same day admit and discharge (99234-99236).
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    Wiki Pulmonary Function Tests

    are you getting paid this way?
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    Wiki Pulmonary Function Tests

    Can anyone help with coding for pulmonary function tests. Prior to January 01, 2012 the pft's were billed as 94010/94060, 94240, 94720, 94260, and 94360. Starting in January three of these CPT's were deleted. The ones I am questioning are 94240, 94260 and 94360. It appears as though 94726 is...
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    Wiki Charging for Medical Records

    Does anyone have any documentation regarding charging for medical records when using a CD instead of photocopying on paper?
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    Wiki sleep study POS

    Thanks for the information. I read the LCD's. I am only billing for the reading of these studies and my physician reads them in the outpatient department of the hospital. I really did not see this addressed as far as the reading of the study. Should it still be billed as home?
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    Wiki sleep study POS

    Could you lead me to the documentation on this. I am particularly interested in the home sleep studies. Thanks
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    Wiki Pos for home sleep studies

    Can anyone please help me with the billing of home sleep studies. My physician reads these studies in the outpatient department of the hospital. I have tried billing 95806/26 with a place of service as outpatient and medicare is denying stating treatment deemed by payer as rendered in...
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    Wiki Billing for Home Sleep Studies

    Can anyone please help me with the billing of home sleep studies. My physician reads these studies in the outpatient department of the hospital. I have tried billing 95806/26 with a place of service as outpatient and medicare is denying stating treatment deemed by payer as rendered in...
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    Wiki POS/DOS for Interpretation of tests

    Does anyone have any information regarding the "Place of Service (POS) and Date of Service (DOS) instructions for Interpretation of Diagnostic Tests" (CMS MM6375). I thought this was going to be effective on 07/01/10. I can not find any information on Medicare's website regarding this except...
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    Wiki Critical Care/Thoracentesis

    I am receiving rejections when billing for critical care (99291) along with thoracentesis (32421) which were performed the same day. I have tried using modifier 25 on the critical care. When calling I was told there was not modifier needed but it is being rejected against each other. Any...
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    Wiki Central Line under ultrasound guidance

    When performing an insertion of non-tunneled centrally inserted central venous catheter (36556) under ultrasound guidance who may bill for the ultrasound guidance. Can a general surgeon bill for this or is this for the radiologist only?
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    Wiki Nursing home level of service

    Thanks for your input.
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    Wiki Nursing home level of service

    When performing audits for several nursing home visits they are auditing out to a higher level due to the documentation of medical decision making. When discussing this with the provider he chooses the level based on the nature of the presenting problem. Has anyone else had this issue. When...
    • cbooker
    • Thread
    • Replies: 2
    • Forum: E/M
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    Wiki New Patient Office Visit?????

    Thanks for the information. The article was very helpful.
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    Wiki New Patient Office Visit?????

    Patient was new to the practice and doctor. My real concern is the fact that we already billed under the physician name for the professional component of the pulmonary function test.
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    Wiki New Patient Office Visit?????

    Physician reads a pulmonary function test prior to seeing patient in the office. Patient comes in to office one week later for their first appointment with the same physician. Physician never saw patient before until the office visit. Is this a new patient office visit?
    • cbooker
    • Thread
    • Replies: 6
    • Forum: E/M
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    Wiki Nursing Home Audits

    When performing audits for several nursing home visits they are auditing out to a higher level due to the documentation of medical decision making. When discussing with the physician he chooses the level based on the nature of presenting problem. Does anyone else have this issue. Which would...
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    Wiki Nursing Home Visits - I have a question regarding subsequent

    I have a question regarding subsequent nursing facility visits. When auditing claims I am finding that most of these visits are coding out to a 99309. I checked in the CPT Manual it states for a 99309 "Usually, the patient has developed a significant complication or a significant new problem."...
    • cbooker
    • Thread
    • Replies: 0
    • Forum: E/M
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    Wiki Newsletter has gone out

    Newsletter Could you please add me to receive your newsletters. Thanks
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    Wiki Help with exam level

    That is what I thought. Thanks
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    Wiki Help with exam level

    I am auditing an office visit on a patient who is at the surgeon's office for a followup to mammogram and ultrasound of the breast. No where in the note in there any physical exam. Would I consider this exam as problem focused?
    • cbooker
    • Thread
    • Replies: 2
    • Forum: E/M
  22. C

    Wiki Points for Referring Patient elsewhere

    So lets same patient was see by his PCP and found to have rectal bleeding. PCP sent pt to gastroenterologist to be evaluated.
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    Wiki Points for Referring Patient elsewhere

    When performing an E/M audit does the physician receive any points in medical decision making under Amount and/or Complexity of Data Reviewed for referring a patient to another physician.
    • cbooker
    • Thread
    • Replies: 6
    • Forum: E/M
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    Wiki Billing for Gyn Exams when Medicare is secondary

    You are probably right on that. We are just trying to get Medicare to pay the patient's copay.
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    Wiki Billing for Gyn Exams when Medicare is secondary

    We do use the G0101 and Q0091 when patient has Medicare as their primary insurance. But in this case Medicare is secondary and the primary insurance does not recognize the G0101 and Q009.
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    Wiki Billing for Gyn Exams when Medicare is secondary

    I am having a problem when patient has Pennsylvania Blue Shield or Blue Cross as primary and Medicare as secondary, when billing a routine Gyn Exam using S0612 for an established patient. Medicare does not accept the local code of S0612. Is there some other way I should be billing this so...
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    Wiki Completing Medical Necessity Certification Forms

    Is there a code to use to bill for completion of medical necessity forms from DME companies to certify medical necessity for oxygen?
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    Wiki Avulsion tip of thumb with cautery

    Patient came into office with an avulsion of the tip of his thumb. Doctor performed a digital block of entire thumb and cauterized with a hyphercator for hemostasis. Is there anything besides a regular E/M than can be billed?
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    Wiki Preventive Medicine Codes versus E/M Codes

    Patient is also being seen for chronic conditions at the same time as the physical, such as hypertension, diabetes, etc. Should I still be just billing the preventive codes?
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    Wiki Preventive Medicine Codes versus E/M Codes

    Can anyone tell me if there is something in writing regarding physicals for medicare. Since medicare will only pay for gyn exams every 2 years is it acceptable to bill a regular E/M code the other year or should it be billed with a Preventive Medicare Code (99381-99397).
    • cbooker
    • Thread
    • Replies: 5
    • Forum: E/M
  31. C

    Wiki Charge for packing cyst

    Thanks. That's what I always understood.
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    Wiki Charge for packing cyst

    Can anyone help me with this. Have a patient that had I&D of cyst. He is out of post-op days. Physician is still having patient come in for repacking. Would these followup visits be just an E/M level?
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    Wiki E/M Audit

    Thank you, I believe we agree.
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    Wiki Modifier 25 in Wound Clinic

    We have a surgeon that treats patients in the Wound Clinic. When billing he usually bills for a debridement as well as an E/M level with a 25 modifier attached to the level. Is measuring the wound and mentioning the degree of healing justified as an E/M level? Does anyone know if there is...
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    Wiki E/M Audit

    We have a physician who states that he does not have to separate the eyes from the ENT exam. On the note he usually states HEENT is unremarkable. According to guidelines that I have found this would only qualify to one point when performing an audit. Does anyone have any documentation stating...
    • cbooker
    • Thread
    • Replies: 3
    • Forum: E/M
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