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    Wiki Diagnosis is Z76.89

    That is what another colleague of mine said. Use the dx of Z00.00. These are new patients seeing out Nurse Practitioners. They do not have any chronic issues, no diabetes, hypertension, no obesity. No health risk, nothing. I will let them read what CPT 99202 & 99203 indicates. Thank you...
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    Wiki Diagnosis is Z76.89

    Good morning, everyone. I have two nurse Practitioners who sees patients and if the patient shows up, I am receiving charge reviews of CPT codes 99202 and 99203 or 99212 and 99213 but the diagnosis code is Z76.89 (Persons encountering health services in other specified circumstances). The...
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    Wiki Nexplanon

    I did a claim review for CPT code 99214, FP modifier, (Family planning Medicaid) CPT code 11983, FP (Removal w/reinsertion of implant) and HCPCS J7307UD, FP modifiers (Etonogestrel Implant system including implant...
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    Wiki 26 Modifier usage

    OK Thank you for that. I am trying to bring up revenue, but I am respecting what I can and cannot bill or code. Thank you once again for answering my question.
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    Wiki Question about HealthCon in Vegas

    Thank you for the plug and thank you for letting me know about the payment plan option. I am looking to see and if I could be an officer.
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    Wiki Question about HealthCon in Vegas

    Why is HealthCon National Conference in Vegas so expensive? The company that I work for is not going to pay for it so I will have to. I will also have to pay for airplane ticket and hotel accommodations. Even the Hybrid is expensive. Do we have price accommodations for seniors (ages 60 and...
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    Wiki Screenings and Routine Annual Exam

    Do I need to keep the screening diagnoses on when especially it is just labs that the medical doctor is ordering? I use EPIC when doing charge review.
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    Wiki 26 Modifier usage

    What I am describing is the provider is in the room with the CMA and patient. The provider does the collecting of the smear, places it in a tube and sends it to the hospital lab (we are with the hospital system). The lab tech, I am thinking looks at the smear and the laboratory provider is...
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    Wiki 26 Modifier usage

    Thank you for answering this question, now I understand it.
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    Wiki 26 Modifier usage

    Good day, everyone: My offices do pap smears, but the reading of the pap smears goes to either the laboratory (i.e., Quest or LabCorp) or the hospital laboratory. Because we collect the specimens, can we add a 26 modifier to the pap smears? My other question is with EKGs, CPT code 93000, can...
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    Wiki Keep it or omit it

    Good afternoon, everyone who reads this thread. I have a bad problem with second guessing myself. If the providers add diagnosis codes Z12.11 or any of the screening lab codes, do I need to keep in my charge reviews? I have been taking them out. Sincerely, Elizabeth aka Liz Greensboro...
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    Wiki 36416 Collection of capillary blood specimen

    I have a question for all of you. I am in North Carolina. I use EPIC EMR. My CMAs/RMAs stick a patient's finger if they know that the patient is diabetic. Which insurance will reimburse for finger sticks? I had to stop billing 36416 because we were getting errors with EPIC and we should get...
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    Wiki Facility Billing vs Hospital billing

    Thank you for everyone who answered my question to clarify everything. I will be using G0463 from now on and see if will make the powers that be happy.
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    Wiki CPT 96372 with Kenolog, Promethazine and Triamcinolone do I use Modifier 51.

    Thanks Deborah I will look at those that you mentioned.
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    Wiki CPT 96372 with Kenolog, Promethazine and Triamcinolone do I use Modifier 51.

    I am using CPT 96372 with Kenolog, Promethazine and Triamcinolone do I use Modifier 51 - 96372-51 with HCPCS J2550, 96372-51 with J3301. E/M code is 99213-25, 96372 and J1885. I hope I am billing it correctly because EPIC is saying that 96372 is duplicated. Please help me, so confused.
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    Wiki Facility Billing vs Hospital billing

    I have been fighting with the Professional Billing Manager @ the healthcare system and I told her that TC & 26 modifiers are used for radiology, but she is insisting that I can use that for duplicating (i,e) 99213 or 99214. I am supposed to be doing split billing using the modifiers TC & 26...
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    Wiki Facility Billing vs Hospital billing

    I have been fighting with the Professional Billing Manager @ the healthcare system and I told her that TC & 26 modifiers are used for radiology, but she is insisting that I can use that for duplicating (i,e) 99213 or 99214. I am supposed to be doing split billing using the modifiers TC & 26...
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    Wiki Facility Billing vs Hospital billing

    That makes a lot of sense now. So then, because we are on EPIC, would I still bill 99214-22 modifier with POS 11, then would I bill 99214 and no modifier?
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    Wiki Facility Billing vs Hospital billing

    I have been pondering this question for months now. We have some auditors on site, and they are questioning why we are not billing hospital charges. I have been told that we can bill (2) 99214 - one with 99214 TC modifier and the other 99214 26. I have been coding for a long time and I know...
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    Wiki Denials of Cataract Surgery.

    My sister called me and asked me about CPT code 66984. The office for which she works is receiving denials for CPT code 66984. They are using the correct modifiers RT or LT for which eye is having cataract surgery. She is trying to find out if there is something else, she is not following?
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    Wiki Hospital Based Clinic

    The ProFee Billing Director at the hospital tells me that since this one particular office is an hospital based clinic, one diagnosis of the patient goes on a UB and the other E/M and diagnoses goes on a 1500, It is very confusing. When I spoke to the Lead Medical Doctor at the clinic, she did...
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    Wiki Hospital Based Clinic

    Hello everyone, I have a question that has been bugging me for the last 2 months, I am the clinics Pro Fee Coder (about 5 clinics that I code for using the EPIC system). I work for a hospital in North Carolina and I have been told that the one clinic is a hospital based clinic. At this time, I...
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    Wiki Hospital based Clinic

    Hello everyone, I have a question that has been bugging me for the last 2 months, I am the clinics Pro Fee Coder (about 5 clinics that I code for using the EPIC system). I work for a hospital in North Carolina and I have been told that the one clinic is a hospital based clinic. At this time...
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    Wiki Wellness Exam Vs. Yearly Physicals

    Happy Holidays to you all: My Front desk staff, who makes appointments for patient cannot seem to get this right. So I need some insight - Wellness exams - my billing manager told me to add to the schedule New Wellness Exam: Biometrics and Establish Wellness Exam: Biometrics. This need no...
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    Wiki Which books: Buck or AAPC?

    Happy New Year: Even though when I took my billing/coding course at GTCC we used Ms. Bucks books, in many offices I have used Optum books which I always buy because I get the discounts because we are AAPC members. When you go to take your tests make sure you take those books from Optum. I...
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    Wiki 36415 denials

    36415 It might be bundling with the CCI edits. Medicaid and Medicare will pay for it, but NCBCBS bundles it with the E/M code. Good Luck.
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    Wiki smoking cessation -component of basic procedure

    Smoking Cessation Add a 25 modifier to the E/M visit. In North Carolina (Palmetto GBA) will reimburse with 25 modifier on E/M and will reimburse HCPCS cod G0436. MCD and Commercial insurance will reimburse with the 99406 along with 25 modifier on E/M code. Don't forget to use 305.1 diagnosis...
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    Wiki Medicaid

    Yes you can bill the patient. Advise the pt why they would have to pay at time of service.
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    Wiki 93720

    We are getting denials from Palmetto GBA (Medicare) for using the CPT code 93720 (which we had it listed as Body Composition Analysis). I did not realize that 93720 can no longer be used. What code can we use for billing Body Composition Analysis. Patient's coming to us for weight loss, have...
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    Wiki CPC Certificates displayed

    Certification I should have had my certification up, but i don't - so maybe i will make a copy of it, frame it so that the world can see. :)
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    Wiki 93720 Plethysmography

    We are getting denials from Palmetto GBA (Medicare) for using the CPT code 93720 (which we had it listed as Body Composition Analysis). I did not realize that 93720 can no longer be used. What code can we use for billing Body Composition Analysis. Patient's coming to us for weight loss, have...
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    Wiki code for weight management again

    97530 being used for Lifestyle Counseling --------------------------------------------------------------------------------:confused: I need help with this one. My boss insist that I use 97530 (which is clearly physical therapy code) for Lifestyle Counseling after doing a 93720 (Total Body...
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    Wiki 97530 being used for Lifestyle Counseling

    Jeramy - thank you for your help on this one. I need to get more insite from other people here but if you dont mind, i will be putting some information together so that I can share not only with my providers but also my boss also. where can i find this in writting?
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    Wiki 97530 being used for Lifestyle Counseling

    I need help with this one. My boss insist that I use 97530 (which is clearly physical therapy code) for Lifestyle Counseling after doing a 93720 (Total Body Plethymography). Medicaid of NC clearly states that the provider is not able to performed 97530. Can anyone out there help me. I am...
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    Wiki 83036 A1c denials

    Dont forget that it is all about the insurance companies. if you are getting denials on 83036 try 83037-qw. Hey I just thought of something, are you adding the QW modifier to your 83036, if not add it and you might just get paid.
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    Wiki New Urgent Care Center-Need answers and advice

    Urgent Care Ctr I am in agreement with the last two writers. A lot of money has just left your practice. Medicaid will not back bill they will only reimburse from the effective date that is on your acceptance letter. I would stop seeing those pt's until you get your effective date. I hate...
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    Wiki Non-covered services by an insurance co

    Non covered service by an insurance co I try not to consider those services as non covered only because what one insurance would not cover the other insurance would. If my medical assistants (nursing staff) do the test, I bill for the test or procedures. If you look at your LCD determination...
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    Wiki code for weight management again

    I work for an internist office. He sees pt for weight loss as well as other internal medicine needs. He is billing a 99213-99215 or 99203-99205 along with physical therapy code 92567, which the practice administrator calls if Lifestyle Modification Counseling (I don't have my book with me...
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    Wiki Weight management counseling code

    weight management counseling code In our practice, we use the E/M codes (99203-99205, 99213-99215) and the overweight code or obesity codes (278.00, 278.01). Now because we do Body Fat Anaylsis (93720) we also use also the V65.3 as well as the BMI codes for adults. What I am trying to tell...
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    Wiki Weight management counseling code

    Weight management couseling code I have the same problem the only thing is that my supervisor is using a physical therapy code for a lifestyle modification counseling code. We need to be using this with an E/M code.
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    Wiki Billing Manager and deadlines

    I understand where you all are coming from, but here is my plythe; I am the only coder/biller on site, the front office receptionist I am training to do some of the billing. Noow I am noticing, we are not getting the EOB's/RA's from the Manager (who is also the Practice Administrator) timely...
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    Wiki dx code tobacco screening

    tobacco Screening Isn't V70.3 a diagnosis that would be used for a physical? I am just confused. I have been using per my practice administrator to use 99406 and 305.1. I have been using 99214 w/25 modifier. 99406 w/59 modifier. There are some new cpt codes as well new diagnosis codes for...
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    Wiki Billing Manager and deadlines

    I have a practice administrator who has an opinion that the billing office has deadlines and from what I know, in billing, there are no deadlines. For example, if you get commercial payments, or medicaid or medicare payments, posting should be done within 48 hours (2 days) or denials should be...
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    Wiki Help on bilateral xrays

    I have a question, I work in a internal medicine office and we do xrays. Lately in the encounters that I see, we have bilateral hips or bilateral knee xrays. I know that a 50 modifer need to be on the xray with lt or rt, am I coding this correctely. Please help
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    Wiki J1815 and J1817

    I need a bit of help. My providers give insulin to pt's when they come in with extremely high diabetes 300 +. According to Cigna Medicare in North Carolina, they will not reimburse for J1815 or J1817 stating that those 2 codes have exclusion dates of 01/01/2003. What should I do at this...
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    Wiki knee injection

    Knee Injections I was reading your thread and I am a biller/coder in internal medicine and we do knee injections on pt with arthritis. I am very interesting in getting a fax or email on the correct billing on these injections. My fax number is 336-358-1582 and my email address is...
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    Wiki coding for gc/chlamydia collection in the office

    gc chlamydia collection in the office I use 87510 for BV Rapid Test and 87808 for Trich Rapid Test. I do not use Q0091 unless it is a pt with Medicare. I hope this help. :)
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    Wiki Pelvic Exam

    Thanks Thank you all for your help in this. In Greensboro, NC it seems that the primary care physician can do a pap if the female does not have a gyn doctor. Most of the females that we see do have vaginitis, because of them being either very sexually active and don't use protection or they...
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    Wiki Pelvic Exam

    Pelvic exam We are using 616.10 and Cervical Cancer Screening diagnosis. Pelvic examinations are done with every pap. I know that with MCR will only pay with the G0101 and Q0061, but commercial insurances does not recognize those codes so what should I do. This is my first time dealing with...
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    Wiki need help with dx code.

    Code Use either V20.2 or V70.3. I hope that this helps.
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