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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 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

    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 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 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

    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 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 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 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 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 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 Pelvic Exam

    In our internal medicine office, we offer women pelvic exam and paps. We bill for pelvic exams. With commercial insurances there has been a question of the pelvic exam code that we are using because that code is generally used with anesthesia. What is the proper code to be used with BCBS of...
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    Wiki E & M and Immunization and Modifier 25

    I have a question regarding the usage of an E & M code and immunization administration (90471, 90472, G0001). If a patient comes in for a follow visit and we give the patient a flu vaccine, should we add a modifier 25 to the E & M Code. We are now noticing that the immunization administration...
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    Wiki Clarification between billing a 36410 vs 36415 for Medicare, Medicaid and Commercial

    My PA (Practice administrator) seems to feel that I should bill 36410 instead of a 36415 because of the reimbursement value, but I want to bill what is correct and she just does not get it, what should I do? Is there a written guideline to this? Elizabeth Comma-Watson, CPC:confused:
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    Wiki Hospital visit and ICU add on code

    I work for an Internal Medicine doctor who also goes to the hospital to visit patient's. One of his patient's was seen while in ICU. I know that we can use 99232 and 99292 but is there an modifier used while billing these two codes?
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