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    Wiki Genetic Testing Questions

    I'm looking for someone with experience in billing a variety of genetic tests for pregnant women. I have alot of questions. Thanks Willie
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    Wiki Genetic Testing Questions

    I'm looking for someone with experience in billing a variety of genetic tests for pregnant women. I have alot of questions. Thanks Willie
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    Wiki Behavior Health - H2014

    Oregon Medicaid. Our policy folks have determined that this service can be provided to a group of 10 individuals. Our fee schedule pays 17.56/15 mins. What is the appropriate way to bill this code for all 10 people? My question is do I bill 17.56/15mins for each individual or do I bill for...
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    Wiki GenerationPMTO

    Has anyone heard of this type of behavioral health service?
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    Wiki Speach Therapy and OT Therapy

    Has anyone ever experienced a pediatric children's clinic providing speech therapy and OT therapy at the same time, same date of service for the same client? This clinic is billing for both services separately.
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    Wiki Lisfranc Fracture

    what is the correct diagnosis of a Lisfranc fracture?
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    Wiki OB Billing when payers change during pregnancy

    I have a question regarding OB Billing..... OB provider provides all OB care (antepartum, delivery and postpartum) to a client and the client switches between managed care plan/FFS coverage throughout their pregnancy. When a provider provides all OB care they should code the OB global codes...
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    Wiki Determining E/M Level

    Good afternoon, I have a provider record that indicates the patient is a new patient here for follow up care for a surgical procedure. In reviewing the documentation, the provider indicates that the individual needs to have a dtap. would you give this provider a point for ordering something...
    • wverret
    • Thread
    • Replies: 1
    • Forum: E/M
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    Wiki E/M Audit Tool - Electronic Version

    Does anyone have an electronic copy of an E/M Audit Tool. I'm looking for something that is not just a PDF copy. I have that. I'm looking for something that is in a Word format that I can click the check boxes. Thanks Willie
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    Wiki Ophthalmologist billing E/M codes vs 92002-92014

    I've got an ophthalmologist who is billing for services using an E/M code rather than the vision codes (92002-92014). Which are the correct codes to bill? Willie
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    Wiki E/M Visit - Patient not present at visit.

    Can provider bill for E/M office visit when the patient was not present? Physician met with parents of severely disabled young adult. The patient did not accompany them to the office visit. Below is a typed copy of the note. Patient: John Doe Age over 30 Established patient DOS: 2013...
    • wverret
    • Thread
    • Replies: 7
    • Forum: E/M
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    Wiki E/M 97 Guidelines

    If a chart note reads brisk cap refill..... Using 97 guidelines, where you give the credit for? Extremities or Edema or ??? We think it might go under Cardiovascular....but we are not sure. Willie
    • wverret
    • Thread
    • Replies: 3
    • Forum: E/M
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    Wiki Modifier 25 - Provider sees patient for sore throat

    Provider sees patient for sore throat. patient has been exposed to strep. Provider orders a rapid strep test. Prescribes Amoxicillin. Documents neg strep. provider bills for 99213 w/mod 25 and 87880 (strep A assay w/optic). is it appropriate for provider to use mod 25? WIllie
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    Wiki Modifier 76 - getting asthma injections

    Scenario 15 yr old male with chronic and severe asthma is seen in pediatrician's office on 8/23/12. Child has been getting asthma injections since 8/1/08. Child receives two injections of XOLAIR biweekly. Services are provided in ped's office, not an ASC or Hospital Surgical suite. Clinic...
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    Wiki Modifier CC

    Does anyone know anything about Modifier CC. I'm an auditor and I'm seeing it in paid claims data for Oregon Medicaid. I'd appreciate anyone sharing their knowledge about it's use and why? Willie
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    Wiki ICD10 PCS Codes for Mental Health & Substance Abuse

    Good morning. I'm work for the State of Oregon, Medicaid Program. I'm working on the ICD10 team, remeadiating our MMIS system for ICD10. We discovered some PCS codes for Mental Health and Substance Abuse. Our first impression of the codes are that they are to be used in an inpatient hopsital...
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    Wiki ICD10 PCS 7th Character "S" Sequla Codes

    I'm working for the State of Oregon Medicaid Program. Our agency has been having an internal discussion about what to do with the ICD10 PCS codes that have the 7th Character of "S". We understand that these codes are the "late effects" codes. Our question is can they be billed as a primary...
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    Wiki Modifier 50 or 09950

    I've been asked by one of the research staff where I work about modifier 09950. I remember CPT used to have these codes in them, but I can't find them anymore. I googled the info and I think they were deleted at some point, but i'm not sure. Can anyone out there confirm whether the 5 digit...
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    Wiki Cpt 97150

    Is 97150 15 minute time based code or a per visit code? As I read the description, I think the answer to my question is....per visit. But I'm just not sure. willie :confused: :confused:
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    Wiki Questions about Vision Codes and Terminology

    I was contacted by a policy analyst by the state medicaid program in Oregon regarding vision codes and terminology. I'm looking for a person that I can contact via email to ask question of. Thanks Willie
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    Wiki Personal Care Services in MH Residental Fac.

    This question is for anyone working in a state medicaid agency. I was asked this by the MH program staff. Do any states pay for personal care services provided in a community-based MH residential setting and if so what code they use?
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    Wiki Radiology Coding/Billing Question

    I have a question about coding outpatient Radiology claims. Scenario: Little Johnny is outside playing he falls off money bars and hurts his ankle. Mother takes Johnny to local ER. ER physician thinks Johnny may have broken his ankle. ER physician does an appropriate exam, hystory and orders...
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    Wiki Billing for School Based Health Services

    Does anyone out there have any experience with billing/coding for school based health services? Do you think 96150 & 96151 would be appropriate to be used in a school setting? Just Curious. Willie Verret, CPC
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    Wiki Abd/Pelvic CT Scan Question

    I am an auditor for Oregon's Medicaid Program. Doing a chart review. Physician order reads Renal CT. Provider billed 74170 & 72194. Are these the correct codes based on the physician's orders? If not, what is the correct code? Thanks Willie
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    Wiki IP Psych in State Run Facility

    Does anyone out there have any experience coding for services provided to clients committed to state-run psych facilities. What we have questions on is how to bill for services provided to folks who have been found guilty of a crime, except for by reason of insanity. They are under the...
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    Wiki Coding for Inpatient Psych encounters in state-run facility

    I an a new coder. I work for the Oregon Department of Human Services. I have been asked to assist the billing/coding staff at our state run inpatient psychiatric hospital. The coding staff are trying to determine what services provided to patients are billable. Specifically they want to know...
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