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    Wiki Anesthesia PLAN vs Anesthesia TYPE

    Thank you!
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    Wiki Anesthesia PLAN vs Anesthesia TYPE

    Good Day from Omaha, Nebraska. I code for a urology practice that contracts with an anesthesia group. The CRNA provides both GENERAL anesthesia as well as MAC. I have attached a redacted copy of the anesthesia record. Looking to find out which field we should be using for coding/billing the...
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    Wiki 44385 with 52000?

    Patient has a urinary small bowel pouch. I know to use 44385 when performing a cystoscopy - but do I also use 52000? I did once & Medicare did pay for both. I read an article...
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    Wiki Code 52315

    We use the 52315 for bilateral stent removals or if the physician dictates it was a difficult removal.
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    Wiki Interstim Modifiers?

    That is how I handle as well - modifier -50 for the PNE & anatomical modifier for the perm implant.
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    Wiki communicating hycrodelectomy in 5 y/o

    Did you ever get an answer? My notes indicate 55500 is the appropriate code. I know it's 10 years later! 🤦‍♀️
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    Wiki Coding bladder instillation (intravesical route)

    We use 51720 & whether the drugs are payable separately depends on the place of service. If a hospital setting - the instillation must be performed outside of the operative session (i.e. in recovery, PACU, etc); however, if performed in an ASC setting, the instillation is payable when performed...
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    AAPC Forums: New Look, New Features

    I do like the new look and color scheme. One thing I don't see, however, is a way to search for something within a specific forum. For example - I used to be able to go to the Modifiers forum and search within that forum for something specific. Please advise if I am missing it! Thanks!
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    Wiki Meatotomy with cysto

    Meatotomy w/cysto In our office, I've been trained to use 52281 for this combination. From the coding/billing supervisor.
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    Wiki Sacral neuromodulation for bladder and bowel control coding question

    Are you talking about the permanent implant? 64581 is for the permanent implantation of the device. We do them in our Urology ASC also - and in 5 years I've never seen them do the permanent on both sides??? The trial, 64561 is done bilaterally as they are trying to determine which side will...
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    Wiki Unilateral Retrograde Pyelogram

    Thomas, Thank you for your opinion. I am of the same...since the -LT and -RT are informational ONLY, I don't see the harm in entering them. It does signify to the payer that only ONE side was done. It was a very new coder (a CCS not a CPC) who brought it to my attention it was not...
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    Wiki Unilateral Retrograde Pyelogram

    Retrograde Pyelogram Thomas, Thank you for your reply. Just to clarify, I did search the forums prior to posting the question. I checked again just now to see if I missed anything - and I do not find a post directly addressing my question. Again, my question is not whether to bill 52005...
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    Wiki Retrograde Pyelogram - My question is how

    Retrograde Pyelogram No, the contrast is not injected into the vein of the patient...it is injected through the catheter(s) placed via a cystoscope into the ureters - I believe. But, I'm also struggling with the retrograde pyelogram code 52005 ..that's the placement of the catheters ..CPT...
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    Wiki Unilateral Retrograde Pyelogram

    Unilateral 52005 That’s what I was thinking too Debbie. I understand that 52005 can be either unilateral or bilateral which is why I was wondering the -LT or -RT was not appropriate. Any thoughts?
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    Wiki Bladder tumor measurements

    I have been taught to go with the physician’s documentation. If his dictated, signed note states 5 cm then go with that. They can also use the terms “small”, “medium” or “large”. The only time I use the path report for measurements is if the size is not indicated. The specimen will always shrink...
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    Wiki Attempted Cystoscopy

    Attempted Cysto Yes, that is what I use in our ASC - I bill both facility & professional fees. Our system gives me the opportunity to add a “line note” to the charge where I can state “doctor unable to advance scope into bladder” as the reason for modifying with -52. Hope this helps!
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    Wiki Unilateral Retrograde Pyelogram

    I’m seeing a number of posts regarding a bilateral retrograde and not coding with modifier -50, -LT or -RT...but how are you coding when the retro is done on just one side? I’ve been assigning the correct modifier based on the side contrast was injected. Is this wrong? Thanks for the assist.
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    Wiki Stent Exchange Diagnosis Codes

    Add'l Stent Questions Debra, So, I've been pondering your response as it applies to the 3rd diagnosis in a stent exchange. If a patient has a continuous stent - wouldn't the condition still be active (i.e. as in hydronephrosis)? With regard to stents in general - for stent removal (i.e...
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    Wiki Stent Exchange Diagnosis Codes

    Thank you, Debra! Can you point me to a good resource that supports this information? I tried GOOGL'ng a thousand different ways. Thanks again!
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    Wiki Stent Exchange Diagnosis Codes

    We do a number of ureteral stent exchanges in our ASC. The ICD-10 diagnoses I assign are T19.1XXA, Z46.6 with the 3rd one being the reason for the stent to begin with ... with hydronephrosis being the most common. My question is two-fold. 1. Does it matter what sequence the codes are in? 2...
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    Wiki Ureteral stent

    Ureteral Stent Exchange/Change In searching the Urology threads, ran across this question. My question is, with ICD-10, what diagnosis code would you assign to a stent exchange? Information received from supervisor is T19.1XXA, Z46.6 - then 3rd the reason for the stent to begin with ... like...
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    Wiki Vasectomy

    Recoupment of Vasectomy I would also contact the patient - let him know the insurance carrier is trying to recoup the payment. Check if this policy falls under ERISA - meaning if the insurance is provided to the patient by his employer/spouse's employer and the employer is NOT a government...
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    Wiki bladder tumor size

    Bladder Tumor Size Hello! If the physician does NOT document the actual size of the tumor or by stating "small", "medium" or "large" - you CAN defer to the pathology report and base your code off the measurements in the pathology report. If you physician performed a cystoscopy in the recent...
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    Wiki Pathology Specimens (Tissue Samples) in ASC

    Yes - these would be samples of tissue removed during a surgical procedure performed in our ASC...hydrocele, bladder tumor, foreskin, etc. I found on the CMS website that "labs" done in an ASC setting that are not considered routine prior to surgery (i.e. UA's, pregnancy tests, CBC's, etc) - can...
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    Wiki Pathology Specimens (Tissue Samples) in ASC

    Hello! Can anyone direct me to documentation regarding surgeries performed in an ASC setting where a tissue sample is sent to the independent lab for processing...? As to whether the tissue sample IS or IS NOT considered part of the ASC facility charge? I'm getting told where I work that the...
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    Wiki Cystoscopy with barbotage

    Unbundling Barbotage from Cystoscopy Has anyone gotten any official documentation on this matter? I have a case I'm holding for anything substantiating that barbotage can be unbundled from a cystoscopy. I did PM the gal who said she received documentation from the American Board of...
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    Wiki Reputation points

    Reputation Points OK. It's been a while since I was looking for my OWN reputation points. Dumb, dumb question - but, what does CP stand for? I don't find those letters on the menu bar ... what am I missing? Thanks in advance!
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    Wiki Spermatocelectomy w/wo Epididymectomy

    Thank you BOTH very much. I went ahead and billed both - but, I "get" what you're saying in the example of adhesion lysis. Will make note for the future. Thank you so very much!
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    Wiki Spermatocelectomy w/wo Epididymectomy

    Hello! When faced with a spermatocelectomy (54840) and needing to perform an epididymectomy (54860) due to significant scar tissue preventing the spermatocelectomy...what criteria do you look for to know when it is OK to code both 54840 and 54860 and when it should NOT be OK? According to CCI...
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    Wiki urethral dilation with sound prior to insertion of scope for urethral stricture

    Hello! I work for a private urology practice ... and we do these in our ASC. Can you copy and paste a redacted note for me to look at? When you say the cysto and dilaton are bundled are you talking about 52000 and 53601 (male dilation)?
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    Wiki HCPC code for Van Buren Urethral Sound

    Hello! I work for a urology private practice with it's own ASC. Curious - where is this dilation being performed? In our ASC anyway - the cost of the dilators is included in the facility charges. I guess I don't know for sure on the office side - I know they sometimes do them in the office -...
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    Wiki Removing bilateral ureteral stents!

    We also use 52315 for removal of bilateral stents in our Urology practice/ASC.
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    Wiki 52000 and 64566 why the multiple rule ?

    Most payers abide by the multiple surgery rule regardless if dx's and body parts are different...the procedure with highest RVU gets the primary payment...
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    Wiki Can you bill 52005 with 52204?

    Sheila, Yes, if the ASC owned the equipment, you would bill with modifier -TC ...and there should be an image available somewhere in the chart..either a hard copy if you use a paper chart system still or a scanned image if you have EMR/EHR...
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    Wiki Can you bill 52005 with 52204?

    I believe you have the modifiers turned around...the radiologist reading/ interpreting the results would bill with modifier - 26 for professional services...the doc performing the test would bill with modifier -TC.....
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    Wiki Re: Pregnancy Testss

    I also know that our local Medicare contractor has a different fee schedule for labs .. Labs are not available on the physician fee schedule. Call your local contractor to see how to find the lab fee schedule. As for doing a routine pregnancy test before doing an x-ray .. Is he doing so at the...
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    Wiki T12-L1 Thoracic or Lumbar...HELP!

    what if the doc does facet block @ T12-L1 and L1-L2? Initially, I used what came up in EMR - 64490 for the T12-L1 and 64493 for the L1-L2 - however, since both codes are the initial injection - it didn't seem right to bill like that ... should I reduce the 64493 fee to what an additional level...
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    Wiki Do I add modifier 50??

    Did everyone get the pages I Emailed to you? Did you find them helpful? Just curious. Thanks!
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    Wiki Pain Management Group

    Please watch for an invite to the YAHOO group ... if you need to, check your SPAM folder. Thanks!
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    Wiki Do I add modifier 50??

    Cynthia, I am Emailing to you now. Please let me know if it helps! Armen, Please provide your Email address and I'll be happy to pass along. Thanks!
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    Wiki Do I add modifier 50??

    Hey ladies, Just Emailed those pages to you! Let me know if you find them to be helpful!
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    Wiki Pain Management Group

    Hello! I work in the pain management field (coding/billing) - from home. I am looking for anyone interested in setting up an Email group or some special group to share and network with. Please Email me at carolyn.kohler@yahoo.com if interested. Thank you.
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    Wiki Refunding Patient Overpayments

    I am not aware of any time frame requirement by Medicare or Medicaid - but, in our office .. we have implemented the practice that any overpayments greater than $100 automatically get a refund (unless there is a specific reason they have such a large credit); by this, I mean - we have some...
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    Wiki Fee Schedule Resources

    the code in question happens to be a category III code, 0282T, for insertion of a peripheral nerve stimulator ... I can go out and find the Medicare fee, but, then how do I set our fee? How much of a percentage is added over and above the Medicare fee schedule? Thanks for the guidance.
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    Wiki Signing orders/test results

    so, am I correct in understanding that your providers are PERFORMING the test (owning the equipment) but they don't interpret? The providers who READ/INTERPRET the results - are they part of your organization as well? If yes, then, you should be billing the whole thing (technical and...
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    Wiki Do I add modifier 50??

    Patricia, I participated in modifier webinar provided by my local MAC (Noridian) ... I have a couple of pages from the handout that I found very useful. What is an Email address I can send copies to for you? Thanks!
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    Wiki Ischial tuberosity inj

    I have been advised, by the pain management consultant I work with, to use 20610; for fluorscopy - you would use 77002-26. Hope this helps!
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    Wiki avoird erx initiative reduction

    So, to clarify - your physician simply doesn't write prescriptions? I am not familiar with an M.D. who has prescribing privileges but chooses not to write them ... I've been researching on the CMS website for the code you state (G8644) .. the only thing I found about it is that this code is...
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    Wiki Need help coding Bilateral Radiofrequency Ablation Injections

    It also depends on whether the RF is done bilaterally or unilaterally. If you bill it with a modifier -50 to indicate bilateral, you can't have multiple units - in that case, I agree with Meagan .. you have to bill the 2nd 64636 w/modifier -59.
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    Wiki Fee Schedule Resources

    What are some good resources to use when setting a fee for a new procedure? Is there a book or manual that can be ordered? Thanks for any guidance!
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