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    Wiki BRAVO Billing in an Ambulatory Surgical Center

    Hi all! I'm just getting back to GI Billing & Coding after a hiatus. The group I now work with is a private GI practice with our own ASC. We are looking into doing BRAVOs at our ASC. Can you remind me how these should be coded & billed? What codes go on the ASC claim and what codes should...
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    Wiki CPT Codes for POC Tests Needed(POCT TRICHOMONAS, POCT CARDIAC PANEL, POCT D-DIMER, POCT BNP)

    Does anyone know what CPT codes we should be using for these point-of-care tests? POCT TRICHOMONAS POCT CARDIAC PANEL POCT D-DIMER POCT BNP Thank you!
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    Wiki Billing for Acupuncture Services rendered in an FQHC

    Can you bill Medicare Part A under the facility for acupuncture services rendered in an FQHC? If so, can you please provide me with your source? If not, do you have a different solution? See below for the question from my biller. I’m trying to get more information on billing acupuncture...
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    Wiki Social Workers Telehealth Direct Supervision Guidance for Incident To Billing

    Our social workers currently bill incident-to the physicians but the rules previous to COVID stated the physicians had to be in the building and available in order to be the billing provider. The question is….how does the change in telehealth affect this once the PHE is over? Since telehealth is...
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    Wiki Nurse visit with limited physician time in the room can it be coded higher than a 99211?

    Can this visit be coded as a 99213? An established patient comes to the office with complaints of urinary burning and frequency. The nurse takes a focused history, reviews the medical record, discusses the situation with the physician and orders a urinalysis. The nurse then presents the...
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    Wiki How do you bill for use of the Erbejet?

    Just got word that my provider is going to be doing a procedure using the Erbejet tomorrow. I have no idea what code to use or if it's even considered medically necessary (Medicare patient). I called the sales rep and they don't have a reimbursement team. Thinking CPT 43229 or 43270. Any...
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    Wiki Abdominal Wall Trigger Point Injections

    We have a new Gastroenterologist in our practice who would like to start billing for abdominal wall trigger point injections for musculoskeletal abdominal pain. Are any of you doing this? If so, I'd love to know more about it. Do you have the patients bring their own steroid that you have...
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    Wiki How would you code screen colon done in asc and hemorrhoid banding done in office

    Our MD did a screening colon on a patient in our ASC and found hemorrhoids so brought the patient back to our office to do a hemorrhoid banding on the same day. I HAVE NO IDEA WHY HE DIDN'T BAND THEM AT THE ASC (we have done that many times)!!!! They are different POS (24 and 11). The banding...
    • cedwards
    • Thread
    • banding global period help!! multiple procedures separate pos
    • Replies: 0
    • Forum: Gastroenterology
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    Wiki National Government Services (Medicare) coverage for Solesta Injections

    We are currently doing Solesta injections. We are billing the L8605 and 0377T as of 01/01/15. Prior to that we were billing the L8605 and 46999 and being reimbursed with no issues. Since we started using the 0377T code we have not been paid by National Government Services (NGS) our local...
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    Wiki Help with - I work for a GI group

    I work for a GI group and have never had to deal with Sandostatin coverage before. I am a pro with Remicade, Entyvio, Humira, etc. One of our patients was started on octreotide 100 mcg b.i.d in the hospital. The patient has not had any since because the patient cannot afford the medication...
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    Wiki After Hours Billing

    If a pediatric practice has office hours posted from 8-5 but indicates that they are closed from 12-1 for lunch can they bill 99050 (Services provide in office at times other than regularly scheduled office hours, or days when office is normally closed) for services that are added on during...
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    Wiki Can this be billed as a new patient?

    A patient new to our practice comes in for a vaccine only visit where the nurse gives the vaccine. The vaccine is billed under the MD. The patient is booked to come and see the physician for a Well Child Check tomorrow. Can they be billed as a new patient for the Well Child even though they...
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    Wiki Job Opportunity

    Resumes should be e-mailed to lanzinger@thehealthychild.biz Busy and exciting Pediatric office in Darien, CT looking for Office/Practice Manager. We are seeking a dynamic person that demonstrates leadership skills, can create and maintain a positive work environment which promotes teamwork and...
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    Wiki Denials for Developmental Screening (96110) when billed with Well Child Check

    I am seeing CPT code 96110 deny when billed with a well child check. Anyone else experience this? If so with which payers? Do you have anything that you use to successfully appeal the denials? Thanks! Christina
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    Wiki Billing for topical ointments and other miscellaneous things

    Does anybody out there have any information regarding billing for topical ointments such as bactroban or mupirocin or other miscellaneous things such as Ibprofin? The doc wants to bill for them but I keep telling them things like this shouldn't be billed separately (because they are included in...
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    Wiki Billing Medicare Secondary for Screening Colonoscopy

    We are billing the patient's primary insurance 45378 with V76.51 for a screening colonoscopy. The primary made payment but patient still has a coinsurance which we are billing to Medicare. Medicare is secondary and denied the claim These are non-covered services because this is not deemed a...
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    Wiki Screening Colonoscopy Billing to Medicare Secondary

    We are billing the patient's primary insurance 45378 with V76.51 for a screening colonoscopy. The primary made payment but patient still has a coinsurance which we are billing to Medicare. Medicare is secondary and denied the claim These are non-covered services because this is not deemed a...
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    Wiki BreathTek/Urea Breath Test

    Anyone performing the Urea Breath Tests in their office using the BreathTek machine? If so how is the reimbursement? Any issues/problems/concerns? Does it require authorization? If so what carriers? I know we would have to send our UHC/Oxford patients to the lab. My providers were looking...
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    Wiki 2012 paracentesis coding question

    I'm billing for the gastroenterologist's professional service. Would you use CPT code 49083 in this case? I'm thinking no because the imaging was performed by the radiology tech and not my MD. Operative report reads: The patient was taken to the endoscopy suite where an informed consent was...
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    Wiki Patency Capsule - know the CPT code

    Does any one billing for and getting paid for the patency capsule? I know the CPT code to use is 91299 and in box 19 I put "PATENCY CAPSULE TO PROVE FUNCTIONAL PATENCY" We are sending along records which include industry literature, the radiology report done after capsule swallowed, colon & EGD...
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    Wiki Can you bill patient when insurance denies inpatient auth

    I work for a private physician group. We provide consultation services to the local hospitals and bill our services through our private practice. We often get denials from carriers as not medically necessary. When the hospitals exhaust all appeals and the denials are upheld can we as a...
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    Wiki CPT Code 82272

    Can you code 82272 X 3 when three Hemoccults the patient was sent home with to complete are negative for occult blood in a patient who presented to the office with change in bowel habits & rectal bleeding? The CPT description states Blood, occult, by peroxidase activity (eg, guiac)...
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    Wiki Billing for Telephone Calls prior to Screening Colonoscopy

    Our providers often do telephone screening calls prior to a Screening Colonoscopy rather than bringing the patient into the office for a visit. They document the call which includes a complete medical History. Is anyone billing for these services and getting paid? If so how are you billing...
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    Wiki V15.89 (high Risk Pap)

    We are billing for a Medicare patient who came in for a screening pap who is high risk. We do not have the info as to why the patient is high risk. When the charge was entered the coder entered it with only the V15.89 ICD-9 code. It hit an edit stating that this V15.89 code is not a primary...
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    Wiki CPC, CPC-H, Busniess Manager In Need of Work

    My name is Christina. I am currently a business manager with 6+ years coding/billing experience. I am looking for a supplemental income. I am willing to work AR, Collections, coding, billing, etc...Below is my resume please e-mail me at christina_edwards@sbcglobal.net with any opportunities...
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    Wiki DX Lap, median pancreatectomy with Rounx-en-Y pancreatic jejunenostomy...

    We are going to be performing a procedure on a patient whose insurance we are not par with. We are in the process of negotiating a fee with the insurance company. Here is the scenario of what the provider plans on performing. Please help me choose the CPT codes... Diagnostic laparoscopy...
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    Wiki Fiducials - We have a general surgeon who will be placing pancreatic fiducials

    We have a general surgeon who will be placing pancreatic fiducials (I believe laproscopically) in the OR prior to cyber knife. Does anyone have any information on coding/billing and or insurance reimbursement on these procedures? I have been checking our carrier's websites but have been unable...
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    Wiki Fiducials - We have a general surgeon who will be placing pancreatic fiducials

    We have a general surgeon who will be placing pancreatic fiducials (I believe laproscopically) in the OR prior to cyber knife. Does anyone have any information on coding/billing and or insurance reimbursement on these procedures? I have been checking our carrier's websites but have been unable...
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    Wiki Seeking Part Time Evening/Weekend Employment from Home

    I am a CPC, CPC-H and currently the business manager of the Faculty Practice Plan at a local hospital. I am seeking part time employment from home on nights and weekends to supplment my income with the increasing cost of living. I have 5 years experience in Gastroenterology coding and a year...
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    Wiki Annual Exam for Medicare Patient's

    Our providers are not only doing the pap/pelvic and breast exams. They are also taking vital signs, doing a ROS, PFSH, examining other body systems/areas, counseling, giving anticipatory guidance, etc. The Q0091 and G0101 codes do not capture the additional services the provider is providing...
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    Wiki Newborn Discharge Coding

    Our pediatricians see a baby on the day before they are supposed to go home and do all the discharge guidance on that day, and then not see them the next day when they are discharged. How should we bill this? We can't use the discharge day codes 99238 and 99239 because they are only for the...
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    Wiki OB/GYN Conferences

    I am in Connecticut. Does anyone know of any OB/GYN coding conferences (can be audio or web based) that are coming up that would be good to attend?:confused:
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    Wiki Pessary Fitting & Insertion to Medicare

    Physician inserterd pessary we billed 57160, A4562. Patient returned the following day because pessary fell out we inserted new ring. What is the correct way to code this? Any insight would be helpful!
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    Wiki Which modifier do I use?

    Physician provided newborn resuscitation (99440) and laryngoscopy by laryngoscope for aspiration (31515). I know both of these codes can be reported together but my delima is which modifier to use??? 25 or 59? The Newborn Resuscitation 99440 code is in the E/M section of CPT so I am thinking...
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    Wiki Coverage for Annual Well Woman Exam

    Does anyone have a list of how often each insurance covers the well woman annual exam? One of our providers wants to know which ones cover based on calander year and which carriers base coverage on the date... Thanks
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    Wiki Newborn Ressuscitation/Laryngoscopy

    Can you bill 99440 newborn resuscitation and 31515 laryngoscopy together? Does it require a modifer? Which one?
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    Wiki Well Care Child Checks???

    we are trying to figure out our billing for our infants - first year We have detailed forms for the initial visit (usually 2-3 days) a 2 week - one month visit and then starts the regular series of 2,4, 6 etc Before we had these forms, we saw the early visits as "weight checks" and billed as...
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    Wiki New to OB/GYN

    I just started a new job coding OB/GYN (I coded for gastroenterology for 5 1/2 years). Any resources, notes, suggestions or information you can pass my way would be greatly appreciated. Thanks
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    Wiki New to Pediatric Coding

    I just started a new job coding pediatrics (I coded for gastroenterology for 5 1/2 years). Any resources, notes, suggestions or information you can pass my way would be greatly appreciated. Thanks ;)
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    Wiki Bilirubin Code

    I just began coding for a pediatric clinic. One of the doctors indicated she did a heel stick for bilirubin. I am not sure which code to use. Any suggestions?:confused:
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    Wiki 99436 and 99222

    Can you bill 99436 and 99222 on the same day?
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    Wiki HGB Fingerstick

    How do you code a Hemoglobin fingerstick?
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    Wiki 45382 Or 45383

    Operative note states..."In the distal rectum, there were telangectasias with oozing consistent with the patient's history of radiation proctitis. This was treated with Argon Plasma Coagulation." Physician believes we should bill 45382 (Control of Bleeding) I think we should bill 45383 (with...
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