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    Wiki delivery

    Good morning! Has anyone ever had to code for delivery 59409 in the ED?? Our ED delivered baby at 39 wks vaginal delivery and then was transferred to another facility for OB care. No complications etc. Can I bill out 59409?? Do I need to add modifiers?? Thanks for your help! Vicki, CPC
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    Wiki intubation

    Good morning! If patient is intubated in the emergency room by the paramedic and the MD documents this also. can we bill for the intubation facility side? profee side? Thanks for your input! Vicki J., CPC
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    Wiki trach suctioning - Please advise! Patient comes to our hosp outpatient

    Good morning! Please advise! Patient comes to our hosp outpatient services for suctioning of his trach. RN places patient in room and the trach is suctioned by Respiratory therapist. RN notes thick white phylm. Patient d/c. How or can we bill for this service?? Thanks for your input...
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    Wiki Hydration 96361

    Need help with the following scenario: Pt comes to ED and infusion started: 21:25 to 21:55 Sod Chloride 21:55 to 22:46 NS 22:12 to 22:14 Rocephin 1gr IVPB 23:30 to 00:05 Sod Chloride Is this the way you would code it? 96365 Rocephin 96361 x2 NS or 96361 x1 Thanks for your help! Vicki, CPC
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    Wiki modifier 54 in ED

    Hi everyone! If ED doc performs closed reduction/manipulation of dislocated elbow do I add modifier 54?? As always thanks for your input! Vicki, cpc
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    Wiki Ivp

    Good morning! I need help with the following scenario please! Patient comes to ED in cardiac arrest and given IVP: 8:56 Epinephrine 9:00 Epinephrine 9:05 Epinephrine 9:12 Epinephrine 9:13 Sodium Bicarbonate 9:27 Epinephrine Would this be coded as: 96374 Epinephrine 96375 sod bicarb 96376 x1...
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    Wiki infusions stop time

    Hello, I have question regarding infusion. Patient comes to ED, receives IV and pt is admitted or transferred. RN did not document a stop time and I know you can't code if there's no start/stop times. My question is if the IV is infusing on departure can you use that time as stop time? OR...
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    Wiki Another Infusion questions

    Good morning! Patient comes to ED for altered mental status, patient admitted for observation IV Sod Chloride 1000ml @ 150ml/hr on IV pump to Left wrist started at 1:00 and stops at 1:47 At 1:47 Sod chloride 1000ml @ 200 ml/hr lt wrist 2nd IV started sodium chloride @ 3:03 to right foot...
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    Wiki Infusions

    Good morning! Need some advice! The MD ordered IVP Phenergan. The RN documented Phenergan 12.5mg IVP start @ 13:00 stop @ 13:32. Our EHR coded as infusion 96365 because it ran 32 minutes. Do I leave this as infusion or change it to IVP per order?? Thanks for input! Vicki Jefcoats, CPC
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    Wiki PICC LINE/infusion

    Good morning, I need help with following: In Outpatient facility, CRNA inserts a PICC line and then the RN infuses antibiotic for 1 hour. Per 3M I can bill 96365 w/59 mod. Is this correct?? 36569 77001 76937 96365 - 59 Any input will be greatly appreciated. Thanks! Vicki, CPC
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    Wiki NCCI edit

    Hi all, I code profee and facility E/M in outpatient hospital Emeregency dept. My E/M are kicking out with NCCI edit stating that the profee is bundled with facility level. I checked MC NCCI edits and they updated 7/1/14 and they are bundled. So do I add 59 modifier to profee level?? even...
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    Wiki irrigation/packing stab wound

    Hello..... I would greatly appreciate any input on the following: patient comes to ED with contaminated stab wound to abdominal wall. After local anesthesia wound was explored and found to be 1.5cm x 5cm deep. The base was bluntly dissected to the skin and through a small punch hole a...
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    Wiki Moderate sedation-code for outpatient

    Good morning! I code for outpatient hospital and we have started doing pain treatment injections by CRNA. Can I bill for conscious sedation 99144 with 62311, 64493 etc.??? I ran this through 3M and it was not bundled. Just need clarification/documentation. Thanks for input! Vicki, CPC
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    Wiki foreign body removal

    Good morning Can anyone tell me how you would code this: patient comes to ED with nail embedded in great toe all the way thru. MD cuts off nail head and pulls the remaining nail out. MD did not make an incision. Coding module wants to use 28190. IS this correct? Thanks, Vicki, CPC
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    Wiki mech ventilation

    Good morning, I need help on the following ED patient. The patient comes to ED with SOB, 02 sat continually drops...physician intubates patient. Respiratory Therapy does mechanical ventilation (portable vent). They want to charge 94002/94003. However cpt states that these codes are for...
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    Wiki failed intubation

    Good morning! Can we bill for failed intubation x 2 by MD in emergency dept? Thanks for any input! Vicki, CPC
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    Wiki IV

    Hello! Can anyone give me some information on coding IV's, IVP, and hydrations in ED or a website? Any help will be greatly appreciated!! Thank you! Vicki Jefcoats, CPC
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    Wiki ED levels

    Hi! When we bill out ED levels for facility and profee and they happen to be the same level for both, their being kicked back as duplicates. Should I be putting a modifier on one? If so, which one facility or profee and where can I find documentation. Thanks again for all your help...
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    Wiki nerve block - Should this be coded

    Good morning! I need help on with nerve blocks. Pt came into the ER with 12 hour old laceration to finger. The MD DID NOT suture but he performed nerve block using 1% lidocaine. Should this be coded using 64400 or 64420 or 64450 OR should this just be part of the E/M? Also had pt with dental...
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    Wiki Mue - I need some help with understanding

    Hello, I need some help with understanding MUE's. I understand if the cpt code has MUE of 1 then thats all your suppose to bill..(?) We have claims denying for MUE when we bill out for facility and profee for same cpt code even though they have different revenue codes. For example...
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    Wiki infusion - appropriate to bill

    Good morning, Can anyone tell me if its appropriate to bill 96374 twice if documented two IV sites ?? can I put a 59 on second?? THanks for input!! Vicki
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    Wiki blood transfusion and IV's

    Good morning, Can anyone give me their input if this is correct way code/bill the following: patient comes to ED and the MD orders the following: NS 2L (time 17:20-18:55) NS 1000 bolus (time 19:00-20:05) KCL /NS 1000 (time 20:05-22:10) Benadryl IVP Banana bag over 4 hours Blood 2 units Is...
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    Wiki levels in ED

    I have questions re: AMA/LWOB/non emergent,referred to clinic. (1) Pt seen in ED, goes thru triage, labs, xrays performed and the MD states non emergent, refer to clinic or followup with your PCP. MD does not see pt. (2) Patient seen in ED, goes thru triage, etc. patient leaves without...
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    Wiki repair face lacerations

    Good morning! I have a pt that came to the ED with (3) lacerations to face from a dog bite. The MD states simple repair with sutures; wound sizes 1.5 cm, 2 cm, 3cm. I'm told you only code/bill for the largest cm which would be 3cm 12013. I thought they would be added together 6.5 cm and 12014...
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    Wiki TB skin test in ED

    Hello! TB skin test in ED would you use cpt 86580 or 90471? I want to use 86580 but was told that is incorrect because the RN is injected under the skin. Any input would be greatly appreciated and if you can tell me where to find documentation to support. Thanks Vicki
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    Wiki critical care 99291 and 99285

    Hello! Can anyone tell me if you can bill in ED for 99291 and 99285?? If so, do I need to add modifier 25 or 27 to either?? This will be billing for the facility (ED) and the physician. Thanks! Vicki
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    Wiki discography

    Hello! Can we bill 62290/62291 for ASC? We billed medicare for 62290 and they denied as included in another service/procedure. They did pay the physician side of charge. Thanks for any input. Vicki Jefcoats, CPC P.S. Can the NCCI's be downloaded from the MC website????
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    Wiki hardware injection - coding a lumbar hardware

    Good morning! I need some help coding a lumbar hardware injection L4 & S1 with fluoro. S/P lumbar fusion. Would I use unlisted code x 2? Diagnosis? Thanks Vicki, CPC
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    Wiki hardware injection

    Good morning! I need some help coding a lumbar hardware injection L4 & S1 with fluoro. S/P lumbar fusion. Would I use unlisted code? Diagnosis? Thanks Vicki, CPC
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    Wiki new question 63650

    Thanks for all your previous help with this code. My new questions is: We billed 63650 (physician) twice medicare pt. with 58 modifier on both lines and 51 on second. They paid the same amount for both. Does that sound correct???? Thanks Vicki CPC
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    Wiki 72295

    Good morning! I have a claim that is denying from work comp for 72295 w/26 modifier. They state that 26 mod is incorrect or no longer valid. This was billed for the physician charges. Thanks
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    Wiki 63650 lead trial placement

    Hi! Need some help with cpt 63650. MD placed (2) leads 63650 and L8680 (16) electrodes for a medicare patient. Also charging for 95972, 77003, 99144. How would you post this per line item? Thanks Vicki
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    Wiki help with knee!

    arthroscopic lateral release of knee and an open patella realignment w/medial retinacular reconstruction using allograft. The arthroscopy was performed the usual w/release of lateral retinacular. THen he made medial parapatellar incision down to medial retinaculum and it was released off the...
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    Wiki Interspinous process decompression

    I have a claim thats being denied by BC as experimental. T0171 insertion of posterior spinous process detraction device lumbar. His dictation states "dilator was placed into the L4-5 interspinous ligament and then sequentially dilated until I get the sizer in. The sizer was placed and I...
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    Wiki Closed fx rt and ORIF on lt by two surgeons.

    Patient seen in ER by my Physician A. Patient has fracture distal fib on RIGHT and a trimalleolar fx on LEFT. He treats the distal fib nonoperatively and with walking boot. He refers the trimalleolur fx to his partner phys B and he does ORIF the next day. Can we bill the closed tx for phys...
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