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    Wiki Transitional Care claim DOS

    I have received conflicting information on when to the report the DOS for TCM's. I have read that the DOS should be reported with a DOS 30 days after discharge and also read that we do not have to wait until 30 days post discharge. Is it appropriate to report DOS when face to face is done or...
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    Wiki Office E/M with modifier 25

    If someone could help with this scenario...... Patient in cardiology office for 1 year follow up and echo regarding hypertension, cad, stenosis( echo was scheduled the same time as the 1 year follow up). Echo was done same time as encounter and reviewed, medically appropriate history and exam...
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    Wiki Modifier 54 and 55-- help

    Can same group providers with same Tax ID report modifiers 54 and 55 on procedures with 90 day global? Should the surgery be billed as global?
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    Wiki DECISION FOR SURGERY

    If a provider documents "We discussed the risks and benefits of a corticosteroid injection" does this meet the documentation requirement for Decision for minor surgery with risk factors? OR does the provider need to include the risk and benefits in the documentation to support decision for surgery?
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    Wiki 25 modifier

    Is it appropriate/necessary to bill modifier 25 with E/M code when CPT 36415 (lab drawn) is done during the visit? Or is the it not necessary?
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    Wiki Drug Therapy monitoring documentation help????

    For Drug Therapy requiring intensive monitoring what needs to be documented? Do providers need to specify what they are monitoring for? Below is example of documentation and I am not sure if this would qualify since specific monitoring is not documented. Provider is seeing patient for 4 mnth...
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    Wiki standing order

    Can providers receive credit for review on a standing weekly CBC order that they ordered? Example-- patient has blood work on 1/12 (standing CBC order) and has a follow up appt on 1/13, provider reviews with patient at follow up.
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    Wiki Test order/reviewed and interpretation of test help!!!!!

    I have a provider that is questioning the credit for test order and/or reviewed and interpretation of test. I will provide a scenarios. 1. He sees patient and will have patient return to office in 1 year with EKG. He does not count the order of EKG with this visit. When patient follows up...
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    Wiki 99203 or 99204????

    New patient is seen for wrist injury and x-rays performed in office determined there is a fracture. It is decided that it does not require surgery, and it is treated with either a cast, splint, or brace. Physician does not review any outside records or test. Patient only being seen for this...
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    Wiki E/M order or considered referral????

    One of my providers came to me with this question...... He is a PCP and wants patient to have routine Colonoscopy. He is considering the colonoscopy as an order instead of a referral. If he orders patient to have colonoscopy by an external provider can he still count test as an order??? I...
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    Wiki E/M external note review

    I have a pain management provider that receives a referral from external provider. He reviews external referral as well as the State Board of Pharmacy PMP that his office prints out. Can he receive credit for reviewing the PMP or does that count for medical history review/medication review...
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