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  1. M

    Wiki Tetracaine

    We are looking to bill patients for the use of tetracaine due to the increase of pricing at the compounding pharmacy and this having to be ordered for each patient individually. Has anyone been successful in doing this? If so, what code(s) are you using?
  2. M

    Wiki KTP Laser ablation

    One of our physicians is going to do an MDL Biopsy & KRP Ablation on a patient's bilateral vocal fold polyps. Also, a left TVF medialization w/Prolaryn on the same patient's paralyzed vocal cord. These will be done during the same surgery. The codes that we have are 31574, 31536 & 31572. When...
  3. M

    Wiki Bundle code and Pre-Cert

    We will try that and see if it works for us. Thanks for your help.
  4. M

    Wiki Bundle code and Pre-Cert

    We are having a problem with pre-certs for bundle codes. An example is: Pre-cert request was put in for cpt codes 31267-maxillary sinus, 31255-ethmoidectomy, 31287-sphenoidotomy, 30140-resection inferior turbinate, 61782-guidance. When the physician got into the surgical procedure, he found that...
  5. M

    Wiki Bilateral and Unilateral

    One of our providers is doing a unilateral sphenoidotomy (31288) and a bilateral ethmoidectomy (31255). Normally we would bill these out in the bundle code (31259) if both were bilateral. With one the (31288) being unilateral and the (31255) being bilateral, would we still use the bundle code...
  6. M

    Wiki 61782 and 31259

    The way I finally got the codes to pass through the front edits was to add a 59 modifier to the 61782 which made no sense to me as it is an add on code and then a 51 modifier to the 31259. The claim went through and we have not heard back as to whether they are going to pay or not. Thanks for...
  7. M

    Wiki 61782 and 31259

    We are billing a claim that has 61782 and 31259 cpt codes with J32.0, J32.3 and J32.2 diagnosis codes. They will not go through the front edits of our software stating "missing or invalid information." We have tried everything we can think of to get the claim to go through to the payer but it...
  8. M

    Wiki Prolaryn Gel Units

    Our providers are using Prolaryn Gel to inject a patient's vocal cords. We are having trouble with the way it is converted to be billed out. We are currently using the cpt codes 31574 and the HCPCS code L8607. These codes are being paid without any problems. However, the problem we are running...
  9. M

    Wiki Laryngeal Botox Injection

    We will take a look at the 96372 and correct that. Thank you for your help.
  10. M

    Wiki Laryngeal Botox Injection

    One of our physicians is using Botox in the Laryngeal Injections he is doing in the clinic. We are using the J0585 cpt code for the Botox itself along with the office visit code, an administration code of 96372 and a 31570 Laryngoscopy code. At this point we are not being paid by any insurance...
  11. M

    Wiki 30520

    The ICD10 codes we're using are J32.0, J34.2 and J34.3. I'll go back and look at what procedure code is pointing to what ICD10 code. Thank you for your help.
  12. M

    Wiki 30520

    Thank you. I'll take a look at everything else on the claim.
  13. M

    Wiki 30520

    We are billing for a 31256 50 51, 61782, 30140 50 51 and a 30520. The 30520 is kicking out on the front end edits stating "missing or invalid information." We tried sending it through with a 51 modifier and it kicked out again for the same reason. Is anyone else having this problem and if so how...
  14. M

    Wiki E/M codes

    When charging for an E/M code, can you use temperature as one of the vitals required?
  15. M

    Wiki Services vs Equipment

    Sorry about the confusion but thank you for your input. It does help very much.
  16. M

    Wiki Services vs Equipment

    I was wondering if anyone else distributing hearing aids to their patients is having any issues with the write offs by insurance companies that are through a network the provider is participating in. Are the claims being processed the same as claims for routine services in done in the clinic...
  17. M

    Wiki Parathyroidectomy

    One of our physicians recently did a left thyroid lobectomy on a patient. During the surgery it was found that the parathyroid was enlarged. He then did a left superior parathyroidectomy and sent half to pathology. It was found to be healthy but enlarged to twice the size as normal. At this...
  18. M

    Wiki Mulitple procedures

    Thank you so much. I will definitely take a closer look at this. It helps a lot.
  19. M

    Wiki Keloid Injection

    One of our physicians is now doing steroid injections for Keloids. Can anyone tell me what cpt codes should be billed for this? We are using the cpt code 11900 and I'm wondering if there is any other ones that may need to be billed in conjunction with it. Thanks for your input.
  20. M

    Wiki Mulitple procedures

    I'll take a look at the X modifier. We were using the 59 but still receiving edits. Thank you for your response.
  21. M

    Wiki Mulitple procedures

    Our physicians are billing for different procedures done on the same date of service at the same time. Examples of the cpt codes used are 30115, 31288, 30140, 31267, 31255, 61782, 30520, and 31276. Does anyone have any suggestions on billing these codes together to avoid receiving front end...
  22. M

    Wiki Myringoplasty

    Thank you.
  23. M

    Wiki Myringoplasty

    One of our physicians did a paper patch myringoplasty in the office. We used the cpt 69610 (repair of a tympanic membrane perforation) for this procedure. Is there any other codes that should be billed along with this code other than the office visit code? Thank you for your input back on this.
  24. M

    Wiki Total Thyroid w/nerve monitoring

    Thank you
  25. M

    Wiki Total Thyroid w/nerve monitoring

    Our physician is doing a total Thyroid w/nerve monitoring. We are billing a 60240 for the Thyroidectomy. What code does anyone suggest for the emg? Any help would be appreciated.
  26. M

    Wiki Prolaryn

    Thank you for your help. We will certainly give it a try.
  27. M

    Wiki Prolaryn

    Thanks!
  28. M

    Wiki Prolaryn

    Our physician is performing an office based injection in the vocal cords using Prolaryn. We are billing for an office visit and also the cpt code 31574 as he is using a scope for the injection. However, we are having trouble finding the correct code for the Prolaryn itself. Is anyone else using...
  29. M

    Wiki Vocal Cord Immobility

    Thank you so much. I talked to our doc and he said that he did do the 31574.
  30. M

    Wiki Vocal Cord Immobility

    Thank you. I'll call them. I appreciate your help. Have a great day.
  31. M

    Wiki Vocal Cord Immobility

    Actually they are not acknowledging the code at all. They are not even listing on the claim on the eob or when I look at the claim online. We do have an the ndc number on the claim and it is on the claim when I look at it in the clearinghouse. So at this point I'm a little confused. I've been...
  32. M

    Wiki Vocal Cord Immobility

    Our providers are using Restylane in an injection on our patient's vocal cords for immobility. We are billing the cpt code J3490 along with cpt 11950, 99070 and 11950. We are having trouble getting the insurance companies to pay for the J3490 (Restylane)? Does anyone else bill for this procedure...
  33. M

    Wiki NDC Number

    We tried to find one on the package but there is not one listed. We've been told Restylane doesn't actually have an NDC number but wanted to double check before having to adjust any charges. Thanks
  34. M

    Wiki NDC Number

    Is anyone billing for Restylane with an NDC number and if so what number are you using? Also, what CPT code. Thanks for any help with this.
  35. M

    Wiki Restylane

    Our providers are using Restylane in an injection on our patient's vocal cords and we are having trouble getting the insurance companies to pay for this procedure? We are using the procedure code J3490 and insurance does not want to pay for the Restylane itself. Is anyone else having these...
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