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    Wiki Modifier 57

    Looking for advice because I am getting conflicting information. I have recently been told that 57 is only used for an E/M the day before or day of major surgery. I have been adding modifier 57 to office visits where the decision for major surgery is made - up to 30 days prior to scheduled...
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    Wiki 99406 routinely denied when billed with E/M

    You may also want to try using Z71.6 - Tobacco Abuse Counseling in your diagnosis codes. The time should also be clearly documented. Such as: "I spent 7 minutes in tobacco cessation counseling."
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    Wiki Plan of Care for Incident To Visits

    I appreciate your insight here! Thank you for responding and for looking at this situation.
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    Wiki Plan of Care for Incident To Visits

    She has been seen for other problems, so she is an established patient. I believe this problem is being addressed as a new problem since it has not been treated for at least 5 years. Yes, both the NP and the MD attended this visit. It is taking place in the office setting, so a "shared" visit is...
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    Wiki Plan of Care for Incident To Visits

    Thank you for responding. I have read the Medicare Benefit Policy Manual chapter 15 section 60.2 and beyond. In addition, Medicare Billing guidelines and have also looked at AAPC articles, multiple forum posts, etc. I have exhausted multiple paths of research. There are VERY clear guidelines...
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    Wiki Plan of Care for Incident To Visits

    In the RHC Orthopedic Clinic setting, when performing an "incident to" visit, what are the requirements related to the establishment of a Plan of Care? I have been unable to locate any specific information from Medicare regarding the minimum information necessary. This is not P/O/S therapy...
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    Wiki Legality of Signature of Non-present Provider

    Yes, there is MUCH more to this issue than can be fully described or solved here. Incident-to can be performed in RHC per our MAC, but guidelines are SO strict I would not choose to bill this way if it were my practice! At this point, I'm certainly headed for my Compliance officer to further...
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    Wiki Legality of Signature of Non-present Provider

    I very much appreciate your response. We are currently working with the provider to delineate his role regarding the "incident to" situation. I feel confident that we have the subject fully researched. The portion where we lack understanding is when signatures from both the NPP and the MD are...
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    Wiki Legality of Signature of Non-present Provider

    I have a provider who wants ALL visits in his hospital outpatient clinic registered under his name, regardless of who the patient actually sees. The visit documentation always has his signature appended, whether or not he actually physically attended the visit. Here is an example scenario...
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    Wiki Waiver Form for Orthotics

    Thank you very much for your guidance and response!
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    Wiki Waiver Form for Orthotics

    The waiver form just states that the patient understands that their insurance may not pay for the orthotics, that the orthotics are considered DME, and that they are willing to be balance-billed if necessary. It includes several codes for custom orthotics with current prices listed. When...
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    Wiki Waiver Form for Orthotics

    I code for DPM services in an RHC outpatient setting. We provide custom orthotics to many of our patients. My question is regarding the necessity of having a Waiver of Liability on file when ordering the orthotics for subsequent pairs - utilizing the same mold obtained at a previous visit. Is it...
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