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  1. M

    Wiki PICU Coding Question

    Thank you for this! We use Codelinks Pro and its not very user friendly.
  2. M

    Wiki PICU Coding Question

    Thank you for the clarification! This particular situation is tricky and we are querying the PICU provider to see what was actually done besides seeing patient in the ED and deciding to admit the pt to the PICU. I have not come across this situation before and I am struggling to find resources...
  3. M

    Wiki Aetna Eligibility Checks

    Hi for aetna we use availity. Hope this helps! https://www.aetna.com/health-care-professionals/resource-center/availity.html
  4. M

    Wiki PICU Coding Question

    Our PICU doc was called for a consultation to see if pt was a candidate for PICU. This note that our PICU doc wrote shows that he saw pt in the ED and spent 40 mins in critical care and consultation. We do NOT have a "Day 1" note for the PICU after this note only a follow up and a discharge...
  5. M

    Wiki Pt has Labor Epid for ~ 15 hrs then decided to do c-sxn. Time between end of epidural and start of c-sxn was 7 hrs. What ASA codes(s) do we use?

    Hi I am an anesthesia coder in California. For labor to c's we code the labor with 01967 and the c-section with 01968 01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary...
  6. M

    Wiki Aetna Eligibility checks

    Hi I am a coder in California! For Aetna we use availity.com. https://www.aetna.com/health-care-professionals/resource-center/availity.html
  7. M

    Wiki PICU Coding Question

    These guidelines were retrieved from https://mcweb.apps.prd.cammis.medi-cal.ca.gov/search/results?q=critical%20care&manuals=false
  8. M

    Wiki PICU Coding Question

    The Day 1 PICU note would get coded with 99471. Pt was 49 days old at that time. My issue is the dr is combining the consultation given in the ED and the actual H&P for Day 1 in the PICU. I don't know which to code, the consultation or the H&P. These are the guidelines that I have. According...
  9. M

    Wiki PICU Coding Question

    Hi, I am not sure how to code the following situation. Our PICU doc admitted pt from ED. We have a SOAP note for this encounter but it looks like the physician is combining the consultation note with the PICU day 1 note. Pt was then seen multiple times next day and discharged. I have read...
  10. M

    Wiki Acupuncture for post-op pain?

    Hello! I have one of our anesthesiologist stating they are using acupuncture as a form of pain relief for kids, mainly for tonsilectomy and adenoidectomy procedure. Has anyone seen this before? I don't believe we can bill for this because the only codes are time based and she doesn't track the...
  11. M

    Wiki Mod -HA for 99292 and Medicaid pts

    Good Morning, We are billing PICU Critical care visits, specifically for the 99292 add on code. We are confused on how/when to use the HA mod and can't find a concrete instructions for use, only that its required to use this. Any help on this is appreciated! Thank you!
  12. M

    Wiki Pain Block Question

    Hi, I have an anesthesiologist who is wanting to charge multiple blocks for his pts and I am not sure if we should add them individually or just use 1 code. Pt had and ORIF of their finger with general anesthesia. Their post op pain blocks are listed as median nerve block and ulnar nerve...
  13. M

    Wiki 2 Ureters on one side Stone extraction...Help!

    Hi, I have a pt that has 2 ureters (duplicated collecting system) on the right side. The dr is doing a stone extraction in both ureters on the same side. I am not sure if I should use a 50 mod because that would mean right and left. Technically pt has 2 ureters on right side. Would modifier 22...
  14. M

    Wiki SCLEROTHERYAPY CT GUIDED CODING HELP!

    Thank you both!
  15. M

    Wiki SCLEROTHERYAPY CT GUIDED CODING HELP!

    Hi, I am coding for anesthesia for a pt that had ct guided sclerotherapy for an anuerysmal bone cyst on of the right humerus. I am not sure how to code this, none of the slcerosant CPT codes seem to fit. From what I see they all deal with the lower limbs or spider veins. Would I be able to...
  16. M

    Wiki INSURANCE CLAIMS NOT PAID

    I could be wrong but this sounds like it would be considered balance billing, which is a no-no . I believe you would only be able to bill co-payment. I see that your location says CT so I looked up the Surprise Law for your state. Hope this helps...
  17. M

    Wiki Incarcerated patient

    I'm not sure about your state's policy , but here in CA if pt is incarcerated there is inmate "insurance" for each facility that we bill not Medicare or Medicaid. Hope this helps! Also, here is a link to CMS that might be helpful to you...
  18. M

    Wiki Embolization of Patent Ductus Arteriosus

    Good Morning, I am coding for anesthesia for a pt that had an embolization of patent ductus arteriosus with right and left heart catheterization, angiogram, and aortagram. I am stuck between 2 codes for the PDA embolization 93582 (includes heart cath) xwalks to 01926 and 37243. I am...
  19. M

    Wiki A-line Placement

    Thank you! :)
  20. M

    Wiki A-line Placement

    Hello, I have a peds pt that had an a-line placed on both the right and left sides during a repair of coarctation of the aorta would I code 36620 twice? Thank you! Megan Donathan, CPC-A
  21. M

    Wiki Recurrent Respiratory Infections

    Hello! I am coding for the anesthesia for a pediatric pt that is getting flexible bronchoscopy w/BAL and the diagnoses that the surgeon put is P07.25, Z93.0. Pt is over 1 yr old and with the P code it will get denied. The report also stated that pt has recurring respiratory infections but I...
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