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  1. L

    Wiki EP Atrial mapping and possible ablation

    93620, 93621, 93613 if your provider is not going to do any ablation. If ablation is planned you would use 93653 and 93613 with possible 93623 and 93462
  2. L

    Wiki 93458-26 and 93503-59?

    True...thank you.
  3. L

    Wiki 93458-26 and 93503-59?

    Jim - even with 2 separate access sites?
  4. L

    Wiki 93458-26 and 93503-59?

    Normally I would not code these together, but please see the report below. Two separate approaches... PROCEDURE NAME: Right and left heart catheterization with right heart catheterization performed from an internal jugular approach using ultrasound-guided Micropuncture access, left heart...
  5. L

    Wiki is Cath placement billable with 37243

    Thank you so much Danny! That was my gut instinct, but I started over-thinkng! As always, you have been extremely helpful! :)
  6. L

    Wiki is Cath placement billable with 37243

    please clarify and help In follow up to the previous question, I need clarification please on "road mapping". Please see the following note. My question is this: Am I able to code for the SMA, Celiac and Hepatic cath's and angio's? Or is this part of road mapping? TIA! :confused: The...
  7. L

    Wiki Ufe cpt 2014

    Please clarify... Do I understand both of you to be saying that we CAN code the placement of the catheter, even if the embolization is performed from that placement? Also, if the physician goes from the right to the left uterine arteries, can we code 37243, 37243-59? Thanks Guys!
  8. L

    Wiki Thromboendarterectomy help please

    "A freer elevator was used to remove the dense, heavy, calcific plaque from the level of the distal external iliac arteries at the circumflex vessels down to the femoral bifurcation. Plaque was truncated at the origin of the profunda which was patent." Debate in office is between 35355, 35371...
  9. L

    Wiki Competitive flow embolization

    If a competetive flow embolization is performed at the time of a fistulogram, would it be appropriate to report follow up angiography 75898? The note states (immediately following the embolization) "A repeat fistulogram reveals flow directed almost exclusively through the fistula. There is...
  10. L

    Wiki 37228, 76937-26, 75710-26-59 help plz

    Thanks Danny! In follow up to the 75710 question, I have a note with this information on it: Right lower extremity arteriogram and tibial angioplasty for poorly healing right fourth toe amputation. The part that 75710 is in question for states "Diagnostic arteriography was performed in...
  11. L

    Wiki 37228, 76937-26, 75710-26-59 help plz

    Based on my understanding of 37228 and the CPT guidelines for these interventions, I have 2 questions: 1. Would one ever code for ultrasound guidance 76937-26 and if so what is the rationale? 2. When would it be appropriate to also code 75710-26? Thanks to all who respond...hope to hear...
  12. L

    Wiki Portal Vein Embolization - please help

    Hello All - Looking for some guidance on this procedure please. Are we on the right path? Are we missing anything? Codes chosen are in in parenthesis below each section. Thank you in advance!!! Neff 21-guage needle access to the portal branch was achieved with ultrasound gudance. Image was...
  13. L

    Wiki Upgrade or not?

    Patient has a previously placed dual chamber generator with only the atrial lead in place because when it was originally inserted, the ventrical lead had to be withdrawn because of perforation; therefore there was only one lead in use, the ventricular lead port on the dual chamber generator had...
  14. L

    Wiki 2013 changes

    crosswalk If you don't mind, I would very much appreciate a copy of your crosswalk as well - Thank you!! lisa.bledsoe@kp.org
  15. L

    Wiki inpatient subsequent plus prolonged svc

    Can anyone help me? Any takers?
  16. L

    Wiki inpatient subsequent plus prolonged svc

    My palliative care provider reports 99233, 99356, 99357. When auditing her documentation for the level of service I usually only get 99232; she is arguing with me that she can code the 99233 based on time, not history/exam/MDM. How can I explain to her that even though we subtract the "typical...
  17. L

    Wiki Critical Care for twins/same physician

    Hi Tessa - yes, that is what I am referring to. I have 2 separate notes for each patient with time documented, but the same physician provided all of the care to both babies at the same time. But given the fact that she took care of them both at the same time negates critical care to me...
  18. L

    Wiki Critical Care for twins/same physician

    I have not done Peds coding in quite some time. One physician provided critical care prior to transfer, on both twins. I don't see how I can code critical care for the same physician on twins at the same time based on the critical care guidelines on page 23 of the 2012 CPT Professional edition...
  19. L

    Wiki xrays in office

    The office owns the equipment; xray films are taken on one day and actually read by the physician the following day. Should this be carved out by day TC/26?
  20. L

    Wiki Pacemaker & ICD

    There is a table in CPT. Page 171 of CPT Professional Edition.
  21. L

    Wiki 99211 Anticoagulation clinic/pharmacist/NPP

    New question to the age old 99211 issue: A clinic employed pharmacist does 36416 and 85610...I know we cannot bill 99211 for the pharmacist to adjust the medication even with proper documentation, since they do not meet the requirements as a Medicare provider. HOWEVER - if a Nurse Practitioner...
  22. L

    Wiki 0295t

    Does anyone have any information from CMS on coverage for this?
  23. L

    Wiki TEE & DC Cardioversion

    That's how I code it, provided all components for 93320-26 and 93325-26 are documented.
  24. L

    Wiki Modifier AS + 80/81/82?

    Clarification from Noridian We received this update today: https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EFkZAyFplAyuTbLBtn&tmpl=part_b_viewnews&style=part_ab_viewnews
  25. L

    Wiki Modifier 80 and Modifier AS

    Per Noridian We received this update today: https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EFkZAyFplAyuTbLBtn&tmpl=part_b_viewnews&style=part_ab_viewnews
  26. L

    Wiki Modifier 80 and Modifier AS

    Yes...we just heard this for the very first time today! We are questioning how this is applied/interpreted. The only other information we can locate has to do with Method II CAH's and PA's reassigning their billing rights to the hospital. Our hospital is not a CAH, nor have the PA's...
  27. L

    Wiki Modifier AS + 80/81/82?

    In our office, the question has now come up as to whether or not the manual is being interpreted correctly. There is a MLN article that specifically applies this scenario to Method II CAH's where the PA has reassigned his/her billing rights to the hospital. Our PA's have not done this; so if...
  28. L

    Wiki Modifier AS + 80/81/82?

    I see it in the manual; but have never been instructed to do this for Trailblazer or Noridian...until today.
  29. L

    Wiki Modifier AS + 80/81/82?

    This is a new one to me. One of our A/R reps was informed by a rep at Noridian that we are required to add mod 80/81/82 as well as AS for PA assists effective 10/1/11. I cannot find any publication notifying us of this new requirement. Does anyone have a CMS link or even better, one for...
  30. L

    Wiki Documentation Addendum

    Thank you; I am in agreement.
  31. L

    Wiki Documentation Addendum

    Do you think this would apply to the office visit documentation from one of the admitting physician's partners?
  32. L

    Wiki Documentation Addendum

    Great info Lance! Thank you!
  33. L

    Wiki Documentation Addendum

    what about this scenario Patient is seen in the office on 11/9/11 for routine visit; ends up in ER on 11/15/11 and admitted by a physician of the same practice as seen on 11/9/11...for his H&P he uses the last office visit and writes a minimal addendum as to why the patient is now being...
  34. L

    Wiki Documentation Addendum

    Does anyone know where I can find information about who can do an addendum to documentation? Specifically, can one provider do an addendum to another providers documentation?
  35. L

    Wiki E and M and Echos incental together

    I have not encountered a denial with modifier -25 on the e/m; but I agree that the McKesson edits are not correct.
  36. L

    Wiki E and M and Echos incental together

    Not all payers follow NCCI edits but create their own. With these payers in particular, it would be appropriate to add mod -25 to the e/m. Save yourself delayed payment and extra work on an appeal.
  37. L

    Wiki Medical Necessity for CPT 33249 - We have received a few denials

    I believe that the facility that actually incurs the cost of the device registers the #'s identifying the device. On your claim, I believe you also need to enter the serial # of the device in addition to the Q0 modifier and the appropriate dx codes.
  38. L

    Wiki G0248-g0250

    Does anyone know where I can find CMS guidelines on these codes?
  39. L

    Wiki Stress Echo Codes

    93351 You can code 93351, but then you can't code any code from 93015-93018. If there was continuous ecg monitoring with physician supervision (93351) that encompasses all components of 93015-93018. However, please correct me if I am wrong! I too have been certified for many years, and just...
  40. L

    Wiki 93351 documentation

    So on our template, it has a place for rest ecg and stress ecg, where the physician notes variables, etc. Is that enough IF there is a "retrievable" continuous ecg? That part is indeed housed with the procedure, but the template does not state specifically "continuous", even though it is.
  41. L

    Wiki 93351 documentation

    Does the documentation for 93351 have to state "continuous ecg monitoring"?
  42. L

    Wiki Coding Stress Echo

    Thank you...it was one of "those days" where I kept going in circles :eek:
  43. L

    Wiki Coding Stress Echo

    I am over-thinking...plz help! If stress echo is done in the hosptial = 93350-26, +93320-26, +93325-26 (if documented) AND 93016, 93018 So, if 93351 (-26) is performed +93320-26, +93325-26 (if documented) and you would NOT code 93016 and 93018 because 93351 specifically states "with physician...
  44. L

    Wiki Stress echo and nuc re-visited

    Thanks Jessica :)
  45. L

    Wiki Stress echo and nuc re-visited

    I am looking for clarification please. Whether done in the cardiologists office or at the hospital, would you code 78452 and 93015 or 78452, 93016, 93018? (I realize at the hospital mod -26 would be added to 78452). Thank you :)
  46. L

    Wiki Echo before new patient visit

    What about the stress echo? Either the MD or NPP would have supervised the stress component...would that be considered "face-to-face"?
  47. L

    Wiki Echo before new patient visit

    PCP's often order an echo on their patients prior to them being seen by our cardiologists. If our cardiologist is the one who read the echo, does that negate the new patient status? I don't think so because no face-to-face encounter occurred. What if it is a stress echo though?
  48. L

    Wiki In-patient device interrogation

    Can we bill for the global device interrogation performed by the MD or NPP on an inpatient if we bring our own equipment to the patient room? I think yes... What about a tech or RN employed by the physician? I think no based on incident to...
  49. L

    Wiki "we cannot tell you how to bill"

    I would try to see if they have a written policy that you can access. I know United HealthCare has one...I am quite certain that Anthem does as well. It could be a lot like looking for a needle in a haystack though! :eek:
  50. L

    Wiki Unna Boot application

    Anyone? Please help - I have a meeting with a practice this week...
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