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    Wiki postop colonoscopy and hemorrhoid banding

    I'm really struggling with this type of visit and what the surgeon is picking for the level 99213. Status post colonoscopy with polypectomy and hemorrhoid banding. States that hemorrhoids are significantly improved has no pain from this and no bleeding. I reviewed pathology with patient today...
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    Wiki Follow up after colonoscopy and hemorrhoid banding.

    I'm really struggling with this type of visit and what the surgeon is picking for the level 99213. Status post colonoscopy with polypectomy and hemorrhoid banding. States that hemorrhoids are significantly improved has no pain from this and no bleeding. I reviewed pathology with patient...
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    Wiki Level for Viral URI

    I code for a family health clinic and we obviously see a lot of viral URI being picked by the providers. How are you coding this type of visit when no Rx is given. I feel the URI is 1 self-limited or minor problem... Providers are picking 99213 with no data and we will see this statement a lot...
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    Wiki Tubal Consult Level?

    True
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    Wiki Tubal Consult Level?

    We also sent a question to ACOG and this is what they came back with. Addressing the issue of contraception is unquestionably a “minimal” or “self-limited” problem. If birth control methods are used to address other medical problems, such as menorrhagia or dysmenorrhea, it could rise to a “low”...
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    Wiki Tubal Consult Level?

    They ordered no other test that I can see. I even had our other coder look and nothing. Thank you for the insight about 1 chronic stable though!
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    Wiki Tubal Consult Level?

    What level would you go with for the Number and Complexity of problems addressed for a Tubal consult? I can't use the consult codes due to the patients insurance. Patient is new to the surgeon and seen in the office. I'm working the Risk up as a 99204 he talked to the patient about the type...
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    Wiki ? 99214 vs 993XX preventative

    DOS was 2/11/2021 Primary Care Provider XX Accompanied by XX Visit Type: Physical Exam Chief Complaint: Annual PE History of Present Illness: XX year old with hx of celiac disease. had Covid 19 in December and has not felt right since. fatigued a lot . episodes of feeling worse. some abd...
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    Wiki Office visit with EKG?

    After sending the AMA link...they now see what I was saying and agree with my audit. Thanks again!
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    Wiki Office visit with EKG?

    I discussed the guidelines yesterday with the individual. This morning I emailed all providers the AMA 2021 guidelines again. I've sent it to them before but that was months ago so a little reminder can't hurt. Yesterday this is what was sent back to me after our phone discussion regarding not...
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    Wiki Office visit with EKG?

    Thanks for responding to my questions. I agree with what you have said but I can’t get someone else to understand. Hopefully more coders and auditors will respond and I can use this as an educational tool.
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    Wiki Office visit with EKG?

    Since we own the EKG machine we will bill a 93000 for our commercial insurances. The 93000 is billed when all elements are meet to bill for the interpretation and report. That being said if my presenting problems meet a 99214 and the provider also orders an ECHO, Holter Monitor and the EKG I'm...
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    Wiki packing follow up different providers

    Thank you!
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    Wiki packing follow up different providers

    Hello, How are you guys coding ie. 10661 when the I&D is done by Dr A and than follows up the next day for packing with Dr. B. All providers are MD's and work in the same RHC Family Clinic. Dr. B did the next day repack due to Dr. A not working the next day. Since we are an RHC we would code...
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    Wiki Lipoma remove 11406/12031 vs 21552

    Thank you for the link it helped me a lot. I have asked my provider to append the actual location ie stating subcutaneous depth for the lipoma removal. After reading the link it states the subcutaneous, fascia and muscle are in the lowest level. So would it be appropriate to use his description...
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    Wiki Lipoma remove 11406/12031 vs 21552

    I get conflicting information when I read the posts regarding this scenario. Some coder say you automatically code lipomas from the Musculoskeletal system. Others say if the documentation does not state how deep than you code from the Integumentary section. So please give me as much feed back as...
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    Wiki organ system vs. body area

    Hi Mike I'm hoping you can help also with the neck for body vs organ. If my provider documents. Neck: Supple; No thyromegaly or nodules. Does this statement support OS? I really struggle with this. Thank you
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    Wiki Preoperative visit for Vasectomy

    Thank you
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    Wiki Preoperative visit for Vasectomy

    If the patient comes in for his consult/preoperative visit for vasectomy. Can we bill for this visit since this provider will also be preforming the vasectomy? When I use craneware it shows 55250 having RVU's for the pre op/intra op/post op. This makes me believe the preop visit in the clinic...
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    Wiki Lipoma removals

    Kim, Thank you so much for getting back to me. This is exactly what I was needing to know!! Nichole
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    Wiki Lipoma removals

    Just came back from our coders meeting and this procedure note was discussed. Does the provider need to state ie subcutaneous to bill from the Musculoskeletal section? Or are all lipomas to be coded in the Musculoskeletal section no matter what? PREOPERATIVE DIAGNOSES: 1. Bilateral thigh lipoma...
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    Wiki Removal of Lipomas

    Hello, We have several patients come into our Family Practice clinic for lipoma removals. We just came across an older article from 2014 and just want to make sure this is still correct information. Per this article a lipoma removal procedure code should come from the Musculoskeletal System NOT...
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    Wiki 20551 with US guidance for needle placement 76942

    20551 bunding with 76942 question Have you heard of this bundling issue or know of any other sites to look at? I also copied and pasted the CPT guidelines for him to read and he responded with. "Pictures taken during Ultrasound guided procedures are being saved onto the ultrasound computer...
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    Wiki 20551 with US guidance for needle placement 76942

    Hi, I found an article from a source I'm not all that familiar with EmblemHealth. It states 76942 is inclusive with injections 20550-20553. States 76942 will be bundled as inclusive services when rendered with the 20550-20553. My patient has MDCR and the provider wants to bill 20551 and 76942...
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    Wiki Cpt code 29580 strapping unna boot question

    29581 Compression layer wrap I have another question regarding PF and facility charges. Example: If patient comes in to our treatment room for f/u compression layer. Provider unwraps dressing and examines wounds. Provider rewraps patients wound with the four layer compression dressing 29581. Do...
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    Wiki Cpt code 29580 strapping unna boot question

    Hello, We have just started this service thru our hospital treatment room. I have a question on how to charge for this service when patient comes in for a scheduled Unna boot change. Sometimes the provider will see the patient prior to the boot being applied by the RN. He will look at the wound...
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    Wiki Question regarding Excision

    Excision Here's the rest of the path report. I just sent you the size documented in the Path. We were told we could not code the size of the lesion removed from the path due to shrinkage. PATHOLOGIC DIAGNOSIS: Skin lesion, right ear: - Poorly-differentiated invasive...
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    Wiki Question regarding Excision

    You will see below the Office note for the excision. I coded 173.22/11641 is this correct? Not sure if I can code the size of the lesion removed by the way the provider has documented. Patient has recurrent skin lesion right ear after shave excision revealing "squamous proliferation...
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    Wiki Condyloma acuminatum removal

    wart removal 4 perianal warts: on on right lower anal verge. 3 left sided samll flat verrucae 1%lido with epi for local. prepped area with betadine. removed verrucae with scissors. cauterized base with silver nitrate. wound care discussed start aldara in 10 days for 6 week trx to avoid...
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    Wiki Condyloma acuminatum removal

    Provider removes the verrucae with scissors. Not sure how to code this procedure. I'v tried removal/destruction/excision..but not finding anything for removal with scissors??? Thanks Nichole
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    Wiki Medicare and subsequent Obs Care

    Subsequent Obs So that would mean if Dr A saw admitted patient he would get 99218-99220 and if he's also the provider that saw the patient up to their discharge I would use codes 99224-99226 for their subsequent obs care visits. But if Dr B provides the subsequent visit I would use 99211-99215...
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    Wiki Medicare and subsequent Obs Care

    I thought Medicare accepted cpt codes 99224-99226 for subsequent obs visits. But the other coder in the hospital thought Medicare didn't accept these codes. Needs some input on this subject please. Thanks Nichole Ramsey
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    Wiki Medicare Blood Work??

    I have been given a very frustrating PI Project. The lab is sending me a list of Medicare Patients that signed an ABN at the time of their blood draw. I am to review the orders to see if the Dx is appropriate for the patient. We have some providers picking V70.0 for everything and some provider...
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    Wiki Billing for a Suboxone Treatment

    Suboxone Visits We have two providers that offer this service. We code an e/m plus the additional code for monitoring the patient. The provider has to indicate in the office note how much time was spent during the entire visit. We use 99354 for the first hour and 99355 for each additional 30...
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    Wiki When to code initial care?

    When to charge Inpatient Admit The ED provider dictates an Emergency Room Report with the Plan Stating:Patient will be admitted for Inpatient for eg pain control to Acute Care in stable condition to the care of Dr Frank. Thats when Dr Frank will see the patient the next day depending on the...
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    Wiki When to code initial care?

    Charging Initial Inpatient Visits We are a Critical Access hosp. My problem is I have always coded the initial visit when the provider sees the patient for the first time in the hosp. But others will only code the initial if the provider dictates a full H&P. If they don't they are saying that...
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    Wiki When to code initial care?

    If a patient comes in to the ED on 9/27 and the PA working the ED admits the patient to the hospital. The hospital will only bill out the ED visit for 9/27 for the the PA 99281-99285. My physician doesn't come in until the next morning 9/28. Would I bill out initial visit or subsequential visit...
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    Wiki Mod 51 versus 59

    When charging out for 45378 colonoscopy and 43235 upper gi endoscopy on the same dos. Do I use mod 51 or mod 59. Some of the coders her say 51 the others say 59. Please help!! Nichole
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    Wiki Inpatient twice in one day by two diff MD's

    Patient was admitted by MD#1 at 8am. MD#2 sees patient at 6:25pm. The only difference in the dx's is MD#2 see's the patient for delirium plus all the other reasons MD#1 say patient for. Is this enough to bill out the visit for MD#2? Nichole:(
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    Wiki Inpatient to Swingbed on same day coding?

    I had a patient as a inpatient from 12/31/2009 to 1/05/2010 d/c at 0850.No documentation for d/c. Status changed to swingbed on 1/05/2010 at 0850. The Swingbed was from 1/05/2010 to 1/07/2010. Provider only saw the patient on 1/7/2010 and this was to d/c the patient. I sent a note to the...
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    Wiki Newborn Care

    Twins were delivered Twin A was admitted and discharge on the same day that required intensive observation. Can I code 99463 for Admit/DC with 99477 for intensive observation care? Twin B was discharged on the 2nd day with the same intensive obersvation care. So can I code 99238 for DC and...
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    Wiki Nursing Service with injection only

    I have a patient coming in for a nursing service injection. Its her own medication. Would it be appropriate to code a 99211 and do I need a modifier for this? Thanks Nichole
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