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  1. L

    Wiki Billing J1010

    With our EMR I have to go into another screen and put in 80 mg and don't use units but use the mg. It is billed per mg now. Make sure the mg is used and that might take care of the problem. The NDC numbers will depend how you purchase, by vial or box. If a box, use that NDC. It will not matter...
  2. L

    Wiki Mental health codes primary diagnosis in family practice setting.

    I was recently told that in the family practice setting mental health diagnosis can never be primary because the insurance will always deny, in this case Medicare. Has anyone had this same experience? There are times when the patient is coming in for a 3 month visit to only address med refills...
  3. L

    Wiki Help with Pharmacy required paperwork

    Has anyone else received paperwork from the pharmacies that the physicians need to fill out before the prior authorization will be approved? We received 5 pages from a pharmacy asking about any other medication that was tried, what the dosage would be, just all sorts of questions before the...
  4. L

    Wiki Secondaries

    I fold the primary EOB until it looks like an orgami piece. The only item copied is the top bar (showing service date, modifiers etc.) and the patient's information. If it is a Medicare claim, I will also copy the back pages with the glossary. Hope this helps. Linda
  5. L

    Wiki 99214 & 11055

    Originally I did code it that way and it was denied stating it lacked information or billing error. There is nothing in the submission ie: missing information so I figured it was a coding error. I do not have the energy to tackle the dreaded phone tree unless absolutely necessary.
  6. L

    Wiki 99214 & 11055

    Help please!! I have a claim which the doctor performed a level 4 exam with paring of callus. I used a modifer 25 on the E/M and a modifer XU on the paring. It is still being rejected. So, what modifers should be used, if any. Thank you in advance.
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    • Forum: E/M
  7. L

    Wiki Z23 Vaccination Question

    Z23 first listed according to book According to the guidelines (page 72 2016 ICD-10 code book) Z23 is not listed as one that can be used as primary diagnosis. Our Code-correct is warning me every time I try and use this for a immunization only visit. So, I ask, what is the correct answer to...
  8. L

    Wiki Cpt 99211

    I am in a family practice and in the past the only time we billed a 99211 with any lab work was with a PT/INR (85610). I am thinking we need to recoup the time for drawing labs and injections but found that NCI Edits 99211 and 36415 will not be payable together. My question is, can I bill just a...
  9. L

    Wiki Coder needed for PT office in SW VA

    Part- or Full-time coder needed for Physical Therapy office. Duties to include coding, posting charges and staying up-to-date with current Medicare guidelines. Willing to discuss flexible scheduling. This person will also continue with the implementation of the ICD-10 coding. Send resume to...
  10. L

    Wiki Patella Instability

    Dx and Tx diagnosis is patella instability, patella tendinitis (726.64) and knee pain (719.46). The referring dr. did not code the instability. I've asked my "go to" coder and she was unsure as this does not involve the joint but rather just the patella. I looked for a good hour and nothing...
  11. L

    Wiki Patella Instability

    How would you code patella instability when it does not involve the joint? This is driving me to mental instability!! Thank you for your help!
  12. L

    Wiki 2nd plea for help, well woman exam's

    Check the CCI edits to see if the codes can be coded together and refer to the guidelines to see what they say. Each policy is so different, you really have to check what they will allow. Good luck! Linda
  13. L

    Wiki Superhuman speed for CPC exam?

    I did finish my exam and and a few minutes to go over the questions I had marked as needing a second look. Do not spend a lot of time on any one question, skip it and go back to it. Figure out how much time you should take for each question (divide the number of questions by the time) and keep...
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