View the ICD-9 code's corresponding Diagnosis Related Groups (DRGs). In a click, verify the DRG, its IPPS allowable, length of stay, and more. Protect your facility's payments by subscribing to DRG Coder.
HELP :/
We are getting denials from Blue Cross for Prolonged services CPT 99358/99359, not sure if our provider should be billing all these codes. Or any resources anyone could recommend to better un... [ Read More ]
HELP :/
We are getting denials from Blue Cross for Prolonged services CPT 99358/99359, not sure if our provider should be billing all these codes. Or any resources anyone could recommend to better un... [ Read More ]
I am having a debate with some staff regarding the appropriateness of billing unspecified codes. While I'm aware Medicare and other insurances no longer reimburse for unspecified codes, my understand... [ Read More ]
Sorry i totally read the diagnosis code wrong (pains of staring at a screen all day)
Any chance one of the following dx codes that do not support Medical Necessity are also included?
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I am not an inpatient coder but my boss brought me a procedure report and asked me if I could find out if there is a different DRG that can be used for the tracheostomy other than 003. Based on the do... [ Read More ]
There is no way of billing the fee.
We bill out the appropriate compound drug code (i.e. Q7799)
Submitting Claims for Compounded Medications, Including Medication Administered via Implanted Infusi... [ Read More ]
Hi all!
Is anyone else in the Ophthalmology field having trouble with denials on new ICD-10 codes worded with ?Preglaucoma? (H40.003) and ?Low-Risk? (H40.013)?
When we convert our ICD-9 codes (which... [ Read More ]
I'm new to opthalmology and have a question regarding medical necessity of a visual fields test. My doc is using pre-glaucoma as a diagnosis (H40.003 to be exact) and I'm receiving denials from Medica... [ Read More ]
We bill for pump refill drugs to medicare using J7799 KD (Prialt is J2278) and we have very few issues with reimbursement. See medicare billing info below:
[COLOR="Teal"]Submitting Claims for Compou... [ Read More ]
[url]https://www.msbcbs.com/medadvpolicy/printerfriendly/N-152-003.html[/url]
I think this link may have been what I was looking for if anyone wants to take a quick glance. That will be helpful thank... [ Read More ]
Know the rules for CLIA waived tests to ensure proper claims payment. Modifier QW indicates a Clinical Laboratory Improvement Amendment CLIA waived test performed by a lab with a CLIA certificate. App... [ Read More ]
70 coding changes are coming soon. The American Medical Association is scrapping almost all of the COVID19 vaccine administration and product CPT codes it has created over the last several years. In t... [ Read More ]
CMS proposes to codify three services that aim to remove barriers to quality care. Healthcare practitioners especially primary care providers are spending more time and resources addressing economic a... [ Read More ]
These mistakes prove the devil is in the details. While most of us need to meet productivity standards we also need to focus on quality and continue to perfect our medical coding skills. In our zest t... [ Read More ]
Offenders may soon pay a hefty price. On June 27 2023 the Department of Health and Human Services HHS Office of Inspector General OIG posted its final rule implementing penalties for information block... [ Read More ]