Recent content by annielou

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    Frequency for AWV

    Medicare AWV We have the patient back for AWVs after 12 months have elapsed.
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    Advanced Care Planning Diagnosis - claims denied for medical necessity

    Advance Care Planning I contacted Novitas who does not, at this time, have an LCD for the ACP codes. there is no list of allowable ICD-10 codes for the CPT codes.
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    Tobacco Cessation Codes

    Tobacco Cessation codes Our providers do not document in the smoking cessation counseling note how smoking affects their chronic problems. They document what they advised the patient, if they prescribed anything for tobacco cessation, and the amount of time spent counseling, which determines...
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    Wiki Diag codes to be used with 99497 and 99498

    Acp I looked around quite a bit yesterday for guidance on these codes, but found none. There is no guidance as to whether 99497 has to be 30 minutes or up to 30 minutes, and not one article addresses the ICD10 coding for this service. The "feeling" I got was that since Medicare is just...
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    Wiki Coding for sore throat/pharyngitis

    strep throat If the strep test is positive the correct code is J02.0. I do remove the pharyngitis code from the encounter, and it still gets paid.
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    preventative office visit

    preventative visit Did the provider bill the preventative code on the first visit? If so, you cannot bill it again. You could bill a 99211 with the vaccines because you have the ROS, etc on the follow up, but then you could not bill the 90471 with the vaccine codes.
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    Review of Systems based on HPI

    I have a note that states HPI: 1)Here to talk about Viagra, 2) feels depression for about a year. ROS: see above. How would this count in the History section?
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    Med Mngmt during global

    Global If the provider addressed the other problems and provided refills for them, besides the global issue, you may use the modifier on the E/M code and bill for the medication management of the separate issues
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    Physical, Medicare AWV, and office visit

    AWV and OV We normally bill a 99213/25 with the AWV code. The dx for the AWV is V70.0. We only bill a 99213 because so much of the HPI is covered under the AWV. It helps to pull in a separate note for one of the medical conditions in the EMR. Medicare and the Advantage plans all pay on this.:)
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    New patient wellness and OV

    Can a new patient office visit be charged with a new patient wellness? The patient was new to the clinic and the provider, and was scheduled for a wellness visit. The patient also has chronic comorbid medical conditions which were discussed and prescriptions provided. My billing office is...
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    We give a lot of 120mg of DepoMedrol injections. We use 80mg multidose vials. My billing office is telling me I cannot use J1030 because we do not have 40mg vials in the office. I disagree because it is a multidose vial and the only way to bill 120mg is with the two different codes. suggestions?
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    Have a question for Family practice coders

    Where to look for information Two good websites are Mayo Clinic and The Cleveland Clinic
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    Zostovax Injection

    Zostavax We have the Medicare and Medicare Advantage patients sign an ABN for Zostavax injection with patients own meds. It is not a covered service for Medicare. Our providers sometimes recommend the patient receive the injection at the pharmacy the get the med from, if the pharmacy does...
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    Labs included in preventive care visit?

    wellness labs Different insurers allow different wellness labs, but generally we bill a CMP, CBC and Lipid profile for adult wellness and get paid. Some insurers will also cover TSH (expecially for female patients) and a UA.
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    Irrigation code 69210

    69210 The description of 69210 in the CPT book states instrumentation is required. An ear wash using irrigation only would require an E/M code.