Recent content by bonzaibex

  1. B

    Hyperlipidemia (E78.5) and Hyperglycemia (R73.9)

    The reasons you have listed above were pretty much all I could think of, too. It's nice to at least know I wasn't missing something somewhere. You're the best, Debra! Thank you for taking the time to expand. :-)
  2. B

    Hyperlipidemia (E78.5) and Hyperglycemia (R73.9)

    Hi Debra, You have been answering a lot of these ICD10 questions. Thank you very much. I truly appreciate your answers. :-) I do understand the Excludes 1 notes, and the fact that you cannot code these 2 together because of the Excludes 1 rule. What I personally was looking for was to see...
  3. B

    Hyperlipidemia (E78.5) and Hyperglycemia (R73.9)

    I have that very same question. I'm really hoping someone will have an answer for you soon.... Rebecca Hardin, CPC
  4. B

    Hospital H&P

    Not to my knowledge, you don't. The H&P is always available through the hospital's medical records dept if you need it, but there's no reason to hold up surgical billing because you don't have it in your chart. Becky H, CPC
  5. B

    Postpartum care after c-section

    Yes, you are correct. If the doctor who did the C-Section is billing for the C-section (which s/he should), then you are left with the antepartum care and the post partum care. Don't forget to bill appropriately for whatever your doc did in the hospital before turning patient over the surgeon...
  6. B

    change of insurance

    Most insurances will want you to split the OB care out, billing the old insurance for only the care provided while the patient was eligible, and then billing the remaining antepartum care + delivery/PP codes to the new policy. I have run across a few (very few) policies that let me bill the new...
  7. B

    27884 vs 11403

    Op report states, "..the right below-the-knee amputation site was approached and sharply debrided into the subfascial plan removing all necrotic and devitalized tissue to healthy bleeding tissue. The would was then copiously irrigated with sterile saline. Hemostasis was achieved with...
  8. B

    27884 vs 11043

    Op report states, "..the right below-the-knee amputation site was approached and sharply debrided into the subfascial plan removing all necrotic and devitalized tissue to healthy bleeding tissue. The would was then copiously irrigated with sterile saline. Hemostasis was achieved with...
  9. B

    Neuromonics Device

    Anyone have any experience billing for a Neuromonics Device? What HCPCS do you use (is there a better one than E1399)? If E1399 is the only code choice, what documentation do you submit in order to maximize any insurance benefits the patient may have? Becky, CPC
  10. B

    Confused About the Sequencing Here.

    I use LT/RT modifiers instead of -59 when I feel it might get me less flak from the insurance carrier. They basically do the same thing as a -59 by indicating different body parts. I do check CCI edits routinely for bundling issues. If a -59 is allowable, I then have to make sure it's...
  11. B

    Laparoscopic Ureterolysis CPT Coding Help

    Lysis work is typically included in the main procedure code and is not billable as a separate procedure. This has been true of pelvic LOA for some time, and CCI edits have recently been updated to include Enterolysis. I suspect Ureterolysis falls under the same bundling edits. If the lysis...
  12. B

    Confused About the Sequencing Here.

    The cystectomy RVUs are slightly higher than the SO RVUs. Maybe it takes slightly more work to remove a cyst from the ovary than it does to remove the entire ovary. That's just a guess, though. I also am not getting any CCI bundling edits on these 2 codes, so technically a 59 modifier...
  13. B

    57287 vs 57295 with 52 modifier?

    The procedure described in the 57287 & 57295 codes are typically done in a facility setting, not in an office setting. Both codes are also listed under the "repair" heading, and this doesn't sound like a vaginal repair procedure. This sounds closer to a foreign body removal kind of thing, and...
  14. B

    Tricky Global Maternity Scenario - HELP!!!

    It's not incorrect to bill a global OB to the new insurance, but I'd recommend contacting the payer first to see how they prefer you to bill out the OB care in this situation. Some will be fine with paying the whole global. Some will want you to separate out the care. If you bill a global...
  15. B

    attempted C-section but had to go vaginal

    Now that's an unusual situation. I'd code a 59510-22 (assuming you are billing a global). Try to get extra reimbursement for the extra time, effort, and risk. You might be able to make an argument for one of the VBAC global OB codes if the patient started out as a VBAC, went to C/S, and then...
Top