Recent content by genenut

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    Looking for coders

    There is an open coder position at my hospital for a CPC (sorry no CPC-A). You have to be able to come here for training and to get your productivity up but once you have meet those goals coding from home is a real possibility...
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    same-day MRI/MRA head

    59 or xu With the addition of the x modifiers would you bill this combination with a 59 still or an XU modifier instead ?
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    Outside Lab service

    I hate to think what would happen if Medicare ever audited any of those claims...
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    Work Comp & ICD-10

    My states hospital association has decided that we are just going to submit everything in icd 10 and wait for individual claims/payers to tell us otherwise in hopes that the united front will encourage them to all covert. I'd submit in what ever format you would normally and wait and see if they...
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    Modifer 52 - A patient's procedure has been coded

    52 indicates reduced services. Was this less than a full colonoscopy? If CA Medicaid (medicare is not state specific) wants a PT modifier in addition that should not be an issue to add PT to the first line item.
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    Icd 10 mutually exclusive question

    I think because the general category states you cant code anything in the m54.1 category with m51.16 that maybe the m54.12 dx is wrong in this case and should be coded possibly from a different category with more specific code as to the cause of the radiculopathy. The Cervical Radiculopathy...
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    different billed charges for same service

    Per CMS rules you cannot charge different prices for the same service. You must bill everyone the same amount and the reimbursement can be adjusted to match your contract. charging different prices can get you in BIG compliance trouble. So if you charge 50$ for a glucose test to one patient ...
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    Medicare covered Labs

    only very certain labs have a preventative benefit. The Medicare and You annual book has good information on what is covered and how frequently. https://www.medicare.gov/Pubs/pdf/10050.pdf
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    medicare SNF reimbrusement

    I didnt think the physician fee was included in consolidated billing. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/ConsolidatedBilling.html
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    Professional or Institutional claim?

    What type of provider is billing for the lab test? Hospital - UB04 facility/institutional claim Doctors office (non provider based billing to medicare) - Everything on the 1500 hcfa form (lab test + office visit) Free standing lab - depends on your contract. (15 yrs exp billing)
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