Recent content by jhack

  1. J

    Family Practice and OBGYN both seeing OB patient

    Family practice doc following a pregrancy and then an OBGYN doc delivers that patient. Can the family practice doc bill subsequent hospital visits and discharge for that same patient or is it included in the total ob package? example - OBGYN bills 59400 on 1/1/2014 Family...
  2. J

    Rn doing an antepartum visit with no dr present

    Hello, I know a nurse isn't able to document all of the pertinant info in the ACOG record for an antepartum visit, without the Dr. having some interaction with the patient, but where would I find these guidelines in writing? I have a provider whom was called out for a delivery and never saw the...
  3. J

    code needed

    Is there a code for "pelvic washings"? (used for ruling out leiomyosarcoma malignancy )
  4. J

    queston on amount and/or complexity of data reviewed

    I have a physician's assistant doing the office visit, and documenting as such. There is a comment in the documentation that says "the patient was seen today by the physician assistant. The patient's chart, hpi, current meds, lab values, and pertinent clinical exam were reviewed by Dr. X. The...
  5. J

    Procrit modifier EA,EB,EC for Medicare

    Dr supplied the drug. We are billing the drug.
  6. J

    Procrit modifier EA,EB,EC for Medicare

    I need to know which modifier to use if the patient has a dx of 285.9 and 238.72 and the hct level is above 30???????
  7. J

    modifier EA,EB,EC for Procrit

    If I have a patient with diagnosis of 285.9 and 238.72 and the cht level is 30.9. If you use EA modifier it will be denied because the hct is above 30, if you use EC modifier is will be denied because of diagnosis, is EB the correct modifier to use is this scenario, or is there another modifier...
  8. J

    J0885 diagnosis - I have a patient

    285.9 and 238.72 are payable per lcd, but I am questioning the mod because billing with EB is denied. MDS is caused by radiation and that;s my reasoning for using EB modifier. Is this correct?
  9. J

    j0885 medicare modifiers

    How do I know when to use EA, EB, or EC modifier with the diagnosis. Is there a listing of diagnosis that are used with each modifier listed somewhere?
  10. J

    J0885 diagnosis - I have a patient

    I have a patient with 285.9 and 238.72 diagnosis, hct level is 32.5. I am needing hlep on which modifier to use. EA, EB, or EC. I am getting Medicare denials for co-50 as not medically necessary. Any help?????
  11. J

    proper billing of services

    Thanks, that sums it all up. I appreciate all of the feedback.
  12. J

    proper billing of services

    Correct, if the procedure for some reason took longer then adding the 22 mod. would be ok. But my question was with the 25 mod. comment on the e/m. If they are coming if for a scheduled lesion removal how could you put a mod on the e/m? It's not seperate and distinct from the service. OR...
  13. J

    proper billing of services

    Yes, the patients are scheduled to come in for the service. If the Dr. is spending more time than usual on the service wouldn't it be more appropriate to put a 22 mdifier on the service. I guess I don't follow why you would put a 25 modifier on the e/m??? If the e/m isn't a seperate service how...
  14. J

    proper billing of services

    I have a Doctor who always does an office visit with the paring or cutting of lesion (11055 or 11056). The e/m is never seperate so there isn't a 25 modifier applied. The question is, does the Doctor HAVE to bill the 11055 or 11056 if done with the e/m visit? The question is coming up because...
  15. J

    patient seen in E.R. on Aug. 10th and admittied on Aug 11th

    THANKS-any ther suggestions, if Dr. sees pt late on day 1 and admits on day 2?