Recent content by jojo1uf

  1. J

    "Incident to" Employment Requirements for NY

    We are a large Hospital System in New York. The MD provider is in an offsite clinic (POS 11). Can the NP bill incident to if the NP is employed by the Hospital? Any thoughts are appreciated. Thanks! Jo
  2. J

    HELP!! Does this visit qualify for a E&M prior to screening colonoscopy.

    Hi All, Our provider coded the below with a 99203 with dx Z86.010 (History of colon polyps). Patient has Medicare. Our compliance department performed an audit and provider failed audit due to this case. Compliance stated that an E&M prior to screening is not allowed for Medicare. (which is...
  3. J

    Punch Biopsy Documentation

    Hi All, Provider ordered "Punch Biopsy" (CPT 11104). Below is provider documentation. Does the provider need to state in her documentation that a "punch biopsy" was performed? I would think so. But, welcome your input. Thanks!! Procedure note: RBA of procedure discussed with pt, including...
  4. J

    Is this a Detailed or EPF EXAM?

    Thank you Christine! I wasn't sure if the exam was "expanded" enough to qualify as Detailed.
  5. J

    Is this a Detailed or EPF EXAM?

    Sorry. posted another thread error.... Is this exam Detailed if following 1995 guidelines? I think it qualifies for a EPF on both the 1995 and 1997 guidelines. Please let me know what you think. Thanks! ---------------------- OBJECTIVE BP (!) 172/90 | Pulse 68 | Temp 98.6 °F (37 °C)...
  6. J

    Is this a Detailed or EPF EXAM?

    Is this exam Detailed if following 1995 guidelines? I think it qualifies for a EPF on both the 1995 and 1997 guidelines. Please let me know what you think. Thanks! ---------------------- OBJECTIVE BP (!) 172/90 | Pulse 68 | Temp 98.6 °F (37 °C) (Oral) | Resp 16 | Ht 5' 9" (1.753 m)...
  7. J

    Is this a 99204?

    Thank you both so much for your help!!!
  8. J

    Is this a 99204?

    My provider reported 99204. I only see the HPI as a EPF which would bring this to a 99202. Can anyone take a stab at this and let me know what you think? Thanks, Jo ------------------------------------------------------------------------------------------- Chief Complaint: new patient...
  9. J

    Prolonged Non Face-to-Face (99358) and Telephone Calls?

    Hi, Does anyone have examples of usage for 99358? I have informed my providers of the following scenarios in order to report 99358: (1) Medical Records review; (2) Review of diagnostic test results; (3) Discussing patient case with another physician; and (4) Any other on-going management of the...
  10. J

    99358 Non Face to Face Prolonged Services.

    RE: 99358 Non Face to Face Prolonged Services. Can the inpatient E/M and the non face-to-face prolonged service be reported by 2 different physicians that are within the same group. For example, if a patient is in the hospital and doctor #1 provides the non face-to-face prolonged service and...
  11. J

    Difference between G0396 and G0442

    Thank you! This was so helpful!!
  12. J

    Difference between G0396 and G0442

    G0442: Annual alcohol misuse screening, 15 minutes G0396: Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., AUDIT, DAST), and brief intervention 15 to 30 minutes I apologize for my ignorance. With regard to Alcohol , what is the difference between G0442 and G0396...
  13. J

    Difference between G0396 and G0442

    G0442: Annual alcohol misuse screening, 15 minutes G0396: Alcohol and/or substance (other than tobacco) abuse structured assessment (e.g., AUDIT, DAST), and brief intervention 15 to 30 minutes I apologize for my ignorance. With regard to Alcohol , what is the difference between G0442 and G0396...
  14. J

    AWV and Consult on same day.

    Hi, Can an AWV G0438/G0439 (either initial or subsuquent) be reported with an outpatient consultation (99241-99245) on the same day? I checked the 10/1/16 CCI edits and these coding combinations are not present. [I am compiling documentation of preventative services for physicians to reference...
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