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  • Kevin,
    Hope you can help me with this question. We are having a discussion at work several of us agree, others are confused. We code the physician side for the emergency room. Many patients are seen by physician assistants, nurse practioners (extenders). Several coders are saying if the "extenders" discusses the case with their supervising physician on duty they should get the 2 points for discussing the case with another health care provider. My understanding is another health care provider should be a "consult" calling or discussing the case with the ortho doctor ,cardiologist etc. This is making the difference between a level 3 versus a level 4. We do have an outside auditing group, but i would like to have information before i discuss with the other coders (usually a heated discussion). Any advice would be helpful. You can email me at cmzstover@yahoo.com. Thanks you all your hard work!!!

    I edited my original message to show * beside the jobs or job duties that I held prior to becoming a coder. I meant nothing demeaning by it and I think that is evident in my message. As someone who regularly mentors coders and HIM interns, I was hoping my comments would inspire folks. I'm sorry that for you that did not occur.
    Axis III is appropriate as primary for brain injury when one is present and the reason for the testing. The nature of the testing determines what is primary--e.g., cognitive testing for dementia, etc.

    I hope this helps. The insurance company may, itself, have interpretations on what is medically necessary, as you may know.
    Hi, can you comment to my post regarding whether 780.93 was EVER payable (or atleast the past few years) for CPT 96116 and 96118?

    Also, is I have a neuropsychologist that is doing 96118, if she has axis 1 as cognitive DO, and axis 3 as brain injury, memory loss, encephopathy, etc, is it appropriate to code axis 3 as prime? or should she code axis 1 prime and axis 3 as secondary dx's? I dont think axis 3 as prime is correct. I am not even sure if a PhD should be using medical dx's at all since they can't bill illness CPT codes (i.e. 99213)? Advise please.

    I was thinking about you today. How is everything going in your neck of the woods? I would love to hear from you when you have a few minutes. Things are going very well here in Colorado. Wish the weather would stabilize a bit, but then again it wouldn't be Colorado if it did. By the way, are you on LinkedIn? I was looking around for collegues to add to that.
    Can you please take a look at my most recent post about what to bill? I really need to get some answers and you seem quite knowledgable.
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