Recent content by LindaEV

  1. L

    Biopsy CPT 11100 vs: 113xx

    I also agree with the physician. Consider that they mean the documentation does not support the medical necessity of the charge. Was the excision you mentioned at a separate site? are they trying to bundle the two?
  2. L

    Annual eye exams

    There are specific codes for eye exams, but MANY eye docs are now billing the E&M codes because of the better reimbursement. As soon as there is any sort of medical dx, they usually do this (e.g. headaches, diabetes...). I have annual eye "wellness" exams for a $10 copay, but with my previous...
  3. L

    Tumor or lesion removal?

    I am leaning toward the tumor excision code (musc/skel section) because it sounds like sub-q tissue.....but waiting on the path report can certainly help with your code decision!
  4. L

    Fat Graft to face

    Hello! Surgeon is excising a cyst off mandible and will take a piece of mandible as well. He will be harvesting a fat pad from the abdomen to fill space of excision. Is this separately billable or considered part of closure? Looking at 20926 for graft, but not finding anything for placement of...
  5. L

    I'm trying to become an auditor

    It really depends on who is hiring and what they require. Obviously a degree is helpful, but I became an auditor without a college degree, based on my years of experience in coding. Someone gave me a chance and I ran with it. I eventually added coding credentials, (E&M, Compliance) and I am...
  6. L

    ICD 10 training

    Best guess, without a complete scenario, is that they left off the dehydration because they are assuming it to be a symptom of the Salmonella. Guidelines tell us not to code symptoms when they are a known part of a condition.
  7. L

    vasectomy coding

    Not likely. How was the vasectomy done? You will usually use only one method/code.
  8. L

    reduction in payment

    there should be no reduction, but your global period will start over.
  9. L

    I&D Groin Wound

    Sounds like the intent was more like an excision than a debridement to me. I would likely use a benign excision and a intermediate repair code.
  10. L

    Medicare Denied a Fluroguide 77001-tc but paid 36561 for port

    Ae you sure you don't need a 26 on the 77001? if the physician was using the images for guidance, that is likely the modifier you need.
  11. L

    pre op

    Is this the same doctor who will be performing surgery? Has the decision to operate already been made?
  12. L

    Facility billing with TC/26

    I'm not experienced in outpatient/facility coding but need help with a question. How do you bill for procedures when there is a TC/26 involved? For example, a specialist see's a pt in out outpt clinic and orders an EMG. HE reads the EMG. The hospital billing department needs to bill the...
  13. L

    Global billing

    We post them internally only with the zero charge, and put them to patient responsibility so a claim will not generate.
  14. L

    What is included in a well woman?

    Are you talking commercial or Medicare? Medicare has a list of 11 elements and you must do at least 7 to bill the G0101 code (Don't forget the Q0091 if you collect a pap)...
  15. L

    medicare preventative wellness exam

    If they have had there IPPE (Welcome to Medicare exam), you can bill a G0438, and once they have there G0438, then yes, every subsequent wellness exam will be a G0439. We use V70.0 as our primary dx code. You might want to check with your Medicare carrier to see if they have another preference...
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