Recent content by mieka.schambach

  1. M

    Telephone services

    My provider is constantly doing phone consults for new issues for established patients over the phone. He spends anywhere from 10-30 mins usually on the phone with patients talking them through their issues. THEY'VE NEVER SEEN US IN THE OFFICE FOR THIS PROBLEM! I believe he should be reimbursed...
  2. M

    Removal of Hernia Mesh

    Mesh removal We use 49659 "unlisted laparoscopy procedure, hernioplasty..." and just send the documentation with the claim
  3. M

    Colostomy takedown, Splenic flexure takedown, hernia repair, and xenograft

    Please help code the following, we coded as so, but 2 of the codes are add on codes and keep denying as not billed with primary code. However, physician did not perform either primary procedure: Procedures: Robotic colostomy takedown with colorectal anastomosis.; Robotic incisional hernia...
  4. M

    Help with operative report

    Exp Lap- 49321 Lysis of adhesions- 44180
  5. M

    19083 Fee schedule

    thank you!
  6. M

    Obama care/healthcare reform

    So we are having trouble with the new healthcare reform. Things we have found out in Austin: Humana offers HMOx Aetna has QHP BCBS has some type of metal in the plan name Superior goes through Ambetter Sendero plan name is Idealcare. We have found out that EVEN if a provider is in network...
  7. M

    19083 Fee schedule

    So I need help locating the fee for this CPT through all the main carriers. Since this is a new code, it doesn't seem to be on all the fee schedules on the websites. If anyone could provide the fee schedule for this CPT for : UHC, MCD, Cigna, Aetna, and BCBS?
  8. M

    Non par denial

    How would he bill for this then? would he have to dictate that he just became credentialed?
  9. M

    44140 & 49561

    We billed a 49654 with mod 51 and 80 and also billed a 44602 with a modifier 80. However we keep getting this rejection from our system "Trigger Procedure [44140] on Claim ID [], Ext/Int Line ID [697734/1] and Target Procedure [49561] on Claim ID [], Ext/Int Line ID [697735/2] are Unbundled and...
  10. M

    Non par denial

    So I have a provider. He was not credentialed with MCR (he now is, but not for those DOS), however he was seeing medicare patients. Therefore he was getting a non par denial. Is there any way to get these paid?
  11. M

    Modifier 22 HELP!!!!

    So my dr is billing a 47562 with a modifier 22, he did a lap chole with lysis of adhesions which took over 50% of the case. How do we get paid for this additional procedure (the lysis) that was done considering he only billed a lap chole? this is Medicare so I can't just send medical records...
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