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  1. V

    Appendectomy with negative path

    I do not think Z03.89 is appropriate, especially since the patient was in OBSV for the Abdominal pain, which was technically caused by the ruptured ovary ...
  2. V

    Appendectomy with negative path

    ok , thank you for the input . I am having issues with the pre authorization team disagreeing with me , but I don't really know what else to tell them . I don't have any written proof otherwise to give them .
  3. V

    Appendectomy with negative path

    I have a patient who came in through the ED with a positive CT of the lower quadrant signifying possible appendicitis . The patient is taken to the OR , The physician does a laparoscopic appendectomy with abdominal lavage , he find the patient has a hemorrhagic ruptured ovarian cyst, this is why...
  4. V

    Melanoma down to the Fascia

    Thank you - I will keep all this in mind the next time I have one similar :)
  5. V

    Melanoma down to the Fascia

    I have a few questions - I have a patient who had a 1.1 centimeters excision of melanoma insitu with wide margins up the upper arm Here is the majority of the OP report Patient taken to OP room , General anesthesia was done . An Elliptical incision was made and carried DOWN TO THE FASCIA ...
  6. V

    placement of balloon occlusion catheter

    I need help coding the urology portion of this. Patient is getting a nephrostomy tube/percutaneous nephrolithotmy done by the interventional radiologist My dr is doing the following Cystoscopy with removal of right ureteral stent , and placement of a right balloon occlusion catheter. How...
  7. V

    re-opening of mastectomy site to remove Pectoalis Major Muscle

    I am needing some help on this procedure. I have never had one like this before and I have researched and searched and I am not having any luck Patient comes in post mastectomy , path came back with positive deep margin in the left breast. Our Dr re opens the mastectomy site to remove the...
  8. V

    Brookesource is hiring for Louisville KY area

    I know it is hard to find jobs out there but there is a company right now that is hiring temp to full time hire for U0fL Physicians. If anyone is interested I would be happy to pass along Brooksource information. I was going to take a job with them but ended up finding one closer to my home. I...
  9. V

    review of systems - enlarged lymph nodes

    Can someone please explain to me a question I have about the ROS ? Here is the example I have : no fever, cough, respiratory issues or enlarged lymph nodes, all other systems negative. So when a Dr says ALL OTHER SYSTEMS NEGATIVE, does that COMPLETE the ROS ? My Dr says that completes it and I...
  10. V

    Question on pregnancy coding

    also with the heroin abuse 648.33 304.00 ( maybe a differential on the 5th digit)
  11. V

    Question on pregnancy coding

    If the Dr doesn't state Hyperemesis gravidarum than NO you can't code that. You can used the unspecified vomiting in pregnancy 643.93 if it just states she is having vomiting during pregnancy and the note is very unspecific.
  12. V

    What DX codes for pap exam with diagnosis charted by provider other than screening

    hpv only , the V code is for screening . If she is coming in for a re pap because of the HPV you don't use the screening V code , since this isn't a well woman screen , it is a diagnostic for HPV
  13. V

    MVA question probably asked 100 times

    Ok everyone - I am having a disagreement with the MVA codes with the other coder. My patient was the driver and involved in MVA on the road with another moving vehicle. Would you use E812.0 or E819.0
  14. V

    ED turns into Observation

    Forgive me ( because like I said I have only done ED for about a month) When I done family practice , the order usually came from my family practitioner but only once the hospital had notified them , therefore that meant that my FP was the only one who could bill for the observation ... is that...
  15. V

    ED turns into Observation

    I am new at ED coding. I used to do physician practice coding. BUT is it possible for a patient to be in the ED and turn into Observation care so that my ED drs can bill observation ( 99218,99219,99220,99217 ) and what has to happen in order for this to be billed? I had an alcoholic that came...
  16. V

    modifier 76 is bringing me stress

    Every Medicare carrier is different . My office is apart of CGS medicare . Today I printed a sheet from our Medicare carrier and MLN matters showing that you need to use the modifier 76 . However, it seems like every insurance company is different... so who knows. I am just wanting to follow the...
  17. V

    modifier 76 is bringing me stress

    thanks , I am pretty limited on what I can look at and I haven't been here long enough to figure out how to run a report. I asked one of the billers if the quantity coding was getting paid and she said "yes" So I don't know There is a lot I can't see but if I want to bill the cpt 93010 with a 76...
  18. V

    modifier 76 is bringing me stress

    I need some help . My boss feels when we do 2 ekg's in the ER that we should just multiply them by 2 . So this is what she wants us to code 93010 X 2 ( they just do the interpret ) I am new here so I try not to butt in with my advice ( I have coded for several years but I am the newbie and...
  19. V

    When is it considered Fraud?

    Daniel I appreciate your response. I am in need of an auditor to verify a few things for me before I take this to my supervisor. The problem I am having is... I am new to this job. I have been there a week. I am not new to coding. I have been coding physician services for 8 years. I feel like...
  20. V

    need some auditing advice

    I posted this on the auditing forum but I am going to post it on here to. If there is an auditor out there that would be kind enough to PM me. I have an auditing question in regards to Physician Services for Emergency Room . I don't want to waste your time but I am having a hard time finding...
  21. V

    When is it considered Fraud?

    I am going through this same thing, except with Emergency Medicine. I am a newbie so I don't feel like it is my spot to say anything. I have been coding for over 8 years but just started this job for ED physician coding. They are billing level 99285 over and over again, when I went through the...
  22. V

    auditing question

    Hello I really need an auditor that can maybe time out of their busy day to help me with an auditing question. It has to do with Emergency Department E/M levels. So if you have time to help me will you please private message me. Thank you Valerie
  23. V

    ED auditing help

    I am new to ED coding. I have coded for physician services 8 years and now recently got a new job in ED Coding. I need help with understanding some auditing for the ED. Can anyone give me a good resource or something to help me better understand ED auditing? From what I can gather from starting...
  24. V

    CPC to INPatient coding

    Can someone advise me on how I could go from doing Professional charges to INpatient facility coding? I am looking for a way to transition. I have worked n coding for over 10 years and I have no guidance on how to transition. I work for a hospital where I do the professional charges for...
  25. V

    Experienced CPC looking for job in Southern Indiana

    I have over 8 years experience in professional coding. I am looking for a job in Southern Indiana. If you are interested I can give you a full resume.
  26. V

    Med assets

    Has anyone out there heard of this company called Med Assets ? Our hospital is hiring ( or I should say spending lots of money ) on this company to come in and "observe" us to see what they can do to make our work go more "smoothly" They done this to our business office about 3 months ago...
  27. V

    Ureteral dilation

    Anyone have any idea on these 2 procedures? I am having a brain freeze Cystourethroscopy , bilateral retrograde pyelogram, right ureteral dilation, right ureteroscopy, with stent insertion I have the stent insertion part 52332 , but not sure what to use for the Ureteral Dilation ... I...
  28. V

    EXAM under Anesthesia,conversion seton

    I am very confused on the following operative note. The patient already has a seton in place, however the Dr is doing a conversion of it. Here is a sum of the note The Bivalve retracto was placed into the anal canal showing the seton located in the fistual tract located posteriorly. The...
  29. V

    cutting seton adjustment

    Did you ever get an answer to this? I have the same issue
  30. V

    perineum wart destruction - cryotherapy

    SO ...what would you use for a man? Since the code you gave was for female gentials only?
  31. V

    job duties

    This might be a weird and stupid question but as a CPC what should my basic job responsibilities be? There is some tension here between Hospital coders and us. Hospital Coders get paid more than we do , but yet we went to school 2 years, took a cert exam, keep up with CEUS, and do a lot of...
  32. V

    injection denials

    We are having issues with the insurance companies denying therapeutic injections when they are billed more than once. For example ..they come in for a problem and then they additional need a testosterone and a B12 injection So we are billing 99213 mod 25 for maybe 401.9 , 250.00...
  33. V

    CCS-p and CPC problem

    Maybe I am already doing this. I code for all this now . I code/key everything in including any procedures done in the office. Supplies, Drugs, Etc. I also code for hospital visits when my doctor goes to the hospital. I think i will buy a CCS-P guide when I get paid again. As far as the case...
  34. V

    CCS-p and CPC problem

    I understand what you mean. I just wish I could find something in concrete maybe accurately comparing the two degrees without people adding opinions...including my own opinion. I know how my boss is more concerned about hospital based coding. ( unfortunately we were pawned on her and she has...
  35. V

    CCS-p and CPC problem

    OK Kevin, is there a place online that is legit that tells about how much more "skilled" a CCS-P should be than a CPC? Because I don't believe it should be a $3.54 different pay grade. I would like to see in writing proof that this is a mastery skilled level and compare it to the skill level...
  36. V

    CCS-p and CPC problem

    Recently, my organization has decided to hire an additional physician coder. We have many phone calls from other departments wanting to transfer to the coding department(most of them with no coding classes or experience ) One of these girls we have known for sometime. FInally at the end of her...
  37. V

    vender vs medicare

    Thanks Debra
  38. V

    vender vs medicare

    awesome I need to see if I can find that article. If you find it or remember it...let me know. Also I could tell all the people in charge that info and they won't listen to me... but i want to know for my own sake
  39. V

    vender vs medicare

    I have posted a thread about this before. It has come up at my employement again. We are a small hospital with about 50 providers with different specialties. I work for the physician side of the hospital. About a year ago we went to a new computer system, and in about 2 months they are...
  40. V

    The Future of the Medical Practice

    Debra That is exactly what I was thinking...that it was a vendor thing. He kept saying that the government is mandating this 2015. However, havent really read too much else into this. I really dont feel , especially if I know for a fact that the code is incorrect , that it is appropriate for...
  41. V

    The Future of the Medical Practice

    In my company we have been having a consulting firm coming in to inform us on some changes our practice/hospital is going to have to make within the next 3 years. I guess I am confused and would like to find some additional information. In one part of this meeting we discussed how the physican...
  42. V

    Diagnosis Coding Question

    OK I am not 100% sure if this will help, and I am sure you had already got your answer... look around Diagnosis 209.30... an odd thing... I had one sort of like this not too long ago, maybe this will help? Good luck, I am still new at oncology and radiation oncology so this has been a struggle...
  43. V

    radiation oncology

    Can someone tell me when the radiation oncologist bills for 77427 - weekly radiation therapy , if you would use V58.0 as primary and the cancer code as secondary? Example: patient is here for radiation treatment for lung cancer. I would use CPT 77427 .... with DX V58.0, 162.9 When I look in...
  44. V

    radiation oncology help

    Hello I am in desperation... I have recently been given the task to do the coding for the professional side of radiation oncology. I have NO CLUE what I am doing. I have been trying to research things about it, but cannot understand what the sites are trying to tell me. The hospital I work for...
  45. V

    coding from home complication?

    Hello I posted this on the employment forum, but want to know if anyone on here can help me out. I did not get any replies to my question on the employment forum. There is some talk about our hospital sending all coders and transcriptionist home to work.I am a coder for the physician side...
  46. V

    working from home complications?

    I appreciate it, however, I have only had experience in Physician coding, however... maybe you can help me out. I am looking to maybe do some online courses for the hospital coding . Do you know a place that offers online courses for this? I feel it would not be too hard for me to do the course...
  47. V

    working from home complications?

    Ok so our hospital recently told us with our new current computer system we should be working from home real soon. . . Here is the problem: I know some other places that has done this and they have basically made their coders contract out to them. When that happened the coder have lost all...
  48. V

    coding Outlook

    Rani Its ok I will take any info I can get. Just trying to figure out what to do work wise
  49. V

    CPC-H Not recognized

    Here is my new problem, I am debating wither or not to go ahead and get my credentialing to be a hospital coder. Right now I am a CPC working in the physician practices in a hospital. BUT it seems I can't find additional schooling for the hospital coding side. I can't seem to find any classes...
  50. V

    CPC-H Not recognized

    I have noticed most of the hospital/facility jobs never say anything about looking for a CPC-H. It always refers back to wanting a CCS or a RHIT. So is it worth getting your CPC-H through the AAPC if no employer will look at that credential? I am confused in general on what to do. I am looking...