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    First Coast Medicare?

    Hello, So, we are in FL, the ones with the oddball Medicare carrier who did not used to want a subluxation code as a primary dx on their claims. Now suddenly I got a bunch of C0-50 denials, looked and saw that there is a new LCD for 98940, 98941, etc (effective 9/12/16)...has anyone else in FL...
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    CPT code for subgaleal fluid collection?

    I have been looking at this procedure note for a week and am totally stumped, so I thought I'd put this out for suggestions. This fluid sampling was drawn by one of my surgeons to rule out meningitis. Brief procedure note: The skin was prepped with betadine prior to the bicoronal incision. I...
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    Assistance please

    I have been told by my supervisor that I do not need access to documentation to bill our doctors' hospital follow-up visits; that I should just bill what the doctor says to bill. Unfortunately, I have found that the doctors mark incorrect dates, don't document the visit at all, or the...
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    Need help w/a Dorsal Column Stimulator Removal Dx

    Hi all, I have a DCS removal that I'm having some trouble coming up with a diagnosis on. The patient had a DCS in place for back and leg pain. He had to have it removed because he required a pacemaker, which would have interfered with the function of the DCS, so my neurosurgeon had to remove it...
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    Non-E/M services being denied by Coventry

    Our office has been having a problem (just this year) with Coventry denying some of our non-E/M services. Here's what's going on: We do nerve conduction studies in our office. These are not face-to-face, or E/M services, but they are being counted as such according to Coventry because, in the...
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    Intraoperative consult code?

    One of my surgeons "scrubbed in" on a co-surgery but the surgery code was not one that can be billed with a 62 modifier; so my surgeon is wondering if he can charge an intra-operative consult code? I have looked in the cpt code book; I have Googled; and I have had no success finding an...
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    Location of services question

    Hi there, I need some assistance. We are having an issue in our office that has to do with the locations where our doctors see our patients. They see them at several different offices, so we told them that they have to state in their dictation where they saw the patient, since we do not have...
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    Tell me your thoughts on this ROS: REVIEW OF SYSTEMS: Not really possible to obtain given the patient's current aphasia. Does this count as 1 element? (1995) Thanks, K
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    Question about hospital consults/follow-up visits

    I think I know the answer to this question but I need something in print. So far I have been unable to find documentation on this subject, so I need some enlightenment. One of our physicians did an inpatient hospital consult, but it was really an initial hospital visit since the patient has...
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    Audit Policy

    never mind
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    Emergency Dept. Services

    Hi all, One of our physicians told us that he was under the impression that an ER visit did not require the "request" for a consultation (our physicians are Specialists) because they were asked to see the patient by the ER physician. Until this point, we had been telling our physicians to...
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    Coding & Compliance Department Policies

    I would be interested to get an answer to this, as well...
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    1995 or 1997 Guidelines/choose 1 and stick to it?

    Hi all, I have looked and looked and can't seem to find anything concrete on my question. I could swear I was told before that an office had to choose which guidelines to use in E/M documentation (1995 or 1997) and stick with that. Now I have been told that the office can choose to use 1995 or...
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    Need help regarding ER Department E/M codes

    :confused: I need clarification on would be much appreciated as there is a big board meeting tomorrow night and we have to explain this to our doctors... Our practice consists of Neurosurgeons and Neurologists. They see patients in the ER a lot, and want to charge an ER visit...
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    Neurosurgery Medical Coding Topic

    Is there any way you could add Neurosurgery to the Medical Coding Specialty Topics? I'd really appreciate it if you could... Thanks for your help! ~Kat
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    cpt code 88172

    I am at my wit's end with this. We are billing with cpt code 88172 (Cytopathology, evaluation of fine needle aspirate) for 4 units, because the evaluation was done on 4 different specimens. An Anthem rep told me they only pay $52 for a total of 1 unit. Curious, I called Medicare to see how if...