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    Template for 98940-98943 Medicare

    Documentation... Hi Susan, I see that no one has responded to your post...I was interested to see what the answer was, too. This may not be exactly what you were looking for, but hopefully it will help a little...
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    First Coast Medicare?

    Thanks for your responses! I have been adding the M99__ sublux codes on (primary of course), and I too have not had a denial on those yet. :) I really do appreciate the input!!! -Kat in FL
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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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    Need a good Neurosurgery reference book

    Sorry I am late replying to this... but hopefully you will see it :) The Neurosurgery/Neurology Coding Companion (I believe it is sold by Optum) is a great reference as far as I am concerned. I refer to it constantly...it has in-depth descriptions of each procedure, and even has lists of the...
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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

    thank you :) Kelly, thank you so much for replying. I PM'd you.
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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

    Meagan, That's a good point about the nerve conduction tests...I'm going to look at the actual denials and see if they are only denying those, and not the EMG's themselves. Thanks for pointing that out... -Kat Update: the denials are on EMG's, and those are the ones performed by the...
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    Non-E/M services being denied by Coventry

    That was a good resource, but I'm thinking we need something to clearly define the difference between an E/M visit and a procedure, since Coventry's point of reference (the decision tree in the CPT book, page 5 in the professional edition) has "suddenly" muddled the two into "any professional...
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    Non-E/M services being denied by Coventry

    The exact wording that we are receiving on the denials is: "Only one initial visit is covered per specialty." You are pretty much right-on with the cpt codes that you stated, as far as nerve conduction studies...95900, 95903, 95904, 95934, and 95886. And yes, the patient is present when the...
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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

    thanks anyway I called the RAC office and asked them the question. Thanks anyway.
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    Location of services question

    Box 32 on our CMS-1500 does state the location in which the patient was seen, but we coders are concerned that the office note does not state the actual location, in case we are audited. So we need something in print that states that the location where the patient was seen has to be stated in...
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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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    Ros?

    You guys are the best. Thanks! ~K
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    Ros?

    Thank you! Is there anywhere I can find this in print, so I can show my doctor? Thanks again, K
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    Ros?

    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

    Thank you ladies, much appreciated ;)
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    Question about hospital consults/follow-up visits

    Thanks Debra, you're quick :) So, I can bill a subsequent visit, even though the patient is new?
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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

    Thanks for the clarification, Debra. It is very much appreciated!
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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?

    Thanks for your input, Leslie!
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    1995 or 1997 Guidelines/choose 1 and stick to it?

    Thank you :D
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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

    Thank you for your responses! It's a LOT clearer now! ~P
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    Need help regarding ER Department E/M codes

    :confused: I need clarification on this...it 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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    any coders in Paris, TN...?

    I'm not in Paris, TN, but I wish I was...it's cold up here in MO!!! Hope you get some responses... ~P
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    AIM Healthcare

    Amy, Just wanted to say good luck to you! ~P
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    Neurosurgery Medical Coding Topic

    Yes, Neurology or Neurosurgery...hear, hear!!!;)
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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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    AIM Healthcare

    Michelle, I'm happy that this is a good thing for you! Yes, I needed benefits and "permanency." I just ended up getting a job at a local hospital, not working from home but close enough. AIM Healthcare wasn't for me but maybe my bowing out gave someone else the opportunity they were looking...
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    AIM Healthcare

    I haven't worked for them, but I did just turn down an opportunity to work for them. My reasons: 1. I need a permanent position, they could not guarantee me that this would be steady work. 2. I live 5 hours from the actual office, and they wanted me to come there 2 times, once for an actual...
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    Pathology - surgical

    never mind
  39. P

    Billing in Units for Medicare

    Thanks, Rebecca. I need to sit down and read this... ~Kat
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    Billing in Units for Medicare

    Regarding MUE... I've been down this road before with CMS/MUE. You open up an Excel spreadsheet with cpt codes, and a 1,2 or 3 next to them. It doesn't tell you anything about any edits! Where do you find the actual wording of the edits? I've been tearing my hair out trying to figure this out...
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    cpt code 88172

    That's a good idea. Thanks for the suggestion! I know what you mean, this gets really frustrating... ~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...
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    Can a CPC open a billing company?

    Hi there Nelsong, I'm not the person you initially posed this qestion to, but I worked for a billing company up until the end of July, and they charged the clients a percentage based on the payments brought in monthly by the billing company. Hope that helps. If you want to know anything else, PM...
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    Free Newsletter (no CEUs attached)

    Newsletter Can you add me to the list too? kirkwood_pathology@hotmail.com Thank you! Kat, CPC
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    How many work from home vs an office?

    I work from home too. ~Kat, CPC
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