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  1. H

    Ip procedurs (10-pcs) question

    I am still fairly new to Inpatient coding and had a question regarding the global days. Do the PCS codes have global days? I was looking at the Medicare Physician Fee schedule and looks like I wasn't able to pull up and Inpatient codes. Any help will be appreciated.
  2. H

    Fluroscopy 76000

    I have a question when this is coded. It states this is used for up to 1 hr. I have a claim that they did use 76000 but states on the report that it was performed for only 2 minutes. Since they still use it can I still code it or not because it is only for 2 min? I just want to double check on...
  3. H

    Inpatient coding guidelines

    I am working towards getting my cert in inpatient coding but do have a question when it comes to diagnosis coding. So if the patient came to the ER then was admitted as inpatient would I just code off the discharge summary or can I code from the discharge summary and the ER report? I just want...
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    Bundling Issues

    I received a denial which they performed 29580 and 11042 which the letter (from BCBS) states that these code cannot be coded together. I double checked in the book and not seeing any issues with those codes being coded together. A modifier has already been appended on 29580. Is there any...
  5. H

    Stat lab list-cms

    I have an account which the CPT codes 81001 and 87086 denied due to those codes not being on STAT lab list. I have tried looking up the list on CMS and unable to find anything. I haven't heard anything about this until today. I am not sure if it named under something else but if anyone does know...
  6. H

    How to code.. (pysch)

    I have a denial due to dx code T74.31XA being as primary dx (IP). I looked through the account and was unable to find another dx code (other than what I have below). From the T74 code that was for "made statements of self-harm". Is there another diagnosis code that I could use for that...
  7. H

    Rev cod 250 and 270

    I have an observation account which Rev code 250 and 270 denied on the account saying that both are not being within the scope of Medicaid contract. I have been looking online to see if there is any rules with this and not finding anything. All I know is that those rev codes do not require a...
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    Hcpcs implant codes c1758, c2617, c1769

    Has anyone that works in a hospital having bundling/packaging issue with HCPCS C (implant) codes? I have one account (BCBS) that they performed a cystoscopy and used C codes for ureter stent (C2617), catheter (C1758) and a wired guidance which blue cross and blue shields denied reimbursement for...
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    Hcpcs implant codes c1725, c1769, c1760

    Has anyone that works in a hospital having bundling/packaging issue with HCPCS C (implant) codes? I have one account (BCBS) that they performed a cystoscopy and used C codes for ureter stent (C2617), catheter (C1758) and a wired guidance which blue cross and blue shields denied reimbursement for...
  10. H

    Cpt code help

    Is there a CPT code for intrathecal pain block? I know it would be in the nervous system section but not sure which one. Please help!
  11. H

    Picc

    So a patient comes in to get blood drawn and they are unable to find a vein so they call a PICC nurse and she uses the ultrasound to find a vein. In this case would you code for the PICC line and if so what CPT/HCPCS code would I code? If they are using a machine to help find a vein I believe it...
  12. H

    Drug screening code 80307

    For anyone that codes for ER department is coding for a drug urine screen code still 80307 or did the code change to something else? On the UB it states G0480 and then on the system that I look at to code I still have 80307. I just wanted to double check that I didn't miss any changes on this...
  13. H

    Implant codes c1725, c1769, c1760

    I have a few accounts where these HCPCS codes are denying (all rev codes 278). Does anyone else having the same issue (It is BCBS and these implants denied reimbursement). I was wondering if you have come across this issue what you have done to resolve it.
  14. H

    80307

    I am not sure if anyone is having the same issues on er visits but we are billing 80307 and it is denying. Excluding medical necessity is there another HCPCS code that we need to change that will cover or anything else? Thanks in advanced.
  15. H

    Rnfa

    Does anyone work for a hospital and bill for RNFA (Registered Nurse First Assistant) services? My hospital is interested in billing it and want to get more information how to do so.
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    Implant HCPCS codes

    I keep receiving denials on HCPCS codes (C1725 and C1760) rev code 278. These items so not meet BCBS TX Implant reimbursement policy that states the item must remain in the body and cannot absorb. I have gotten a couple of these and not sure how to resolve this. Has anyone gotten a similar...
  17. H

    HCPCS CODE FOR Busiprone

    I am unable to find the HCPCS code for Busiprone. I looked in the HCPCS and not seeing the drug in the table. The generic name is Buspar.
  18. H

    G0463

    I have an account that got denied due to not being a covered code. I double checked and this is a valid code for the dos provided (2018). Then I was trying to see if this code had a LCD or NCD guidelines to see if this would help me out. I am AAPC coder and I am unable to find anything. Does...
  19. H

    Hydration

    I need a quick refresher on IV hydration: Rocephin (IVP)- 15:32=17:58 96365/96366 Sodium Chloride: 15:00-17:58 96361 Since the Sodium Chloride is performed by itself for 30 minutes I am able to add the 96361?
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    Health Panel (80050)

    I am working on ER account and have been getting a couple of denials on some accounts where they do provide 80053, 84443 and 85025 and the insurance wants to delete those codes and change it to a general health panel. Someone did tell me that since it is an ER visit this doesn't apply. I have...
  21. H

    J7030--Age limit

    I have been getting multiple denials from Medicaid for J7030 for not being paid for age limit. I had 3 accounts and only 1 paid for that code and the patient was 16 years old. The other claims the patients were older and it was being denied. I wanted to know if anyone is having the same issue? I...
  22. H

    Atlertative to 3M

    Hi guys So my company can not provide 3M for me because it is too expensive and they ran out of licenses when I started here. Does AAPC have something similar that I can buy? Like the encoder?
  23. H

    Implant (hcpcs c code)

    So I work at a hospital and I have been getting a couple denials on HCPCS codes C1894, C1765 and other implant codes saying that they are being unbundled. I wasn't sure if there is a CPT code that was can use describing the implant codes instead of coding for them separately? I have been trying...
  24. H

    Health Panel (80050)

    I work on ER account and have been getting a lot of denials on some accounts where they do provide 80053, 84443 and 85025 and the insurance wants to delete those codes and change it to a general health panel. Someone did tell me that since it is an ER visit this doesn't apply. I have been...
  25. H

    OIG Work Plan 2019

    Hi I am going to take CPMA exam in 2019 and trying to look up the OIG work plan for the coding area so I know to prepare for this exam. I was unable to find it online does anyone know where would it be? Thanks for the help.
  26. H

    OIG Work Plan 2019

    Hi I am going to take CPMA exam in 2019 and trying to look up the OIG work plan for the coding area so I know to prepare for this exam. I was unable to find it online does anyone know where would it be? Thanks for the help.
  27. H

    Modifier for 73130

    I got a coding denial from my work saying that RT modifier 73130 is invalid and needs a valid modifier. This X-ray was performed 3 times (AP, Lateral, Oblique) on just the right side on the wrist. After all that my manager is saying that it's not billed with appropriate modifier. I am little...
  28. H

    Respiratory Failure with hypoxemia

    So I keep getting denials from Inpatient claims where they say that the diagnosis code is J96.01-Resp Failure with hypoxia, but when I look in the discharge summary I only see hypoxemia. So since hypoxia (deficiency in the amount of oxygen reaching to the tissue) and hypoxemia (abnormal low...
  29. H

    Modifier 27

    I need some help on this modifier. So I have a claim denied. Er trip #1 patient came in for other stimulant abuse (F15.10) in the morning then ER trip #2 (on the same day) came in for Nausea (R11.0) So since the patient came in 2 times within a day, would it be appropriate to append the...
  30. H

    UD Modifier

    Hello, Does anyone used UD modifier before? And if so can you explain what the modifier means? I have never seen this modifier before and unable to find the reason online. Any help will be appreciated.
  31. H

    Alcohol withrawl coding

    Hi so I have a claim that the diagnosis is F10.239; alcohol withdrawal syndrome, severe. To me that would be F10.232 because it is severe.. I am not familiar with mental health diagnosis coding if anyone have some good guidelines that they are willing to share please do. Thank you in Advanced...
  32. H

    Nutritional Counseling 97802

    Hello, So I got a lot of denials back from this specific code saying that the diagnosis code isn't covering. I have looked all over the web and I am not able to find a LCD/NCD of this procedure code. Does anyone have a link that would help me out with this? Thank you.
  33. H

    Clia 81003

    So I received a denial for an ER pt on CPT code 81003 which had a (XU mod appended), saying that the modifier appended got denied. I looked online and per CLIA instead of mod XU I can put mod QW? It is a simplified test and the test is CLIA approved...
  34. H

    Modifier Help!

    Hi, so I received a claim with 75625 and 75716 wanting those appended with a modifier. I am looking at the NCCI edits and they had a 1 by them. When I go to the claim I am still unable to append any modifier. Is this because they are bundled? These codes were denying with HCPCS C9600. I have...
  35. H

    80307 vs g0481

    Hello, So I have been getting a couple of denials from Medicare on the procedure code 80307. I looked up online and saying that if it is Medicare I can change it to a HCPCS code (G0481). Some of those denials when I change the code the diagnosis is covered. I looked up on this some, but is this...
  36. H

    Mvc diagnosis coding

    Hi I am a little weak on diagnosis coding when it comes to MVC (external cause)coding. I have a pt that hit a telephone pole and backed into them (he was the passenger). His wife was driving. I want to got with V40.6XXA because it was the passenger that got injured and his wife is the driver. I...
  37. H

    Multiple Units of 88341

    So I got an account with 19 units of 88341. I went to the MUE and allowing 9 to be billed and others are needing a modifier. I am not sure which modifier to use. I think it would be -91 because it was the same lab testing on multiple units. Payer is Medicare; they will allow 9 of them but the...
  38. H

    70544 and 70457

    Good morning, I received a denial for these codes needing a modifier (2017). I did look at the CCI edits and unable to find them on there. The locations are different, but the time is the same. Would I append a mod 59? The CPT book doesn't state any restrictions with these codes.
  39. H

    Coding Help

    Good morning, How do you code for Removal of embedded jejunostomy tube. From the medical record they just removed the tube and didn't replacement. The CPT code that I got from research is 49460. Any help would be appreciated.
  40. H

    Iv hydration

    Hi I work in a hospital and I am working on auditing IV hydration therapy coding. I haven't worked on this area in a long time and trying to understand it, but seems like I am not getting it (or overthinking it). I have an example of one which this example is really confusing me. 1. Dilaudid...
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