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  1. J

    Family Practice and OBGYN both seeing OB patient

    Family practice doc following a pregrancy and then an OBGYN doc delivers that patient. Can the family practice doc bill subsequent hospital visits and discharge for that same patient or is it included in the total ob package? example - OBGYN bills 59400 on 1/1/2014 Family...
  2. J

    Rn doing an antepartum visit with no dr present

    Hello, I know a nurse isn't able to document all of the pertinant info in the ACOG record for an antepartum visit, without the Dr. having some interaction with the patient, but where would I find these guidelines in writing? I have a provider whom was called out for a delivery and never saw the...
  3. J

    code needed

    Is there a code for "pelvic washings"? (used for ruling out leiomyosarcoma malignancy )
  4. J

    queston on amount and/or complexity of data reviewed

    I have a physician's assistant doing the office visit, and documenting as such. There is a comment in the documentation that says "the patient was seen today by the physician assistant. The patient's chart, hpi, current meds, lab values, and pertinent clinical exam were reviewed by Dr. X. The...
  5. J

    Procrit modifier EA,EB,EC for Medicare

    I need to know which modifier to use if the patient has a dx of 285.9 and 238.72 and the hct level is above 30???????
  6. J

    modifier EA,EB,EC for Procrit

    If I have a patient with diagnosis of 285.9 and 238.72 and the cht level is 30.9. If you use EA modifier it will be denied because the hct is above 30, if you use EC modifier is will be denied because of diagnosis, is EB the correct modifier to use is this scenario, or is there another modifier...
  7. J

    j0885 medicare modifiers

    How do I know when to use EA, EB, or EC modifier with the diagnosis. Is there a listing of diagnosis that are used with each modifier listed somewhere?
  8. J

    J0885 diagnosis - I have a patient

    I have a patient with 285.9 and 238.72 diagnosis, hct level is 32.5. I am needing hlep on which modifier to use. EA, EB, or EC. I am getting Medicare denials for co-50 as not medically necessary. Any help?????
  9. J

    proper billing of services

    I have a Doctor who always does an office visit with the paring or cutting of lesion (11055 or 11056). The e/m is never seperate so there isn't a 25 modifier applied. The question is, does the Doctor HAVE to bill the 11055 or 11056 if done with the e/m visit? The question is coming up because...
  10. J

    patient seen in E.R. on Aug. 10th and admittied on Aug 11th

    I have a Dr. Who was called to see a pt. in the E.R. late Aug. 10th and did and h&p and then found out pt. wasn't admitted until Aug. 11th. What are the guidelines for dos to code for? If the h&p is billed with admit date of the 11th and the documentation states the 10th there will be issues...
  11. J

    cortisone injection

    Code J0810 has been deleted and there is no code to replace it. I found it's inclusive to the injection (20600-20610) Is this correct?
  12. J

    cortisone injection

    Code J0810 has been deleted and there is no code to replace it. I found it's inclusive to the injection (20600-20610) Is this correct?
  13. J

    need codes please

    I am in need of codes for retrograde filling of bladder, pelvic washings and peritoneal washings. Any help???:confused:
  14. J

    disposable speculum

    Anyone have a code for this?
  15. J

    Auditing Template

    Anyone have a website that lets you print templates for doing e/m audits? I am looking for the grid that you check your hpi, ros, past family social hisoty, etc.
  16. J

    No Show For Medicare Patient

    Are there any guidellines that prohibit you from billing a Medicare patient for not showing up for a scheduled appointment?
  17. J

    Any code for pt transport?

    Looking for a code that would cover the cost of bus transportation for pt to Dr. office. Does anyone know of any code? This is a request of a pt to bill out to insurance.
  18. J

    9928* done in inpatient hospital setting

    If a Dr is called to room where pt is at code status and Dr. does what is eeded but result is pt passing away- which code should be used?
  19. J

    9928* and 99220

    I understand that the e/m would be included with the observation code, but what if one Dr does e/m visit and then another Dr, same group, does the observation? I have done cci edits on the 2 codes and a modifier is allowed on 9928* but was looking for examples of this. I need to know if it's...
  20. J

    99291 and 93010

    I have a Dr who did the interp for ekg during critical care visit. It is my understanding that the ekg can be billed sep. but am seeing denials from ins. Per cpt, info stored in computer, 99090, which includes ecg, can't be billed but the ekg can correct??? Any clarification would be appreciated.
  21. J

    Subungual Abscess and f.b. removal

    :confused: I have a report that Dr did "wedge resection of nail performed to allow for adequate drainage of subungual adscess and removal of lodged foreign material" Any help on the cpt that should be used?????
  22. J

    Physically Inactive

    Looking for dx for physically inactive and history of osteoporosis.:confused:
  23. J

    featl demise 17-19 weeks and vaginal delivery

    I have a situation where a pt went to the e.r with excessive bleeding and no prenatal care. The pt went through a vaginal delivery. Would this still be billed as 59409?
  24. J

    history of rectal bleed

    Report has no current findings of rectal bleed, but pt came in with complaint of blood in stool. Tests neg for blood, but only dx given is history of rectal bleed. Any suggestions on where to locate this code?
  25. J

    dx for axilla cysts???

    I am in need of the dx for axilla cysts.
  26. J

    Q0091 and 90000

    Q0091 And 90000 -------------------------------------------------------------------------------- What if the Dr is doing a pap and handling Q0091 and other labs with handing of 99000. Are both handling fees able to be billed in this situation? Any help is appreciated.:confused:
  27. J

    Routine annual exam with ultrasounds done

    I have an issue where pt comes in for an annual exam and complains of pain, so 76700,76770, and 76856 may be ordered. The problem arises when billed out. They are denying the ultra. codes because it was done with an "annual ":) exam. I have not seen any documentation for the visit, but seems...
  28. J

    99080 - Can you please give me a description/examples

    Can you please give me a description/examples of when this code can be billed. I have a Dr who bills this for filling out the FMLA paperwork. This initiates several angry patient calls and is being billed with a $25.00 charge. Any help is appreciated!!:)
  29. J

    99441 to 99443

    Can you please give me some resources with examples of when these codes can be billed. I have a Dr who bills these out when he fills a script for a pt. This seems a little excessive, and initiates lots of angry pt calls.
  30. J

    prenatal visit and e/m on same dos

    If a patient comes in for scheduled routine appt. and during that appt complains of fall previous night and Dr does further workup for that fall would it be appropriate to count the scheduled routine as one of the prenatal visits and also bill for the office vist on the same dos? :confused: