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  1. H

    LTAC Inpatient billing

    Hoping someone can help or point in right direction Patient is Inpatient with Medicare Part A (no Part B coverage) and Husky C as secondary for Husky our contract is to bill all inclusive-by day for room and board and all charges as one. What would you do in the instance that we can not bill...
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    Pos guidelines

    I work at an LTACh facility that bills Inpatient and Outpatient services. my question is-if a patient is here for Inpatient admission, we bill POS 21. If he leaves our facility to go to Dr.s office (different Tax ID POS 11) for services we can not provide. How does the Dr.s bill Medicare to...
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    new angioplasty codes

    Hi!! i am having a really hard time understanding the new 2017 codes--can someone help me with this op note ? walk me through it? or give me the best articles-i dont have the best resources(i.e nothing that cost anything) thank you 1. Left brachial approach second order aortogram.2. Bilateral...
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    Bariatric surgery w/ hiatal hernia

    I usually code basic general surgery so i am unclear on specifics for bariatric cases-any info is appreciated Mainly-can you bill a hiatal hernia repair with a lap bypass or sleeve? My coding software says no but my physician says yes! it does say modifier 59 allowed but i dont see it as...
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    Hospital consults

    our office is a private owned office and we team up with another surgical practice for on call--if a patient has a procedure done with Office A can office B bill the post op/follow up care? thanks for any info!
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    General Surgery ON CALL ??

    question our office paired with another general surgery office for on call dates now I run into the issue if office B does surgery on Thursday but office A is on call next day plus weekend-are those progress/post op notes billable for office A? DIfferent TAX ID's and address but its post op...
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    debridement and flap

    im curious to see if im even close with this coding-is the closure billable since flap was not created? The patient was placed in supine position on the operating table and general inhalation anesthesia was induced. The open right transmetatarsal amputation was prepped with Betadine solution...
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    reversal of gastric bypass code??

    ive seen revisions but not a reversal so im a little confused ATTEMPTED ROBOTIC REVERSAL OF GASTRIC BYPASS, UPPER ENDOSCOPY, CHOLECYSTECTOMY, INSERTION OF J TUBE AND G TUBE, SMALL BOWEL RESECTION, GASTROGASTROSTOMY, REVERSAL OF GASTRIC BYPASS. LYSIS OF ADHESIONS (Modified if anyone is willing...
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    Ncci

    so we have ultrasound codes that we bill for in office-same codes 93880, 93923-93926, 93970 now these are on ncci list-some with 9 and some with 1-we are having a difficult time getting paid when 2 or more of these u/s are done on same day- can someone please run through or give some...
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    pacemaker coding

    im new to this type of coding and thought I figured out battery changes and insertion-I don't think I did does anyone any suggestions for training purposes? I keep rereading the cpt book but claims keep coming back! any help is appreciated thanks
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    mutually exclusive

    I need some help regarding 3 codes 93924 93925 93926 they are always scheduled on same day (all 3 or combination of 2) and not always get paid-I need help understanding the MU edits better ive read through the medicare guidelines and still cant explain it to schedulers correct basically 93924...
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    op note help needed!!

    this patient has no bariatric coverage-dr. wants to put through as gastrectomy-im seeing revision of bypass can anyone help? I know op note is lengthy but any help is appreciated!! Specimens Removed and Size: 2 specimens. The first was the gastrojejunostomy with a posterior penetrating ulcer...
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    Bariatric question???-done laparoscopically

    when removing a lap band and converting to gastric bypass-all done laparoscopically- would this be coded as just a new bypass 43644? the removal would be included, right? thanks for any help
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    IVUS coding

    Ive never come across an IVUS procedure and not sure where to start 37252 and 37253 are both add ons any help is appreciated:confused: The patient was brought to the endovascular suite, placed in a Supine position,and draped in routine sterile fashion. right groin region were prepped ...
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    op note help

    so im very new to coding for our vascular surgeon and im getting something different from him on my first note-any help is appreciated The patient was placed in supine position on the angiographic table and intravenous sedation was given. The left groin was prepped and draped in standard...
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    Need help

    sooo the coder we had is no longer with us and now im coding vascular and bariatrics (usually im thoracic and general) Im having a tough time with vascular-always have. what are some good training books/webinars? TIA
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    multiple lipomas

    we have a pt who had 22 lipomas excised-all path came back as lipomas I have codes but on the modifiers would they be -50 or multiple units since 9 were performed on arms or are they all individual with -59 and -rt/lt? thank you!
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    Ultrasound BEFORE office vist

    so we have a vascular surgeon who does u/s done on patients(new patients) prior to their initial office visit-but when billing we bill (i.e 93970 on 11/3/2015) and now our 99203(on 11/05/15) is null and must be a 99213?? these were just examples to show dates and np vs est. is there any way to...
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    chest wall implant excision

    so im not sure where I would even go with this op note -im going towards 19260 but it still doesn't fit any help is appreciated Operative Note Patient 65-year-old woman admitted for left upper lobe resection. The lesion was consistent with a carcinoid tumor, and plans are made for robotic...
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    43280 outpt only???

    we have a denial for this claim-the procedure was done as inpatient. I know we called prior to surgery for auth-they did tell us surgery needs to be outpatient for payment. Surgeon still wanted to keep as inpatient-looking through notes of inpatient only list-it doesn't look I should appeal...
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    Medicare non covered diagnosis

    we have a patient whose surgery was denied as noncovered diagnosis for medicare-patient does have Medicaid secondary-is that billable to billable to Medicaid?
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    Evlt ???

    Can a PA bill for an EVLT 36478 procedure by herself-the description says physician and on policies Ive been looking at-it doesn't specify (unless im completely looking in wrong place) Thanks for input!!
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    lung op note help

    can anyone walk me through this op note please TITLE OF OPERATION: Exploratory thoracotomy with resection of superior segment, right lower lobe and wedge resection, right upper lobe with nodal sampling. An On-Q pain pump was also placed. DETAILS OF THE PROCEDURE: The patient was brought to...
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    included or unlisted???

    im having trouble with the 'biopsy of bladder' portion of this note-any help is appreciated DETAILS OF PROCEDURE: The patient was brought to the operating room and placed in the supine position. Following the induction of general anesthesia, placement of bilateral lighted ureteral stents...
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    lipoma excision

    just to settle a discussion-would this code be from 114xx or 21xxx path report came back as adipose consistant with lipoma thanks!! NARRATIVE: This is a pleasant 53-year-old male growing a lipoma in the posterior portion of his neck. It is becoming more painful to him and he would like to...
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    Help with an op note????

    Ok I feel like im over coding and have too many codes-which may or may not be correct any help walking me through this is appreciated! DESCRIPTION OF PROCEDURE: ...... The 12 mm Airseal port was placed in the right lower quadrant, a 5 mm port was placed in the right mid abdomen, a 12 mm port...
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    Bariatric question???

    If someone is having complications with a gastric band and decide to have a bypass...would you ever bill 43774 and 43644 together?? im thinking this would be bundled..maybe a -22 if note qualifies. a co-worker thinks just because BCBS approves BOTH procedures BOTH s/b billed and paid TIA:)
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    Revision of Gastrostomy tube

    For some reason I feel like im reading the same sentence over and over again- I keep coming up with lap codes or open that don't seem to fit--any help is appreciated NOTE On the day of surgery, she was brought into the Operating Room and placed in supine position on the Operating Room table...
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    New coding software

    our office is looking to update and get new coding software/emr everything. we currently use optum encoderpro for physicians as part of our coding software-does anybody have any other suggestions for coding software? thanks
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    coding supplies?

    so, we have an "angio center" in our office, where our vascular surgeon can perform his cases...aside from the cpt codes can we bill for supplies?? like radiology material,catheters etc?
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    there is no easy hernia repair to me...

    i seem to always have trouble with abdominal hernia repirs OPERATIVE FINDINGS: Included approximately 3 cm separation of the rectus muscles from the xiphoid to the umbilicus. There was incarcerated preperitoneal fat. There was a small umbilical hernia defect. There was excellent coverage of...
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    recommendations for EHR

    My office might be the only office not on EHR but we are finally looking into it. we've checked out a few and the dr.s were not impressed...any suggestions? hopefully we can have our billing and clinical on same one and get rid of dictation/transcription service Thank you:D
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    Medicare remits

    I cant find any information on a new adjustment code used for medicare for all the fees/cpts payable 223 Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code can be created. thanks for any help:)
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    Resection of epiploic appendage cpt?

    ok 44238 was billed for the epiploic appendage-op notes sent in and was denied any others codes i overlooked?? TIA DETAILS OF THE PROCEDURE: The patient was brought to the Operating Room and placed in supine position. Following induction of anesthesia, she was prepped and draped in the usual...
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    Mesenteric cyst excision

    which code is appropiate for laparoscopic version of 44820-Excision of lesion of mesentery (separate procedure)? Would it be the unlisted 44899-usually unlisted codes state if procedure was done laparoscopically or not Thank you
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    Incident to Billing

    Can someone verify how to fill out CMS-1500 if we are billing incident to with a PA in our office? I think our software is filling them out incorrectly based on what we've read Thanks:D
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    Pqrs - non covered charge

    We are billing PQRS codes but they are coming back as non covered charge. Shouldnt they be coming back as approved. am i missing a step? Thanks
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    PA billing

    Can anyone give me a quick run down on PA billing...Ive read and re-read multiple articles(including medicares guidelines) but I just want to make sure I completely understand Thank so much!!
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    umbilical hernia, appy, epiploic appendage op note??

    I could use some help with this note...the codes im thinking are open and I dont think I can charge for appy but want to make sure, I still get confused when its performed at time of other surgery-it appeared to be healthy. Then the whole epiploic appendage kinda through me for a loop...any help...
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    Post op billing???

    ok I'm confused with a couple op reports for the same patient... 01/15/2013- partial colectomy, splenic fexure mobilization,adhesiolysis, repair small bowel tear "small bowel tear occured during adhesiolysis"--44204, 44213 01/21/2013-segmental small bowel resection "the site of previous...
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    banding in office

    Sooo... my dr started doing hemorrhoid banding in office, he received a quick reference from company he is using on billing. They state you can bill 46221-Ligation of hemorrhoid by rubber band 46600-Diagnostic Anoscopy(use -59) 45300-Proctoscopy (use -59) A4550-Surgical Tray office visit code...
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    Pqrs ??

    Starting PQRS, we have 4 surgeons in our office. To avoid ALL penalties does EACH NPI need to be submitted or jus t ONE NPI as long as they are all on same tax ID? I did read through the manual but just not sure. Thanks for any help clearing this up for me
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    anterior resection op note

    i need help breaking down this note PROCEDURE: The patient was brought to the operating room and placed in a supine position. Following induction of general anesthesia, wide ureteral stents were placed by Dr. and this will be dictated in a separate note. With the patient in the modified...
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    hernia help

    patient is status post inguinal repair...comes in because of pain. has groin exploration, excision of hernia mesh and neurolysis performed. I always get confused on hernia mesh removal since 11008 is an addon and NO debridement was performed. and would 64708 be correct for neurolysis or would...
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    whats bundled?

    Pt came in 2 weeks ago had Extended ileocolectomy with transverse colectomy and en bloc small bowel resection. This was followed by wedge resection of subserosal gastric nodule. came back yesterday-op note.... FINDINGS: Operative findings included a large amount of purulent material within the...
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    hernia coding - I just want to double check

    I just want to double check--i am only seeing one repair for hernia, right, even though it says umbilical hernia was after inguinal--but doesnt dictate inguinal, before i go ask to redictate his note,because thats always fun FINDINGS: Operative findings included approximately a 1 cm umbilical...
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    colostomy procedure

    this patient had a colectomy 2 wks prior-im thinking this is more than just a colostomy code thanks .......... There were some adhesions from small bowel to the area of the anastomosis and these were carefully taken down. In the region just above the anastomosis there was ischemic and...
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    mesh removal with hernia repair

    can mesh removal be coded separetly from hernia He was then prepped and draped in the usual sterile fashion using ChloraPrep. A previous infraumbilical incision was opened. This was extended approximately a centimeter to left and right. This was carried down through skin and subcutaneous...
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    terminated port insertion??

    my doc started a port-a-cath insertion on left : Initially the left chest was prepped and draped in standard fashion. Local anesthesia was injected below the clavicle. The subclavian vein was needle punctured. Multiple attempts were made to advance the J-guidewire through the subclavian vein...
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    lap 44661

    my surgeon did cpt 44661-Closure of enterovesical fistula; with intestine and/or bladder resection --only laparoscopically. I did bill an unlisted lap code but was denied stating there is specific procedure code for this service. Can 44661 be used for open and lap?? Thanks for any help
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