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    Identified Over Coding

    I am trying to get a sense of what other compliance programs are doing in regards to identified over coding in relation to E/M services. For example, a provider may report new patient E/M 99204; however, upon an annual internal audit the PFSH was incomplete or there were only 9 ROS documented...
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    Moderate (conscious) Sedation ADMINISTERED and monitored by hospital employed nurse

    I am trying to obtain clarification of when moderate sedation can be reported by the same physician performing the diagnostic/therapeutic service when performed is a hospital setting. Is it appropriate to bill 99151-99152 if the moderate sedation if it is ordered by the physician, but is...
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    Compliance Audits

    I am aware that each state has laws regarding medical record retention. Are there any publications that specify how long compliance audit reports are retained. Thank you
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    Modifier 57 for Renal Transplant H&P

    Thank you both for your input. The next argument from the surgeons is that the initial evaluation and decision for surgery may have taken place 6 months to a year prior to the date of surgery due to patients being placed on a waiting list for the transplant organ. Therefore it is medically...
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    Modifier 57 for Renal Transplant H&P

    I have transplant surgeons who insist on billing for the H&P for a renal transplant with CPTs 99221-99223 with modifier -57 to indicate a decision for surgery. I have advised them that the H&P is bundled into the major surgery global package, and it should not be separately billed. The patient's...
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    Medicare Teaching Rules

    I am currently coding/auditing for a teaching institution. I am trying to obtain coding guidance in regards to inpatient consultations performed by a resident, and the attending does not see the patient until the following day. Since Medicare does not allow consultation CPTs, these are...
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    The Coding Network

    Has anyone had recent experience working for the Coding Network as a remote coder? I have seen some not so great reviews from the past (2013 and older). Most of the feedback I found was regarding the hiring process. Sounded like the testing for the hiring process was outdated with the use of...
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    Teaching institution/ GC Modifier

    In a teaching institution does the teaching physician attestation statement/ GC modifier still apply when the resident performs the history, exam and medical decision making, but the teaching physician documents the entire encounter? It is almost like the teaching physician is being a "scribe"...
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    Pulmonary Critical Care

    In relation to Pulmonary Critical Care, the provider documents that the patient's critical condition is respiratory failure. The patient had been intubated and placed on a ventilator on a previous DOS. The decision is made to begin spontaneous breathing trials and weaning the patient off of the...
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    Urodynamics Split Billing

    I am trying to obtain information of how to bill for urodynamics that were performed by an NP, but interpreted by a physician on a separate date. Both providers are in the same practice, and own the equipment. Is it appropriate to bill for example: 51728,TC under the NP on the date the test was...
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    Modifiers 26/TC

    I am trying to obtain information of how to bill for urodynamics that were performed by an NP, but interpreted by a physician on a separate date. Both providers are in the same practice, and own the equipment. Is it appropriate to bill for example: 51728,TC under the NP on the date the test was...
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    HCCS Remote Coding Positions

    I am looking for feedback from any individuals Regarding HCCS HIM Services located in Fort Myers Florida. I have recently been contacted by HCCS for a remote coding position, and would like to make sure this is a legit business. Has anyone had any experience with this company? I would greatly...
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    Hospital Care during Global Prenatal

    This pateint was seen in our office for 6 routine prenatal visits. She was then admitted to our hospital @ 27 wks for placenta previa, and was hospitalized until delivered via C/S. Pateint was seen in the hospital 5 times before her C/S.Patient has global ins carrier (BCBS). Do I need to append...
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