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    Who is ultimately responsible for Correct Coding

    I attended a seminar a couple of years ago; where the speaker cautioned us on changes to definitions in the laws. They specified; these changes allow the OIG to look at BOTH an organization AND the coders involved for fraudulent claims. I have unfortunately misplaced the notes for this. The...
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    Spinal Arthrodesis counting

    Hello! I have a question regarding Posterior Spinal Arthrodesis. Anterior is clearly defined as interspace, Posterior is confusing me a bit. 22630 states Interspace, 22633 states interspace 22600 states single level; and the add on that follows is per segment How would we count the initial...
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    External Fixator in the OR

    Hello! We have a physician; who is using an external fixator in the OR. It is being applied to reduce the fracture so the physician can apply the internal fixation without an extra set of hands in the extremity. It is then removed and casted and/or braced following surgery. I don't think this...
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    Diabetic Wound Care Diagnoses

    When billing for Diabetic Wound Care; our LMRP suggests the patient need to have co morbidities to support the billing of the Wound Care. Our physician is listing the following in his impression Diabetes Mellitus Ankle Ulcer Peripheral Neuropathy Venous Insufficiency He debrides the wound We...
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    Hernia repairs with Excision of leasion of spermatic cord

    Hello! When billing for an inguinal hernia repair (49505), if a physician performs a spermatic cord lesion removal (55520) Is it ALWAYS separately reported with a 59 modifier. I know there is a CPT assistant (Sept 2000 page 10) that states: AMA Comment: Code 55520, Excision of lesion of...
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    ERCP with Stent exchange; and additional stent placement

    I am looking for clear cut documentation to support coding the following service: A 10FX5cm double pigtail stent was removed via snare. The CBD was cannulated. Retrograde opacification reveals a high grade stricture...A 10FX5cm double pigtail stent was inserted. There was immediate drainage of...
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    Documentation question (smoking cessation)

    I have a physician who wants to bill for smoking cessation. She did not document it in her progress note-but did in her letter to the referring provider. I do not think it is billable this way, my impression is an auditor would look at the progress note, and for the presence of a return letter...
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