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    HCC Drop Tables

    Does anyone have a link they could share where I can find the Disease Hierarchy spreadsheet showing which HCC catagory trumps another? For example, it shows catagory 8 is higher than 9 so 9 would be dropped. Thanks!
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    Referrals for screenings

    If the PCP is referring the patient out for a screening (i.e., mammo) and the patient does not have any symptoms (it's just for a regular screening), what Dx would you use? We can't use V70.0 because the patient is in for a follow-up visit nor the V76.1x codes because that's for the actual...
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    250.70, 443.81, 443.9

    Has anyone seen where the doctor will assess that the patient has DM II w/ peripheral angiopathy and separately assess PVD, coding all 3 with 250.70, 443.81 and 443.9? Thoughts/comments? Thanks!
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    Cardiology training

    Hello, Does anyone know of where I could learn cardiology coding? Any courses, training materials, books, etc. Looking for something that would teach the basics to the advanced...a step-by-step education for someone new to the specialty. Thanks!
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    Hi Coders, I am wondering what other's thoughts are on the new CIC certification? I also wonder if it's comparable to RHIT and would offer the same job opportunities...any thoughts/comments? Thanks! Donna
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    Medically Unlikely Edits Archive

    Does anyone know where I can find the old Excel spreadsheets for MUE's? I am looking for 2010 & 2011 (needing to see UOS). Thanks!
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    CPT restricted to certain POS codes

    We are being denied for invalid POS for 61070; does anyone know where I can find a listing that shows what POS codes are allowed with this CPT? The payer does not have a listing for us & just stated they use Encoder. I tried searching CMS but had no luck. We are hoping someone knows of a...
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    Physicians On-call Schedule Software

    Does anyone know of a good software or online program to use for physician on-call scheduling? My doctors cover different areas in the hospital 24/7 and I currently have to update the schedules manually using Excel with Macros. Thanks!
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    Clinical Documentation Improvement (CDI)

    Just wondering if anyone has the Clinical Documentation Specialist (CCDS) certification through acdis? Any opinions on how this has helped you or any other comments? Thanks
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    Rx Management

    Happy New Year, Everyone! I need your assistance/comments, a psychiatrist goes to a nursing home for prescription management of an estabilished patient but doesn't see the patient. He reviews the chart and discusses patient care with clinical staff. Can he bill a 90862 or M0064? In what I've...
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    Anybody been using Telehealth (telepsych)? If so, are you seeing reimbursements from insurances? Thanks,
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    Code for emergent restraint IP encounter

    Patient has been inhouse for a few days. Attending physician sees patient during the day for follow-up visit. Afterhours the patient becomes combative. The on-call physician is called in for restraint order. I looked at the note and was thinking to code as 99232-25 since the attending already...
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    Academic Hospital - ER Coding

    If a psychiatrist or multiple psychiatrists (same group, billing under 1 tax ID) sees 1 patient on the same date of service at the ER what code(s) would you bill? Our patients come into the ER and sometimes stay for awhile. Within an 18-hour period they may be seen between 2 and 3 times...
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    Prolonged Service Codes

    Does anybody use these? Any issues with payers? Thx!
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    Geriatric Psychiatry

    If one of our general psychiatrists asks that one of our geriatric psychiatrists comes sees his patient (inpatient floor, physicians within same group), can we bill a 90801 or does it have to be an inpatient consult code? (The general psychiatrists did a 90801 initially now the geriatric...
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    Consult or 90801?

    Our psychiatrists provide a consult service for the ER. The ER has a separate area for psych patients. There are 2 scenarios: 1. Patient goes into a medical room (not the separate psych area), seen by ER Dr because they may have physical conditions, then if needed he requests a psych consult...
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    Place of Service (POS)

    Hi, one of our psychiatrists has started to see patients at Life Foundation. They are a non-profit organization dedicated to stopping the spread of HIV and to assist people who are living with HIV and AIDS. The services offered there are programs such as AIDS case management, school based AIDS...
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    ED to Inpatient on Same Day

    Scenario: Patient comes into ED, Dr. A bills a 90801. Patient admitted to inpatient from the ED (same day), Dr. B bills 90801. Dr's are within the same group, same specialty. As a group should we only be billing 1 of the 90801s? Dr's say patient may need an eval when they come into the ED then...
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    Same DOS, Different POS

    Dr sees patient on the day of discharge at the hospital. Patient presents to the outpatient clinic for follow-up on the same day as discharge. Dr is asking if he can bill a 90862 (med mgmt) for the clinic visit in addition to the 99238 (discharge) since they are 2 different places of service...
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    Teaching Hospital - bundling

    Scenario: Resident sees patient in ER and calls attending to discuss. Patient discharged (only physically seen by resident). Patient comes back into the ER the next day; this time is seen by the resident and attending. Can these 2 days be bundled and billed by the attending? (He seems to recall...
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    Place of Service Code

    Hi, the hospital is a major medical center. A portion of the hospital is a locked psych ward. Would the place of service be 21 Inpatient Hospital or 51 Inpatient Psychiatric Facility? I was thinking 51 would be if it was a stand alone psych facility. Thanks!
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    Charge Tag/Superbill

    Hi, I am in the process of re-doing our charge tag (superbill) and was wondering if anyone could share examples that their psych doctors use? Thanks!
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    Does anyone have an E/M template for documentation geared towards Psych? Thanks!
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    DSM-IV to ICD-9

    Hi, I can't seem to find a nice pocket-sized ICD-9 resource for my physicians. 1 of them gave me a laminated booklet of DSM-IV...not sure where this came from. Most of the DSM-IV seem to crosswalk, but I rather give the Drs ICD-9 since they need to bill with that. Any thoughts? Any resources you...
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    Estimated Length of Stay (LOS)

    Hi, does the estimated LOS need to be documented for 90801? One of our Docs thought he read that somewhere. I haven't come across anything saying it's required. Thanks for your input!
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    Late entry

    Are there penalties for entering a note late? Thanks!
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    ER to Inpatient

    Scenario: Patient comes into ER, psychiatrist is asked to consult and determines patient should be admitted to psych floor. The attending, within the same psychiatrists' Dr group, evals the patient on the psych floor on the same day as the ER visit. Can the consult in the ER be billed from the...
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    Late Entry

    Resident and attending physician saw ER patient on 08/23/08. Resident finished/filed note on 08/23/08. The attending didn't add her PATH note until 09/24/08. I couldn't find any regulations on this. Can anyone tell me if we could get in trouble for the late co-signature/late note entry? Please...
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    Late cosign

    Resident and attending physician saw ER patient on 08/23/08. Resident finished/filed note on 08/23/08. The attending didn't add her PATH note until 09/24/08. I couldn't find any regulations on this. Can anyone tell me if we could get in trouble for the late co-signature/late note entry? Please...
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    Discharge Summary and a Progress Note

    Hi, Is it required that a progress note be done in addition to a discharge summary on the same day or is just a discharge summary sufficient? I think just a discharge summary, but one of our physicians thinks both are needed and wanted me to check. Thanks for your help! Donna :)
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    "no change"

    Is it ok for a Dr to put "no change" on the progress note for the Dx or do they have to actual list the Dx? Thx! :)
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    Under which ROS would you credit "Denies any other physical symptoms"? Thx! :confused:
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    E/M Psych Code - Minimum Time?

    90817 says the Dr sees the patient for approximately 20 to 30 minutes, would it be okay to use this code if the Dr only saw the patient for 10 minutes? If not, any suggestions on what to use? Thanks! Donna :confused:
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    Remote Opportunities

    Does anyone know of remote coding or remote auditor positions where travel is not involved and you can just work from home? If you know of which companies offer these types of positions, please let me know. I've come across remote jobs but they all seem to require travel. Thanks! :)
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    If the Dr doesn't document the time for a visit that is dominated by counseling and/or coordination of care, and we've already billed out the service: can I ask him to do an addendum to add in the time? or does the payment need to be retracted? Where can I find info on this? Also, where...
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    CPT Handbook for Psychiatrists

    Just thought I share what I found since Behavioral/Mental Health/Psychiatry info is so hard to find. Here's a link to a really helpful book I came across: You also may be able to find the book cheaper on Amazon. A hui hou, Donna ;)
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    E/M Psych Codes (i.e. 90817)

    Hi, can anyone share examples of documentation they think would qualify for a psychiatrist to be able to use a psychotherapy E/M code (90817, 90819, 90822)? I am reviewing my Drs notes, he did a mental status exam, is that sufficient to qualify for psych E/M? Thx!!! :)
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    Psych E/M Code with Modifier

    I am not sure what modifier to use on a 90817 (Psychotherapy w/ E/M) when billed with 90853 (Group Psychotherapy). 25? 51? Thanks for your help! :)
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    E/M Times

    If a Dr sees an inpatient for 10 minutes, can they bill 99231 (this code says the Dr "typically" spends 15 minutes with the patient/on floor)? I thought I read somewhere the time has to be equal to or greater than 15 minutes, but I can't find that documentation. Thanks for your help! :)
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    Consult within Same Group

    If Dr. A sees a patient for 99251 (inpatient consult) and Dr. B sees the same patient on the same day for 90801 (initial psych eval) or any other service (i.e. 90862 medication mgmt), the Drs are within the same group, can they both bill? Thanks! Donna :)
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    Time Based Consult in Teaching Facility

    I am new to E/M and trying to understand how to have our residents and teaching physicians (TP) correctly document an inpatient consult. This is my understanding of what's required...please provide feedback: 1. Total time of visit (entered by resident). 2. Reference that visit was >50%...
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    Time Based Visit

    Hi, I am new to E/M coding and trying to understand how to document a time based visit (counseling &/or coordination of care >50%) for Psychiatry. My understanding, is they only have to document: 1. Total time of visit 2. State that visit consisted of >50% counseling and/or coordination of...
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    Marshfield Clinic Points System

    Hi, I've been looking online to try & find clarity on how to use the points system. I have some books that I've been using to study E/M chart auditing. They have audit tools with points in the MDM tables but I am not sure what it means when a catagory is given 3 points - do I assign a point per...