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  1. P

    Medical Supervision modifier questions

    if the anesthesiologist is supervising 2, 3, or 4 concurent procedures we use Qk, for the CRNA we use Qx
  2. P

    Billing two E/M on the same DOS for separate providers in the same office

    we are able to bill if they're two different specialties...one will need a 25,27 and if a patient has medicare , it requires a G0 condition code. hope that helps.
  3. P

    well child components

    do you bill the well child components for all insurances? we used to write them off if an insurance didn't pay for them, but now our manager wants us charge for them, which I disagree with.... I think it should only be for the medical assitance etc. (we had an audit in 2013 that said we needed...
  4. P

    well child components

    do you bill the well child components for all insurances? we used to write them off if an insurance didn't pay for them, but now our manager wants us charge for them, which I disagree with.... I think it should only be for the medical assitance etc. (we had an audit in 2013 that said we needed...
  5. P

    G0402/g0463

    if the patient complains of any other issues above and beyond the IPPE we charge the G0463 but i wouldn't use the Z00.00 dx (example: oh by the the way doc, I have stomach pain.... and the doc examines them, orders labs, xray) if they have no other dx, then i wouldn't be charging the E/M G0463
  6. P

    Gardasil 9

    that is what we use too....maybe the insurance company needs to update themselves? we haven't had any problems :)
  7. P

    Preventive, Breast Pelvic, and Pap for Medicare Patient

    At the clinic i work at, it's our policy to bill the preventive px with a GY mod and then reduce the price of it by subtracting the cost of the G0101 (if at least seven components were met...) and Q0091 example 99397-Gy $246.58 G0101 -78.95 Q0091 -75.71 TOTAL $91.92 for px
  8. P

    99212 vs. G0463

    I work at a clinic/hospital where we do provider based billing (PBB) so we use both G0463 (the technical) and a 99212 etc (professional side)
  9. P

    allergy shot coding

    in MN we would code 95117 with dx V07.1 hope that helps
  10. P

    Influenza 87804

    in minnesota, we are able to bill it as 87804X2 and haven't had any problems
  11. P

    GI screening colonoscopy for MCR advantage

    I may be way off on this but 210.3 "benign neoplasm of floor of mouth" is not relevant to the colonoscopy-- do you have to have that code on there?
  12. P

    CPE denials...

    we get these all the time...people always call and want us to change it to an office visit or vice versa, but if they came in for a px there's nothing we can do. It's their responsibility to know whats covered BEFORE they come in, not after :)
  13. P

    What modifier can I use for 77001

    we have only been ablle to use this code once per day per patient....the 26 is only the professional side of the code
  14. P

    Medicare and Rabies shots

    you could try putting a GY mod on it?
  15. P

    Testosterone Injections

    we still use 96372 if the nurse gave the shot....
  16. P

    Coding from the "Procedure Title"

    I would say it's bad practice to use the title....we require them to say they made it all the way to the cecum etc....do they do this for an EGD too? we require them to say they made it to the duodenum.
  17. P

    TC modifiers for radiology in hospitals

    I'm in MN and we use TC all the time, but we're provider based, so maybe that's why?
  18. P

    Clavicle X-ray (twice)

    i would bill on two different lines, one with a 76 or 77 like said above.
  19. P

    CPT Code 90863

    from what I've found it says that it's not recognized by medicare for oupatient claims and it's status E-- non-allowed item or service (it's also an add on code so it would have to go with 90832 etc for other insurances) hope that helps :)
  20. P

    54056 with 17110

    when i run those 3 codes (99213,17110,54056) thru our coding program, the only thing that needs a mod is the office visit (25) so maybe the problem is the 59 on the 17110?
  21. P

    Wiki Injection Code 96372 - We are giving on two seperate parts of the body

    we bill 96372 X 2 etc all the time but has to be two different "pokes" (rt arm, lt arm, etc etc)
  22. P

    Backwards question on fracture care

    i would say he can because he's taking on the resposibility/risk of treating that patient and any follow up of it...
  23. P

    Sick visit with a well visit

    in our office (MN)we have to put the the office visit on a different claim...it's weird, but that's how they want it? hope that helps
  24. P

    Chest wall lesion

    of the skin? would just use 709.9
  25. P

    PSA's

    we use V76.44 for alllllll insurances in MN, hope that helps
  26. P

    Cleared for new medication

    I would use ADD if that is the dx they have and the reason for the meds
  27. P

    Dx code for "well child"

    we use V65.5 for feared complaint not found, happens all the time :)
  28. P

    Flu-like symptoms

    we use the 487.1 too, influenza-like codes out to linfluenza....it's one of the few
  29. P

    retained ear canal foreign body

    how about 931 hope that helps :)
  30. P

    Pre-op exam

    i would bill an office visit based off of the documentation with a dx V72.83 and with whatever reason the surgery is for (354.0? 366.9? etc etc) we do this all the time :)
  31. P

    cold bx and hot snare removal

    i would need a little bit more info, but what I'm coming up with is 45380-59 and 45385-- hope that helps
  32. P

    Lactation Counseling Advice

    we bill in under the mother but with a dx of V24.1 because they don't always have feeing problems.... hope that helps.
  33. P

    OB global, How to bill complicated pregnancy?

    we always bill office visits for anything that is above and beyond the scope of a normal pregnancy. anything else is included in the OB package
  34. P

    intradermal flu 90654

    if the patient is over 65 would they have MC? if so we would bille the Q2039 instead
  35. P

    Really need a hand with this question...

    there are many times this happens... and like previously said we can't decide what's ethical and what's not....if they can dx based on symptoms alone, we can't argue with them (ie, pneumonia....they don't always need a chest x-ray to decide if it's pneumonia, or lyme disease is common in our...
  36. P

    ROS constitutional

    I would say no also, to me, constitutional for ROS is fever, weight loss...the vitals are constitutional for the exam :) hope that helps
  37. P

    Parental Counseling

    Our practice is that if the patient isn't present we can't bill it to the patient...we would bill this to the mother (and most likely her insurance wouldn't cover it--we would use a counseling dx code)
  38. P

    Awv - np

    we have been billing the AWV out under NPP and they have been fine :)
  39. P

    Awv - What icd9 code do

    for the AWV I use V70.0 for any labs I would use screening codes or V72.62 unless they have dx (hyperlipidemia etc)
  40. P

    Groin Pain?

    if it's for a female I use 625.9
  41. P

    DOT exams

    does the patient have a medicare replacement plan? some replacement plans cover preventive....
  42. P

    Active Labor

    was she transferred because of complications? I would code the complication...
  43. P

    Admin Code - Injections

    are they denying because you're billing a 90471 with it? we can never use both at the same time so we would use G0008 and then 90472 for the next shot and for the J1040 we would use 96372 for admin. hope that helps? aw
  44. P

    billing an officd visit for OB px

    Just wanted to poll other coders to see how many places bill an office visit for the OB px. We haven't in the past and now are being told to do so, but the CPT book states that the global package includes the inital exams etc. When we've searched for more info, it seems like it's 50/50. Not sure...
  45. P

    billing an office visit for OB px

    Just wanted to poll other coders to see how many places bill an office visit for the OB px. We haven't in the past and now are being told to do so, but the CPT book states that the global package includes the inital exams etc. When we've searched for more info, it seems like it's 50/50. Not...
  46. P

    Uncooperative Pediatric Patient

    hello-- are there any other dx for this visit? if not, based on the age I would use fussy infant 780.91 or V65.5 feared complaint not found or just code any symptoms they may have had... I wouldn't use the disturbance of conduct code. hope that helps.
  47. P

    Help w/ 80076

    if it's missing ANY part of the panel, I would bill each lab seperately :)
  48. P

    Need Help with Dx code

    do you have more info? bone metabolism is just a natural process, not a dx or symptom....but does patient have a disorder? i guess I'd just use 733.90
  49. P

    DM with Microalbuminuria help

    i get two codes for this...yes the 250.80 first and then 791.0 hope that helps :)
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