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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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    Thanks for the insights!
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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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    code for skype session

    Not sure if it falls within the parameters, but you may want to research Telepsych guidelines.
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    Psychotherapy & E/M on same date, different providers

    I agree. If they are billing under the same TIN, they are considered one so they should be combining the services & using the add-on code. You may be able to dig around & find something in writting on the CMS site.
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    Provider Credentialing for Behavioral Health/Mental Health

    You shouldn't have to wait. You should be able to submit all your app's at the same time. Usually the various insurers credentialing committees meet at different times so you'll want to get them in as soon as you can. I know there is a certification you an get for credentialing through another...
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    New to Bahavioral Health, Setting up Fees

    You may want to take a look at Medicare's fee schedule for the codes you'll be using & set-up your fee at 200% of that.
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    Billing Family therapy, family members are both beneficiaries

    Just a thought, if he does 2 visits (2 separate notes), each visit focusing on 1 of the siblings, he may be able to bill 90847 for each on a separate claim.
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    Resource for Psych coding

    Hi, I've found that the Behavioral Health Services Coding and Payment Guide book from Optum is helpful.
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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

    Suzanne, thank you for the reply. I had seen that article. I am hoping someone will have something more specific that breaks down the restrictions by CPT/POS.
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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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    RHIT/RHIA Certification

    Hi jyvincent, AHIMA requires that you complete an approved RHIT program before they allow you to take the test (at least this is how it was the last time I checked). If you go to the AHIMA website you can find out which colleges in your area or online offer an approved program. Good luck! :)
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    Psychiatry - Do any of you have psychiatrist

    Yes, when med mgmt isn't the sole purpose of the visit and more is involved. They use both options depending on the visit, Hx/Exam/MDM when the visit isn't dominated by counseling/coordination.
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    Medical Records - Bound or Not Bound

    Our physicians work within the hospital and the hospital's medical records are bound and organized. They use a simple folder that has a metal fastener at the top on each side of the folder when you open it. Of course, now we are EMR though (thank goodness!). I agree with you, they have more of...
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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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    coding jobs going to India

    In a casual conversation with one of my docs he mentioned this would probably eventually happen. It is disturbing to think our medical info would go outside the country. I wonder, and would hope, they would have to abide by HIPAA. It also upsets me to think more of our jobs in the US are...
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    New Healthcare Bill

    Here's a link for more info on what's going on:
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    New Healthcare Bill

    The bill has changed so much since the beginning that I am not sure what we are and aren't getting. I am concerned about how it will affect everyone in general. I don't think it will affect coders jobs negatively. If anything, I think we'll be even more needed because of the increase of people...
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    ER to Inpatient

    Hi Leslie, Thanks, so, for example (non-Medicare): patient is seen by consultant in ER on 03/02/10, another doctor admits the patient on 03/02/10, the hospital changes the status to inpatient admission date of 03/02/10 (i.e., patient was admitted from ER and is an inpatient from 03/02/10 to...
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    Physician's and residents

    I am in Hawaii. Our carrier used to be Noridian and now it is Palmetto. I don't know if our local carriers were ever asked about the pre-printed paper note (these were used prior to me working here) but we work within a hospital so I would think if it had been a problem the hospital wouldn't...
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    Physician's and residents

    We bill for our supervising physicians who see patients with residents and have pre-loaded attestations in our EMR. Here's an example of what may go on the bottom of the resident's note: I saw the patient on 2/15/10, performed psychiatric evaluation with psychiatry resident, Dr. X, and...
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    ER to Inpatient

    Hi Leslie, Thank you for the info. I am mainly wondering about non-Medicare patients; anyone? Thanks!
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    Going from coder to supervisor

    I know DeVry offers campus and online AHIMA approved programs (RHIT and RHIA). Good luck! :)
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    ER to Inpatient

    OP Consult vs. IP Consult in ER I am trying to understand this, so if a patient is seen in the ER and admitted: The consultant (just a consultant, not admitting doctor) would bill an OP consult code even though the status changed to inpatient? I would think it would be an inpatient consult code...
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    Auditing Psych notes

    I also used the CPT Handbook for Psychiatrists and Coding & Payment Guide for BH to estabilish criteria for auditing psych. We do random audits - pre & post billing. We have an EMR that lists the type of note at the top.
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    Psychiatry in Residential Care Facility

    Hi Jennifer, I would say the 99304-99310 because in the CPT guidelines for "Nursing Facility Services" it states that "these codes should also be used to report evaluation and management services provided to a patient in a psychiatric residential treatment center..." Hope that helps.
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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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    Billing 90862 for a Medicaid patient

    Hawaii Medicaid also accepts 90862. I wonder if they are denying you because of frequency limits or the diagnosis not supporting medical necessity. In Hawaii, a patient is allowed only 12 in a given year.
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    RHIT/RHIA Certification

    Telecommute I am wondering other people's thoughts on if having a RHIT and/or RHIA certification, in addition to the CPC, would open up more opportunities in obtaining a telecommuting position? And, is a RHIT sufficient or should a person just go straight for RHIA? Thanks!
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    inpatient consults

    For us, the subsequent visit codes aren't changing; it's just the initial visit that changes because of the consult codes, for CMS, being eliminated. Depending on the service, you can use the inpatient subsequent codes 99231 to 99233, psychotherapy codes, or Rx management codes. :)
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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

    Great, as always, thanks Kevin! :)
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    Academic Hospital - ER Coding

    Thanks everyone for the comments. I agree, bundled. :)
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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

    They do initial evals and E/M services. I told the doctor asking this question that if a patient is seen more than 1 time in a day all services would be rolled into 1 code. The concern is if they are doing a 90801 they won't be able to bill anything in addition to that for the follow-up visits...
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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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    90801 and 90847

    Per the Medicare CCI edits, mutually exclusive table, you can bill 90847 as the primary code and 90801 with a modifier (modifier 59). Depending on the payor it may or may not be paid.
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    Hi Rinny, I had to create my own. I'll be happy to send you what I got. Just send me a private message with your email address. If anyone else wants, just send me your email address.
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    Nursing Home - Need Inputs

    That's interesting. Please share what their denial reason is. Thanks!
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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?

    Thanks, they wouldn't be inpatient. Still in ER area.
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    Can I bill a 90801 again??

    Funny I was just re-reading about this today in the CPT Handbook for Psychiatrists. It states that a 90801 is not a timed code, but the initial eval generally takes 45 minutes to an hour. In instances where the eval would take longer than that, the CPT, modifier -22 should be used. Be sure to...
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    Consult or 90801?

    Thank you for the response. Do you, or anyone out there, have patients that come into the ER and stay for a day or so after they come in? Our Dr's do a follow-up visit the next day and aren't sure how to bill that. I spoke to another coder that said to use the estabilished outpatient visit codes...
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    What society does your provider belong to? AMA