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  1. M

    Question Proper Verbiage for direct supervison of a Physician Assistant

    Hi, Anyone have any suggestions on the correct verbiage to place in an office note when a supervising physician is overseeing a physician assistant ie; Patient seen under direct supervision by ________ ____________, MD? Also, what are the documentation guidelines for the office note. Is it a...
  2. M

    How do you bill physician assistant claims?

    Thank you for your input. I have started a spread sheet regarding which insurances require billing under a supervising physician and require SA modifier amongst other nuances.
  3. M

    How do you bill physician assistant claims?

    Hi, Can anyone please tell me how they are billing physician assistant claims? Most insurance will not credential PA's and with that being said then we need to bill under a supervising physician. Question is: can a PA see new patients and bill under the supervising physician? Any advice much...
  4. M

    Need help with Physician Assistant Billing

    Hi, Can anyone help with this billing question please? Can a PA treat a new patient and bill under the supervising provider? Or does the PA only bill the new patient under his NPI? Some insurances are requiring that the PA bill under the supervising provider. So, I'm confused as to whether or...
  5. M

    ROS is this acceptable?

    Hi, Can you please advise what you would give credit for? Provider states in note (this is found in the HPI): "no change in energy Yes. fatigue during wakefulness Yes. no leg movements with sleep Yes. no change in memory/concentration Yes. no change in mood Yes. nighttime...
  6. M

    Home Sleep Study done in Skilled Nursing Facility. Need advice

    Found out that we would bill the SNF directly and the SNF would bill Medicare.
  7. M

    Home Sleep Study done in Skilled Nursing Facility. Need advice

    Hi, Has anyone ever encountered billing for a HST when the patient is in a SNF. We are a private group practice and not sure if we could bill this and be reimbursed. The insurance is Medicare. Any advice would be greatly appreciated. We typically bill 95806 with POS 12. Thank you, Michelle
  8. M

    CMS-1500 Line 24J NPI #?

    Hi, I am being instructed by an insurance company to use the group NPI# in Line 24J? Is that even allowed/legal? I've never done that before and I always thought it is suppose to be only the rendering physician's NPI # that goes in box 24J. Can anyone offer any advice or input on this...
  9. M

    Incident to Scenario- Please help

    Thank you Hi Kim, Thank you for the advice and will read the article. Have a nice day! Micki
  10. M

    Incident to Scenario- Please help

    Hi, We need guidance on the below scenario. Our doctor evaluates patient at first visit, second visit the NP follows treatment plan with same dx (bills incident to), then a psychologist treats patient with a new dx, then the NP follows up with patient after psychologist and adds the new dx code...
  11. M

    Is there any billable charges in this scenario? Need assistance please

    Thank you Pam! Your advice is always appreciated!
  12. M

    Is there any billable charges in this scenario? Need assistance please

    Hi, I'm hoping someone can assist with this issue. I have a provider that has gone to a skilled nursing facility to review a patients records, discuss patient care with the SNF, and download information from a BIPAP machine. Is there any billable charges in this scenario? Also, is there any...
  13. M

    Is there any billable charges in this scenario? Need assistance please

    Hi, I'm hoping someone can assist with this issue. I have a provider that has gone to a skilled nursing facility to review a patients records, discuss patient care with the SNF, and download information from a BIPAP machine. Is there any billable charges in this scenario? Also, is there any...
  14. M

    Bad Debt need advice on collecting payment

    Thank you very much for your advice and the templates. I truly appreciate it! I hope you have a wonderful day! Micki
  15. M

    Bad Debt need advice on collecting payment

    Thank you and I totally agree with you. Most of these bad debt accounts we won't even be working anymore as they are a waste of resources. There are a few that are worth pursuing in small claims court. Do you send them notice that if failure to make payment then you will be seeking judgement in...
  16. M

    Bad Debt need advice on collecting payment

    Hi, I am not sure how I should go about collecting on these bad debt accounts. We have a collection agency that won't work the secondary placement collection accounts that are old. So we have transferred these accounts to bad debt. Any suggestions on how to collect on these accounts? Thank...
  17. M

    Incident to question- please assist

    Thank you for your advice and have a nice day!
  18. M

    Incident to question- please assist

    Hi, If a Nurse Practitioner is seeing a patient as a follow up visit and following the treatment plan of the MD from the previous office visit. We bill that as incident to. My question is if the NP has added a new diagnosis that was not included in the previous office note by the MD but is on...
  19. M

    Denial CPT 95811 - Not medical facility please help

    Can someone please assist with this denial? The insurance is now wanting to do a take back stating procedure not done in a medical facility. We are a Sleep Center that bills POS as 11. We have been billing this code for years and now all of a sudden this happens. I'm not sure how to address this...
  20. M

    Need assistance with Out of Network billing policy

    Thank you for your input. Have a nice day! Micki
  21. M

    How do I fix this? Appeal or phone call?

    Thank you for your input as that was a disagreement in our office. Have a wonderful day!
  22. M

    How do I fix this? Appeal or phone call?

    Hi, I had a corrected medicare claim that was primary and a consult was billed out. The correction was made for a level 3 E/M. Medicare sent the corrected claim to the secondary insurance (Anthem) and now the secondary insurance wants to take back the difference between a consult and the level...
  23. M

    Small Balance Write off, collections, and bad debt

    Thank you for your input and you are so correct in what you stated. Definitely do not want to write off co-pays :) Have a wonderful day!
  24. M

    Small Balance Write off, collections, and bad debt

    Yes, this is a case by case basis but I was looking for a general rule of thumb or an average that other practices were doing. As of right now there is nothing in place and I was thinking on the lines that nothing less than $25.00 should go to collections and anything less than $25.00 would go...
  25. M

    Small Balance Write off, collections, and bad debt

    Hi, What is the typical small balance write off amount? What is the lowest amount you would consider sending to collections and/or just write off as bad debt? Thank you in advance for your input! Micki
  26. M

    Collections

    Thank you so much for your input. It will be helpful going forward.
  27. M

    Collections

    Hi, Does anyone know what the average collection percentage is that agencies charge the practice? I need to have a ball park figure so I can start reviewing fees from varying agencies. Thank you, Micki
  28. M

    Need assistance with Out of Network billing policy

    Hi, Can you please assist with how your office handles Out of Network claims? Do you see OON patients? Do you have a billing policy in place for OON claims? What do you do with your denials? Patient/provider liable? Do you have patient's pay the allowable or the full charge? Need advice...
  29. M

    Would there be a scenario to reduced services for a HST?

    Hi, I'm new to coding sleep studies. Would there be a scenario as to when it is appropriate to bill reduced services for a Home Sleep Test? Example if there was 6 hours of recording but the oxymeter was not on during the entire time would that require a 52 modifer? Any advice would be...
  30. M

    Need assiastance on coding for allergy serum-----Please

    Hi, Here's my situation...... I have a patient that has been receiving 5.0 ml custom immunotherapy serum injections. We don't make the serum but purchased the serum from an outside company. The company cannot supply any codes for this serum. I don't know how to bill this out. We have only been...
  31. M

    Need HCPCS code for 5.0 ml Custom Immunotherapy Serum Please help

    Hi, I hope someone can help with this. I need a code for 5.0 ml Custom Immunotherapy Serum. Any suggestions? Thank you in advance for you assistance, Micki :confused:
  32. M

    Need help with cpt coding RT SHLD Arthrogram px

    Hi, I hope someone can suggest the cpt codes for the below procedure. I am not sure that I am capturing all the charges on this. ULTRASOUND GUIDED GLENOHUMERAL SHOULDER ARTHROGRAM INJECTION CLINICAL INDICATION: Right Shoulder Pain RISKS: Risks of the injection including bleeding...
  33. M

    Please help with CPT code for injection

    Thank you very much for your input:)
  34. M

    Please help with CPT code for injection

    Hi, Can someone please advise which CPT code to use for the following injection? The office note states: "After sterile prep, under ultrasound guidance, injection of 10cc’s lidocaine was given into the anterior and posterior interosseous nerves through dorsal approach." There appears to be...
  35. M

    Evacuation of Subungual Hematoma - does cautery qualify for code

    Thank you for your input and have a nice day:)
  36. M

    Evacuation of Subungual Hematoma - does cautery qualify for code

    Hi:) Can someone please tell me if a physician cauterized a subungual hematoma would it qualify for using 11740? What would the provider need to document in the note to have it qualify for billing out the procedure? Thank you in advance. Michelle
  37. M

    New to inpatient coding 99231 or 99024--help please

    Sorry, I made a mistake the mod 57 was not used on the 02/14 visit (was a consult) but the 02/15 visit is an inpatient visit the day before the surgery for the same condition that the surgery is. So it is not a post op. How should I correctly code that?
  38. M

    New to inpatient coding 99231 or 99024--help please

    Thank you but I am still confused. Patient was seen on 02/14 decision for surgery made on that date. Follow up visit was 02/15 and surgery was 02/17. How would I bill out the 02/15 visit?
  39. M

    New to inpatient coding 99231 or 99024--help please

    Hi, I am not sure how this should be billed. No one in office knows answer. I hope I can get some quick insight here. Patient is an inpatient at hospital and has been charged for a consult with decision for surgery made now midlevel provider is doing a brief follow-up (99231) the day before...
  40. M

    ROS acceptable or not----Adivce please

    Hi, Is this acceptable or not? Provider uses a form for the Review of systems that patient fills out. There is only 8 systems listed with the associated symptoms listed with it. The patient is suppose to circle all that applies or has experienced recently; which in this case nothing is...
  41. M

    What are you using for icd 10 code for Psuedogout LT knee?

    Hello, Any suggestions for psuedogout LT knee? Thanks in advance! Mickie
  42. M

    Need help- DX code POSTOPERATIVE DIAGNOSIS: Right non-healing Achilles tendon wound

    Thank you for the advice. I wasn't 100% sure whether that was the code I should use or if I was just missing something.
  43. M

    Need help- DX code POSTOPERATIVE DIAGNOSIS: Right non-healing Achilles tendon wound

    The patient suffered a traumatic injury that required surgery. Patient had surgery and the surgical wound never healed.
  44. M

    Need help- DX code POSTOPERATIVE DIAGNOSIS: Right non-healing Achilles tendon wound

    Hello, Can anyone help with a dx code for Right non-healing Achilles tendon wound? This is post op wound complications. Thank you in advance:) Micki
  45. M

    Any suggestions for this icd 10 dx code?

    Hi, Can anyone advise what they use for a dx code for Plantar fascia interstitial tearing? Thank you in advance, Micki
  46. M

    Need DX code for ACL Deficient Knee

    Hello, Does anyone have a suggestion for ACL Deficient Knee (right)? Not sure if M23.51 is accurate. Thank you in advance! Micki
  47. M

    Stumped for a icd 10 dx code for SI Joint OA--------suggestions needed

    Thank you Thank you for your advice and have a fabulous day!
  48. M

    Stumped for a icd 10 dx code for SI Joint OA--------suggestions needed

    Hello, Any suggestions on what the most appropriate code for SI joint OA? Thank you in advance and have a wonderful day! Micki
  49. M

    Help locate new, revised, and deleted ICD 10 and CPT codes for 2016

    Hello, Can anyone help with trying to locate new, deleted, and revised ICD 10 and CPT codes for 2016? Either provide a link or guidance on where to find these. I was hoping the CMS or AMA sites would have this info but I am unable to locate. Thank you, Micki
  50. M

    Need help with CPT code please

    Thank you Thank you Penny! I appreciate your input. Have a great day!
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