Search results

  1. H

    LTAC Inpatient billing

    Hoping someone can help or point in right direction Patient is Inpatient with Medicare Part A (no Part B coverage) and Husky C as secondary for Husky our contract is to bill all inclusive-by day for room and board and all charges as one. What would you do in the instance that we can not bill...
  2. H

    Pos guidelines

    Thank you Debra! I really appreciate you confirming-it didn't seem right , for whatever reason to me
  3. H

    Pos guidelines

    I work at an LTACh facility that bills Inpatient and Outpatient services. my question is-if a patient is here for Inpatient admission, we bill POS 21. If he leaves our facility to go to Dr.s office (different Tax ID POS 11) for services we can not provide. How does the Dr.s bill Medicare to...
  4. H

    new angioplasty codes

    Hi!! i am having a really hard time understanding the new 2017 codes--can someone help me with this op note ? walk me through it? or give me the best articles-i dont have the best resources(i.e nothing that cost anything) thank you 1. Left brachial approach second order aortogram.2. Bilateral...
  5. H

    Bariatric surgery w/ hiatal hernia

    how about this if your feeling up to it how about revision-when he takes out a band and does bypass he wants 2 codes billed-but again i see as bundled? what would be best coding for that?
  6. H

    Bariatric surgery w/ hiatal hernia

    thank you I cant tell you how much this helps!! thank you so much-after review of this vs. op notes-it certainly wasnt billable. thank you again!:o:o
  7. H

    Bariatric surgery w/ hiatal hernia

    I usually code basic general surgery so i am unclear on specifics for bariatric cases-any info is appreciated Mainly-can you bill a hiatal hernia repair with a lap bypass or sleeve? My coding software says no but my physician says yes! it does say modifier 59 allowed but i dont see it as...
  8. H

    Hospital consults

    our office is a private owned office and we team up with another surgical practice for on call--if a patient has a procedure done with Office A can office B bill the post op/follow up care? thanks for any info!
  9. H

    General Surgery ON CALL ??

    question our office paired with another general surgery office for on call dates now I run into the issue if office B does surgery on Thursday but office A is on call next day plus weekend-are those progress/post op notes billable for office A? DIfferent TAX ID's and address but its post op...
  10. H

    debridement and flap

    im curious to see if im even close with this coding-is the closure billable since flap was not created? The patient was placed in supine position on the operating table and general inhalation anesthesia was induced. The open right transmetatarsal amputation was prepped with Betadine solution...
  11. H

    reversal of gastric bypass code??

  12. H


    so we have ultrasound codes that we bill for in office-same codes 93880, 93923-93926, 93970 now these are on ncci list-some with 9 and some with 1-we are having a difficult time getting paid when 2 or more of these u/s are done on same day- can someone please run through or give some...
  13. H

    pacemaker coding

    im new to this type of coding and thought I figured out battery changes and insertion-I don't think I did does anyone any suggestions for training purposes? I keep rereading the cpt book but claims keep coming back! any help is appreciated thanks
  14. H

    mutually exclusive

    I need some help regarding 3 codes 93924 93925 93926 they are always scheduled on same day (all 3 or combination of 2) and not always get paid-I need help understanding the MU edits better ive read through the medicare guidelines and still cant explain it to schedulers correct basically 93924...
  15. H

    op note help needed!!

    would anyone have any advice for this? thanks for taking time
  16. H

    op note help needed!!

    this patient has no bariatric coverage-dr. wants to put through as gastrectomy-im seeing revision of bypass can anyone help? I know op note is lengthy but any help is appreciated!! Specimens Removed and Size: 2 specimens. The first was the gastrojejunostomy with a posterior penetrating ulcer...
  17. H

    Bariatric question???-done laparoscopically

    thank you!! I guess im thinking of it like prep for 43644-but it is a whole different procedure
  18. H

    Bariatric question???-done laparoscopically

    when removing a lap band and converting to gastric bypass-all done laparoscopically- would this be coded as just a new bypass 43644? the removal would be included, right? thanks for any help
  19. H

    IVUS coding

    Ive never come across an IVUS procedure and not sure where to start 37252 and 37253 are both add ons any help is appreciated:confused: The patient was brought to the endovascular suite, placed in a Supine position,and draped in routine sterile fashion. right groin region were prepped ...
  20. H

    op note help

    so im very new to coding for our vascular surgeon and im getting something different from him on my first note-any help is appreciated The patient was placed in supine position on the angiographic table and intravenous sedation was given. The left groin was prepped and draped in standard...
  21. H

    Need help

    sooo the coder we had is no longer with us and now im coding vascular and bariatrics (usually im thoracic and general) Im having a tough time with vascular-always have. what are some good training books/webinars? TIA
  22. H

    multiple lipomas

    we have a pt who had 22 lipomas excised-all path came back as lipomas I have codes but on the modifiers would they be -50 or multiple units since 9 were performed on arms or are they all individual with -59 and -rt/lt? thank you!
  23. H

    Ultrasound BEFORE office vist

    can anyone point me in right direction for this? thanks
  24. H

    Ultrasound BEFORE office vist

    so we have a vascular surgeon who does u/s done on patients(new patients) prior to their initial office visit-but when billing we bill (i.e 93970 on 11/3/2015) and now our 99203(on 11/05/15) is null and must be a 99213?? these were just examples to show dates and np vs est. is there any way to...
  25. H

    chest wall implant excision

    so im not sure where I would even go with this op note -im going towards 19260 but it still doesn't fit any help is appreciated Operative Note Patient 65-year-old woman admitted for left upper lobe resection. The lesion was consistent with a carcinoid tumor, and plans are made for robotic...
  26. H

    43280 outpt only???

    any input for these outpatient only codes?
  27. H

    43280 outpt only???

    we have a denial for this claim-the procedure was done as inpatient. I know we called prior to surgery for auth-they did tell us surgery needs to be outpatient for payment. Surgeon still wanted to keep as inpatient-looking through notes of inpatient only list-it doesn't look I should appeal...
  28. H

    Medicare non covered diagnosis

    it was gastric bypass-but by the time the surgery happened-bmi was just under-that's why it was denied for noncovered diagnosis-we don't need to get the preauth for surgeries ill double check the LCDs again Thanks
  29. H

    Medicare non covered diagnosis

    we have a patient whose surgery was denied as noncovered diagnosis for medicare-patient does have Medicaid secondary-is that billable to billable to Medicaid?
  30. H

    Bill out 2 hernia repairs or just one with a 22 mod?

    unless they are noted to be in 2 completely different areas and incisions I would just use 1 plus modifier if it qualifies. Sometimes my surgeon documents 2 hernia repairs but no more than an extra 15 min for second and I don't think that constitutes a 22 mod
  31. H

    Evlt ???

    Can a PA bill for an EVLT 36478 procedure by herself-the description says physician and on policies Ive been looking at-it doesn't specify (unless im completely looking in wrong place) Thanks for input!!
  32. H

    lung op note help

    can anyone walk me through this op note please TITLE OF OPERATION: Exploratory thoracotomy with resection of superior segment, right lower lobe and wedge resection, right upper lobe with nodal sampling. An On-Q pain pump was also placed. DETAILS OF THE PROCEDURE: The patient was brought to...
  33. H

    included or unlisted???

    thank you-wouldn't that be included in the colostomy procedure-so would I just code the colostomy
  34. H

    included or unlisted???

    im having trouble with the 'biopsy of bladder' portion of this note-any help is appreciated DETAILS OF PROCEDURE: The patient was brought to the operating room and placed in the supine position. Following the induction of general anesthesia, placement of bilateral lighted ureteral stents...
  35. H

    lipoma excision

    Thanks! just making sure because the hospital used 11426 and was denied-we were paid but used 2xxxx code and they would like us to change it :/ I was doubting myself for a minute!!
  36. H

    lipoma excision

    just to settle a discussion-would this code be from 114xx or 21xxx path report came back as adipose consistant with lipoma thanks!! NARRATIVE: This is a pleasant 53-year-old male growing a lipoma in the posterior portion of his neck. It is becoming more painful to him and he would like to...
  37. H

    Help with an op note????

    so you don't think any code needs to be for the bladder/colon fistula? thanks again
  38. H

    Help with an op note????

    44661(but that's an open) then 44204 (included) and 44213(but is the mobilization included with 44661 also?) then the 44188 because the transection is included already? Im really not sure if Im even on the right path...
  39. H

    Help with an op note????

    Ok I feel like im over coding and have too many codes-which may or may not be correct any help walking me through this is appreciated! DESCRIPTION OF PROCEDURE: ...... The 12 mm Airseal port was placed in the right lower quadrant, a 5 mm port was placed in the right mid abdomen, a 12 mm port...
  40. H

    Bariatric question???

    this helps soo much. its not on postop-or a complication. Wasn't "working for patient and she decided to try a bypass" Im going with bundled and thank you for giving me direction to look in!
  41. H

    Bariatric question???

    If someone is having complications with a gastric band and decide to have a bypass...would you ever bill 43774 and 43644 together?? im thinking this would be bundled..maybe a -22 if note qualifies. a co-worker thinks just because BCBS approves BOTH procedures BOTH s/b billed and paid TIA:)
  42. H

    Pre gastric bypass

    billing from the surgeons office-we use 278.01 and sometimes v72.83 depending on what visit they are here for
  43. H

    Medicare non-par

    I have a similar scenario-we have a dietician on staff she does not par with medicare. Some secondary's like bcbs cover this service. so are they not billable because we do not par medicare? Like you said-these claims don't even make it through clearinghouse for the denial to send over? We do...
  44. H

    Rectus Diastasis Repair this is the best article that helped me-I know its from 2010 but it may have some codes you can you use for whatever procedure he will be doing
  45. H

    Revision of Gastrostomy tube

    For some reason I feel like im reading the same sentence over and over again- I keep coming up with lap codes or open that don't seem to fit--any help is appreciated NOTE On the day of surgery, she was brought into the Operating Room and placed in supine position on the Operating Room table...
  46. H

    Nutrition counseling

    would 97802 and 97803 work--V65.3 ?these are billed in units for every 15 min
  47. H

    New coding software

    our office is looking to update and get new coding software/emr everything. we currently use optum encoderpro for physicians as part of our coding software-does anybody have any other suggestions for coding software? thanks
  48. H

    coding supplies?

    so, we have an "angio center" in our office, where our vascular surgeon can perform his cases...aside from the cpt codes can we bill for supplies?? like radiology material,catheters etc?
  49. H

    LapBand Fills (Bariatrics)

    we bill (usually) 74240, 77002, and s2083(in office) we have no problem with bcbs, but aetna oxford and cigna -do not radiology codes in office--was this in post op period?
  50. H

    there is no easy hernia repair to me...

    i seem to always have trouble with abdominal hernia repirs OPERATIVE FINDINGS: Included approximately 3 cm separation of the rectus muscles from the xiphoid to the umbilicus. There was incarcerated preperitoneal fat. There was a small umbilical hernia defect. There was excellent coverage of...