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  1. S

    20526 and 96372

    Hi, I'm getting a rejection for the above two codes. Should the 20526 be billed without the 96372? Thanks!
  2. S


    Hi, can someone please tell me if codes 90620 and 90472 be billed together? Thanks!
  3. S

    CPT 90686

    Hi, can anyone tell me how many times in one day CPT 90686 be billed for a 2 year old? If so how would it be worded in the dr's notes? Thanks so much!
  4. S

    Pulmonary function tests

    Hi, I need some help! We billed the following codes. 99214 w 25 mod, 94010, 94727, 94729 and 94618. All codes pd except for 94010. Would it be ok to use a 59 modifier? Thanks so much!
  5. S

    Local coverage determination

    Hi, I'm looking for some help. I received a denial from Medicare stating the dx we used wasn't listed under LCD policy. It was pointed out to me that the codes was no good because it was listed under group 7 codes. What exactly does that mean? Thanks!
  6. S

    Question Injections and admin codes

    Hi all, I need some help! We're billing 2 injection codes (J1030 and J3420) along with 2 admin codes (J1030 and J3420). I'm getting a denial stating it's a duplicate claim. If there are 2 different juices being administered shouldn't it be ok to bill 2 injection codes. Thanks for any help!
  7. S

    Pediatric Immunizations

    Hi, can someone help me understand how to bill immunizations? I'm kinda confused. I have the following cpt codes 90716 with one unit, 90707 with three units, 90633 with one unit and 901713 with one unit. Thank you for any help!!!!!!!!!!!
  8. S


    Does anyone know the difference between BCBS and Highmark BCBS? If so can you please explain to me? Thanks so much!!!
  9. S

    Midwife billing

    Does anyone have any experience and if so how does it differ from the Dr. delivering the baby? Thanks!!!
  10. S

    New to OB coding/billing

    Hi all, I just started doing ob coding and it's quite intimidating...does anyone know of any useful websites or possibly any book that can be helpful? Thanks for any help!!! Colleen
  11. S

    Postpartum Care

    Hi all...I REALLY need some help! I'm billing a postpartum code 59430. The patient has Horizon BCBS. I was under the impression 59430 was to be billed to Medicaid and Medicaid HMO's. Am I right? I'm really lost! Thanks:D
  12. S


    Hi, I'm billing the following the CPT'S...20605, 96372, 96372, J1100 and J1885. The claim initially denied for procedure codes 20605 and 96372. I also added an LT modifier to the aspiration, but it still denied. I appreciate any help!!! Thanks!
  13. S


    Can someone help me out with injectons??? We're billing 20605, J1100 and J1885. I have a denial on the 20605 stating a modifier should be added. I'm a little confused. Appreciate any help! Colleen
  14. S


    Hi, can anyone tell me why cpt 76821 Echo exam of the heart is included in an NST and Doppler velocimetry. Thanks!!!
  15. S


    Hi, I'm billing at initial hospital care code 99223 with Thoracentesis with/imaging. The claim denied and it stated it can be overidded with a modifier. Would the modifier go on the initial hospital care code or the the thoacentesis? Thanks
  16. S


    Hi, I billed out 3 pft's and I received a denial stating a 26 modifer was needed. I've billed these before and never added a modifer. I'm wondering why the insurance company is stating this. Appreciate any help!!!
  17. S


    Hi all, does anyone know if cpt code 20610 can be billed with the admin code and can it be billed with a J code? Thanks for any help!
  18. S

    Billing pediatric vaccine codes

    Hi all, can someone out there help me figure out how to bill the following vaccines. Patient is 11 months old. First vaccine is Pediarix, second is hiberix and the third is prevnar. I appreciate any help!!!
  19. S


    Hi all, I'm billing a subsequent hospital code 99232 along with a change of a windpipe 31502. The claim denied stating a modifier. Which code requires a modifier and what modifier needs to be used? Thanks for any help!!!
  20. S


    Hi all, we have a patient that came in for and I&D for his thumb. The Dr. started giving him the lidocane but stopped because the patient couldn't tolerate the needle. She billed an office visit along with 96372. Does lidocane get billed with the injection? Thanks for any help!
  21. S

    Hospital admission

    Hi all, I have a question regarding hospital admission and initial hospital care. We have a Dr. that admitted a patient on 1/7/19 and on 1/8/19 billed for initial hospital care. I'm confused I thought the admission was the same as initial hospital care. Can someone help clarify this for me...
  22. S


    Hi all, can someone explain how bullets fit in to coding e/m code codes? Thanks!!!
  23. S

    Evaluation and Management Coding

    Hi all, I don't know about anyone else out there but I'm having trouble understanding e/m coding. It sounds simple, but not to me. Can anyone recommend a website or book that can easily break it down? I appreciate any help! Thanks!
  24. S

    Skilled nursing facilities

    Hi all, does anyone know if cpt codes 99308 and 99309 can be billed together? If not what is the reason? Thanks!
  25. S

    Critical care and subsequent hospital care code

    Hi all, I need some help! I have a patient that was seen in critical care on 11/28. 11/29 and 11/30 are subsequent care codes, how do I bill these??? Thanks!
  26. S

    Initial hospital care and critical care

    Hi all, I have a claim for a patient that had initial hospital care on 11/27 then on 11/28 was moved to critical care. Is it ok to bill as is? Thank you!!!
  27. S

    Initial hospital care

    Hi all, does anyone know if the initial hospital CPT is the same as the admitting CPT??? Thanks so much!!!
  28. S

    Chorionic villus Samplilng

    Hello all, does anyone know how to find an ICD-10 code for a failed Chorionic villus sampling? I'm not sure if there is even one. Thanks so much!!!
  29. S

    Cpt 76815

    Hi, does anyone know what cpt codes can be billed with 76815? Thx
  30. S

    Cpt codes 76816 and 76820

    Hi all, does anyone know if the cpt codes 76816 and 76820 can be billed with dx O36.5930??? Thanks!!!
  31. S

    Maternal Fetal Medicine Billing/Coding

    Is there anyone out there that has experience in mfm billing/coding???
  32. S

    Maternal Fetal Medicine Billing/Coding

    Hi everyone, does anyone out there have experience with MFM billing/coding. I'm finding alot of the insurance companies don't like the dx codes given to me by the Dr. I'm also seeing their documentation doesn't support the codes...any help or suggestions would be much appreciated!!! Thanks
  33. S


    Hi all, can someone help me understand how to bill immunization codes? I know pediatrics are billed by components, but I'm confused from there. Thanks!!!
  34. S


    Hello all, can someone explain what rvus' are and how they work??? Thanks!!!
  35. S

    Office visit with ultrasound

    Hi all, I'm billing a follow up ultrasound along with an office visit. How exactly do you know when you can bill a visit and ultrasound together??? Thanks
  36. S

    Office visit with ultrasound

    Hi all, I'm billing a follow up ultrasound along with an office visit. How exactly do you know when you can bill a visit and ultrasound together??? Thanks
  37. S


    Hi, does anyone know if CPT code 76816 be billed twice??? The patient is having twins, I'm assuming it can be billed twice and add a 59 mod??? Thanks
  38. S


    Hi all, can someone help me understand billing injections for children. I'm billing meningitis and tdap. I know these get billed by components, confused. Thanks so much!!!
  39. S


    Hi all, ok this has nothing to do with coding but by any chance does anyone have experience with rev manager in cerner??? Thanks for any help!!!
  40. S


    Hi all, I'm billing the a above code with additional u/s codes. I'm always having issues getting this pd b/c of the dx. The insurance is Aetna. Can anyone lead me in the right direction. Thx
  41. S


    Hi, we're having trouble getting this u/s paid through Aetna. Recently two u/s were done on the same day, the dx codes used were 030.032, Z03.71, 028.3, 028.1 and z3A.18. I'm confused b/c Aetna usually doesn't accept Z codes. Any advice??? Thanks
  42. S

    Cpt Book

    Hi, can anyone help me...I'm confused when looking for a procedure in the book. I'm not sure what key words I should look for. Appreciate any help!!!
  43. S


    Hi, can anyone out there help me??? I'm really having trouble navigating through the CPT book. I'm also having trouble understanding how to code integral conditions and the primary dx I should be looking up... Thanks for any help!!! Colleen
  44. S

    Essential and nonessential modifers

    Can someone please explain the difference between essential and nonessential modifers??? Thanks so much!!!
  45. S


    I'm billing an antepartum code of 59426 to Aetna Better Health, they're stating a modifer is required. I don't agree and I've never heard of that before...Can anyone help???? Thanks
  46. S


    Can someone please help me...when pt's have commercial insurance how do i bill the antepartum code after delivery??? Thank you!!!
  47. S


    If a patient has IBX, but it also states on the card KHPE. Does it matter where the clm gets sent as long as they have the same EDI#? Thx:)
  48. S


    Does anyone know how many times a 59 modifer can be used when billing several ultrasounds? Thanks
  49. S


    Does anyone know what guidelines have to be met to bill a 99214? Thx
  50. S

    59 Modifer

    How many times can I add a 59 modifer when the patient has multiple ultrasounds in one day? Thx