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    Aetna E&M Policy

    Our office started to get denials for E&M stating this was partially or fully furnished by another provider. This is for a NEW PATIENT! 99204 Their new policy states FOR ALL PLANS "We allow 1 of this group of codes per patient per day across all providers based on CMS guidelines." CPT codes...
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    Little Frustrated

    I would just like to voice opinion if anyone at AAPC is listening. Member ship fees bit pricey. And last year when renewing my membership I was offered 12 months of webinars for $150 this year it went up to $215. And the CEU's went from 2 per webinar down to 1. Just wanted to put that out there.
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    TAVR Denials from Aetna

    Is anyone experiencing Aetna Denials for Transcatheter Aortic Valve Replacement Codes 33361 due to Services of an Assist Surgeon, Co Surgeon, or Surgical Team are not covered. Per NCD Guidelines 33361 must always be billed with modifier 62 because a cardiac surgeon and interventional...
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    Aetna Plan TAVR Denials

    Is anyone experiencing Aetna Denials for Transcatheter Aortic Valve Replacement Codes 33361 due to Services of an Assist Surgeon, Co Surgeon, or Surgical Team are not covered. Per NCD Guidelines 33361 must always be billed with modifier 62 because a cardiac surgeon and interventional...
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    Radiopaque Markers during CABG

    Our physician has started to place Radiopaque Markers around the aortocoronary anastomosis during CABG procedures. Does anyone have or currently bill this for the thoracic surgeon? I am looking for a CPT code. Thank you
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    Novitasphere Portal

    May anyone please give me some reviews on using this service. We do use a clearing house. Will they send the revised EOB still by paper or we only see changes electronically? Any Pros/ Cons would be helpful. Thank you
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    Same Dx During Global

    Any help appreciated. I am coding for the surgeon. He performed a 90 day global procedure. 1 month in the repair has failed and the original DX is now again symptomatic. (Stated they left the OR with none of the DX and his immediate postoperative course was unremarkable) in the office setting...
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    Critical Care in global of CABG

    I have seen this question being asked many times and answers are not specific to our specialty so I will just start with examples of my questions. If our surgeon performs the procedure then monitors his care while he is in the hospital. Procedures ranging from CABG, Aortic Valve replacement...
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    2 Office Consults in Same day

    We have an established patient that came into the office to see our physician for his follow up on a condition. But suggested that another physician in our practice take a look at it because he specialized in it. They are both in the same group both happend on the same day. One would qualify as...
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    Medical Non Comliance

    I am new to coding E/M and was coming across medical non compliance in a HPI. We have very ill patients most of the time and all 4 slots can be taken. Should V15.81 be looked into more often if needed? Any feed back would be appreciated.
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    Modifier 22 - We had a surgeon that performed

    We had a surgeon that performed a complex procedure that took place in the OR from 8:30am till 5:00pm. There was a total of six procedures done by our surgeon. The pt had a carotid subclaian bypass bilaterally. By the 1st assist two days prior to the surgery. The patient was very high...
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    Billing Primary when Secondary is Medicare

    If you bill the consult code if you have commercial insurance as your primary and your secondary is medicare. Is it illegal? Example Pt has BC/BS and we send out claim Hospital consult inpatient. And Medicare is secondary. Are we Still supposed to follow medicare guidelines. We bill 99222...
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    Greenway and ICD-10

    Is anyone working with Greenway and ICD -10 transitions yet? Thoughts reviews?
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    99495,99496 Chronic Care

    Is anyone in cardio thoracic using these codes or are we allowed to. A lot of our patients have chronic illnesses and from what I am reading on these codes our surgeons may be one of the physicians in the coarse of non global care. If they decide to not get surgery. Has anyone been using these...
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    Saphenous Vein Harvest

    I am aware that procurement of saphenous vein is included in a CABG. But I have this in an op report Saphenous vein was harvested in the left leg utilizing endoscopic vein harvesting technique. It was prepared for bypass grafting. Can 33508 be added to the CABG codes, for this kind o f...
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    CABG W/O by pass

    Is there a code for a CABG w/o bypass. I keep coming across 33503 but that looks like it is for a congenital issue. And This was for Vein and Artery. So would it need two codes? Would there be a code for CABG w/o bypass for CAD the procedure we coded ended up being 33533 , 33518 but the surgeon...
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    TC Modifier

    Our physician does radiology guided stenting with the radiologist present, assisting. Our physician is performing the procedure. Would we use TC or 26?
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    ECMO 33960 Modifier

    Is there a modifier that goes with 33960-33961 for the global period?
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    93750 VADS and Medical Necessity

    Can any one help me with hospital subsequent care information about this code for New Jersey. I am New to the field and will be coding these reports. Does any one have the medical necessity for this code? And appoved Diagnosis codes that would go along with it, I do know that you have to out the...
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