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    CPC looking for remote position

    Hi Shawna, We are looking for a certified coder to code for an ambulatory surgery center that performs Orthopaedic, Spine, Pain Management, and Podiatry cases. The surgery center performs about 150 - 200 cases per month. This position would not work directly for the surgery center, but be an...
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    Shrinkage of ACL

    What cpt code would you use to code an arthroscopic shrinkage of the anterior cruciate ligament?
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    billing Medicare ASC

    Most ASC's do bill under Medicare Part B, but there are ASC's that bill under Part A. Is your ASC independent or hospital based?
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    Implants is something that certainly should be considered part of the contract. It is always best to get them carved out and reimbursed at cost + %. Some insurance companies are paying based off the Medicare allowed amounts and the reimbursement for implants are already considered, therefore...
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    What kind of colonoscopy - screening(high risk or low risk) or not - were any polyps removed, if so, what technique - anything else done during the colonoscopy?
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    Anesthesia code for 63685

    What would the anesthesia code for 63685 (insertion of a spinal cord stimulator)?
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    coding for removal/reinsertion of SCS

    You should bill with code 63685 for the replacement of the spinal cord stimulator.
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    AMKAI and SourceMed

    Go with AdvantX. We use it in our facilities and have not had any major problems. I have used Vision and didn't like it. Too new, too many bugs to work out, and not as user friendly as AdvantX - especially with regards to the reports area.
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    What to charge

    Most billing companies will charge about 5% of collections. If you are doing the coding as well, I would charge about $3-4 per chart to code and then the 5% for the billing and collection work.
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    For Consultants(? On Salary)

    We use a CPC-H, that codes part time, to code for the facilities we manage and are charges $3 - $3.50 per operative report coded. Other larger companies will charge $5 - $14 per operative report based on specialty. Ortho and spine are generally in the mid to high level of those charges. If I...
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    Rectal polyp ICD-9 569.0 vs. 211.4

    It should be coded as 211.4. DX code 569.0 excludes adenomatous anal and recal polyps.
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    In Office Billing of ESI

    If there is a facility licensed, you would need to bill under the facility name with the same procedure code(s). If there isn't a facility licensed, then the physician should receive a higher reimbursement for the site of service differential.
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    RE: only viewing cecum from a distance in colonoscopy

    I have to disagree and say that it can and should be billed as a complete colonoscopy. The CPT description states "proximal to splenic flexure;". If the doctor was able to view the cecum, then they went past the splenic flexure and did a complete colonoscopy.
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    did not retrieve polyp

    I agree, no modifier is needed for this and you would use 45385.
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    The colonoscopies will most likely be done under MAC (monitered anesthesia care) and would not use a modifier 23. Modifier 23 is used for physicians and not ASC facilities and MAC is not unusual for colonoscopies.
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    Help needed, Trying to Negotiate Salary ....

    Rather than just picking a figure to negociate with, start be making a list of all the things you were responsible for at your last review/increase and what has changed. What additional responsibilities are you now doing? Have you met your objectives from your last review? What additional...
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    Essure procedures

    Thank you for your response. Are any of the carriers paying for the L8699 for the implant?
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    Essure procedures

    Is anyone doing Essure procedures in their ASC facilities? If you are, what codes are you using and how is the reimbursement?
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    I believe the Essure procedure itself is billed with CPT code 58565, not sure about the rest.
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    Essure procedure

    I work for an ASC company and we have a physician that wants to start performing Essure procedures. Can anyone tell me about these procedures? What cpt and/or HCPCS code(s) would be used?
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    Modifier 50 vs LT/RT

    Medicare guidelines will tell you to bill with modifier 50 for bilateral procedures. However, I found that the normally pay incorrectly with the 50 modifier. I always use the LT and RT modifiers for all insurance companies.
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    Your workday

    I post payments for and manage the business office for 3 IDTF facilities and 1 PA billing company. I also manage the business office for 4 ASC facilities. Two of the facilities are local and two require some travel. About half of my time is at the ASC facilities we manage and half in the...
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    Radiation seed implantation

    Your are right, Medicare should be paying for them. What is the denial reason they are giving? I am curious as an ASC I work with just billed two Medicare patients within the last two weeks for the Brachytherapy procedure, but we used the C2638 (stranded). Also, what state are you in? I know...
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    Pain management in an ASC

    The cpt code would be 77003 - but most insurance companies will not pay you for it. I believe the rev code is 320, but not 100% sure on that.
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    Epidural Steriod Injections

    I am not familar with physicians stating "interlamina", but it sounds like it would be coded as 62310 (epidural injection) or 64479 (transforaminal). You would also bill the fluoro with 77003 w/modifier TC or 26 as appropriate.
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    New in ASC-Opthalmology

    You should be very careful about billing patients for any lenses. The reimbursement for cataract surgery is normally inclusive of $150.00 for the lense itself. There is only one or two lenses that would allow you to collect any additional money from the patient.
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    fluoroscopy in ASCs

    sdyches - I am curious as to what state your facility is in that you are getting reimbursed for the fluoro and what insurance companies are reimbursing you and how much. Also, does your ASC facility have a physician employed there that does the reading of the fluoro? Your facility does not pay...
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    SG Modifier Per Coding Edge Feb. 2008

    As of 1/1/2008, per CMS guidelines, you are not to bill with the SG modifier for Medicare patients. Most other insurance companies do not want the SG modifier either. There are some Medicaid and Tricare areas that still require the use of the SG modifier. So the bottom line is, for Medicare -...
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    New fee schedule for Medicare ASC

    The new fee does include the supplies, so you would not bill the L code(s), just the CPT Code(s). As far as the FB and FC modifiers, they are used when the surgery center gets the implants for free or a significant reduction or credit. This is Medicare's way of trying to make sure they don't...
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    fluoroscopy in ASCs

    If your physician owns the equipment and uses it during procedures, you do not use any modifier. This would mean that you are billing globally (for the technical and professional components). You also state that most insurances do not pay for it. What is their denial reason? Are you being...
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    Can you bill 45378 and colonoscopy thru stoma

    The codes for a colonoscopy via stoma start at 44388 and then are broken out if anything else is done (biopsy, removal of polyp, ablation, ect...)
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    Removal of Polyps-Colonoscopy

    I would use the 211.3 for the colon polyp.
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    Fluoroscopy in Physician Office

    Thanks Toni. Does your physician perform the procedures in an ASC? Have you received payment for any 2008 Medicare procedures yet? Craig
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    Epidural Steriod Injections

    Need a bit more info. but here is a start - 62310 - Cervical / Thoracic epidural steriod injections 62311 - Lumbar / Sacral ESI 64470/64472 - Cervical / thoracic facet injections - Modifier RT or LT 64475/64476 - Lumbar / sacral facet injections - Modifier RT or LT 64479/64480 - Cervical /...
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    Fluoroscopic Examination During a Procedure . . .

    I would use the 76000 code with the 26 modifier.
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    fluoroscopy in ASCs

    I disagree with sdyches. You do need to indicate the 26 or TC modifier is you are billing for the professional or technical component. Only, if you are billing globally, then you would not use a modifier. The facility would only be billing for the technical compent and should use the TC modifier.
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    Reporting Discontinued Services

    You would use the modifier 74 for the procedure as the patient should certainly have had anesthesia since it sounds like the scope was already inside the patient but could not be advanced due to a poor prep by the patient.
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    Fluoroscopy in Physician Office

    Do any of the Pain Management physicians have a C-Arm in their office and are you billing for the fluoroscopy (77003)? If so, are you getting reimbursed for the global service (professional and technical components) from Medicare? I have a few other questions about it as well, but want to...
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    Is this a HIPPA Violation?

    This certainly is a HIPAA violation. Any person with access to confidential information needs to treat it as such. Any breach of that needs to be reported to the HIPAA compliance officer. If you do not see the compliance officer take any action, it doesn't mean that no action is taken. The...
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    Nerve Block and Modifier 50

    If the procedure was done bilaterally, you would use modifier 50 with 64483, or list it twice with RT and LT. The additional levels (64484) is used when the injection moves. Example L2/L3 - 64483 then L3/L4 would be 64484, and you would use modifier 50 if they were done bilaterally.
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    Ultrasonic guidance 76942

    What procedure is being done with it? It can make a big difference if that is the correct code or not.
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    What is Up with Bilateral Procedures and Medicare???

    If you are billing with cpt code 73520, there is no need to put the modifier of 50 as the code states it is bilateral. That is why the modifier is invalid and improper. You should keep the number of units as 1, but should not be doubling your charge. You may have to review your chargemaster...
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    radiation oncology coding question

    As an ASC facility, you certainly should be billing for the 55875, no modifier is needed. Although, I am a little surprised that your facility has an ultrasound machine (most surgery centers don't). Currently, you will not get reimbursed from Medicare for any radiology codes, but that is...
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    Code 490

    Rev code 360 is used for OR Services and is used by hospitals. ASC's should bill with Rev code 490 (Ambulatory Surgical Care) which emcompasses all facilities fees, not just the OR.
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    Injection anesthetic agent lumbar or sacral

    You would have to check with the local Medicaid office. Medicaid may not reimburse enough to cover the expense of doing the procedure in the office. What state are you in?
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    Chapter President Terms

    I don't think that the terms should be made longer. Although, I feel that people should be able to be re-elected for additional terms with limits a two or three year limits. This way, any position can be held by the same person to allow time for changes, but not too long. There also needs to...
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    Colonoscopy Procedure Coding

    You should code it as a screening colonoscopy and use the V76.51 code as the primary dx and the 562.10 as the secondary dx. If any biopsies, fulgration, or other procedures were performed, then bill for the cpt code with the v76.51 as primary and other dx as secondary.
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    Screening Colonoscopy - Is everyone else using codes

    I have used the G codes for Medicare and Commercial carriers and have not had any problems with using them. What code would you use for a screening colonoscopy if you weren't using the G codes?
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    asc software-VISION

    I don't know of any asc's using Vision. If you contact your account manager, they should be able to provide a list of centers that are using it in your area.
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    ASC pain management with surgery

    I agree with you. If the block is for the part of the body that is being operated on, it is part of the anesthesia and cannot be billed separately. You can always refer to the federal register showing that anesthesia is part of the asc's reimbursement. I would be interested to know of any...