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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?

    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...
  3. 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...
  4. 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...
  5. 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
  6. 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...
  7. 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...
  8. 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...
  9. 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...
  10. 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...
  11. 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...
  12. 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...
  13. 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...
  14. 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
  15. M


    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
  16. 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...
  17. 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...
  18. 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...
  19. 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:
  20. 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...
  21. 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...
  22. 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
  23. 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...
  24. 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...
  25. M

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

    Hello, Any suggestions for psuedogout LT knee? Thanks in advance! Mickie
  26. 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
  27. 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
  28. 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
  29. 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
  30. 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
  31. M

    Need help with CPT code please

    Hello, I am not sure what CPT code should be used for the following? Any suggestions please. I attached a portion of the op note. POSTOPERATIVE DIAGNOSIS: Right distal biceps joint adhesions and scarring. PROCEDURES PERFORMED: 1. Wound exploration with right distal biceps tendon...
  32. M

    Need hep with an icd-10 code

    Hello, I am having a difficult time trying to figure out what code to use for intercostal strain. I was leaning towards s29.011 - Strain of muscle and tendon of front wall of thorax. Any suggestions? Thanks in advance:) Micki
  33. M

    Wiki Need help with ICD 10 code for groin strain

    Hello, Any suggestions on what to use for ICD 10 code for groin strain? Thanks in advance:) Micki
  34. M

    Provider switches practices-how to bill in a post op period

    Hi, Can any one please tell me the correct way to bill this out? If a provider does a surgery at another facility and then comes on board to our practice do I bill the office visit as a post op or would I bill out the E/M level with a modifier (assuming that the diagnosis is directly related...
  35. M

    Would surgical treatment during post op period qualify as active treatment?

    Hi, I'm a little confused for coding active care for surgical treatment in ICD 10. If a patient is in the post op period would that still be considered active care as pertaining to the surgical treatment or would I code it as subsequent because the patient had the surgery and is now in the...
  36. M

    Need CPT code for whole blood injection NOT PRP

    Hi, I'm hoping someone can help me locate a code for whole blood injection. This is not a PRP injection. Thank you in advance, Micki
  37. M

    Can you bill CPT codes 76942 with 76881 or 76882?

    Hi, The physician is under the impression that we cannot bill out 76942 with 76881 or 76882. I have checked the CCI edits and don't see a problem. It is allowed. Does anyone know if this is not billable and payable together? Thanks in advance!
  38. M

    which cpt injection code

    Hello, Not sure which cpt injection code to use. The patient received a corticosteroid injection and I have posted the procedure here. Any suggestions as to which code I should use. Under ultrasound guidance, 1 mL of 40 mg per mL of Depo-Medrol and 3 mL of 1% lidocaine, were injected...
  39. M

    Elbow Excision of sinus tract with open irrigation and debridement need cpt code

    Hello, Any idea what CPT code I should use for Left elbow Excision of sinus tract with open irrigation and debridement? Thank you in advance, Micki
  40. M

    which one? 20604 or 20606

    hello, Can you please tell me which injection code to use for CMC injection with ultra sound for CMC arthritis? Have been going back and forth whether this is a small or medium joint. Thank you in advance! Michelle
  41. M

    Question Is Bone on Bone Arthritis the same as osteoarthritis

    Hello, Can some one clear up the definition for me about whether bone on bone arthritis is the same as osteoarthritis? Thanks in advance!
  42. M

    Help with billing US

    Hello, Can you bill out 76942 (ultrasound guidance for injection)and 76881(ultrasound complete exam) together? Thank you in advance, Micki
  43. M

    Don't know what CPT code to use for procedure--Please advise

    Hello, I have 2 MD's that attempted a closed reduction on a locked bucket handle tear using ultraound guidance and injection of lidocaine. One earlier in the day was unsuccessfull while the other MD's reduction was successful. Not sure how to code this cpt procedure. Please help. Thank you...
  44. M

    Need a dx code for pars stress reaction

    Hello, I need assistance with diagosis code for pars stress reaction. Would I just use Stress fx other bone 733.95? Any advice would be appreciated. Thank you in advance and have a nice day!
  45. M

    nerve block with excision of nail bed? Help please

    Hello:) Can I code for nerve block with excision of nail bed? I'm not sure if the block is included in the procedure.This is the procedure paragraph: "4 mL of 1% lidocaine was used to anesthetize the toe, using a digital nerve block. He is still having some minor discomfort with the...
  46. M

    Need help with ICD 9 code

    Hello, Can someone give guidance as to what code I should choose for this diagnosis: scapulothoracic dyskinesis Thank you in advance for any help on this.
  47. M

    Is it appropriate to code a consult?

    Hello, Is it appropriate to bill a consult in this suituation: A patient that was seen at an Urgent Care facility is sent for a consult at an orthopedic facility. The criteria of the 3 R's would be met. Does that seem right that a patient is sent for a consult from a urgent care facility? It...
  48. M

    need help coding this fx care

    Hello, I'm not too sure on the coding of this fx reduction. I plan on using code 27810 but i'm not too sure of the hematoma block. Is it included with the 27810 and would I code the block out under 64450? Here's the excerpt from the note: PROCEDURE: Under using sterile preparation, a hematoma...
  49. M

    Need cpt code for Hydrodissection

    Hello, Any guidance on cpt code for hydrodissection? This is the excerpt from the office visit note: "high volume hydrodissection was performed between the undersurface of the Achilles and the fat pad, which was adhered and scarred down. 25 cc of saline mixed with some Marcaine was used"...
  50. M

    need help please with CPT code---Hydrodissection

    Hello, I need help with coding this procedure: Left Achilles tendinosis and calcifications. PRP was performed over the mid portion of the Achilles in the area of the tendinopathy. In addition, some high volume hydrodissection was performed between the undersurface of the Achilles and the fat...