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  1. M

    Modifiers for EGD & Colonoscopy

    I also agree with Nelenaz as no mod is needed as they are two different procedures. I do know with Medicare, special rules apply for multiple endoscopic procedures apply if the procedure is billed with another endoscopy in the same family, for example, another endoscopy that has the same base...
  2. M

    Billing Telephone services Question??

    thanks for the help, I am aware that I can use the 99441-99443, but the catch is that is has to be initiated by the patient and I was wanting to bill with the Dr initiating the phone call, that is why I thought of using the NOC. Not sure I can do it, but may bill one with documentation and see...
  3. M

    modifier

    Use the 24 modifier if it an E/M code, I worked at Medicare for 16 years and you should use the 24 mod and your DX must indicate a different DX, and if you have a pt with a chronic condition, use that DX too, ASC has nothing to do with it. the 79 is for only surgical codes anyway, hope this...
  4. M

    Billing Telephone services Question??

    I need some help on this one as soon as possible.... I know there is the new codes for non-face-to-face E/M, 99441-99443, and it states that it is initiated by the patient, however, is there a code or a way to bill if the physician is off work due to medical reasons and they want to go over...
  5. M

    modifier help

    To elaborate more on the -24 mod, if the pt has a chronic condition then it should be paid regardless, or is by medicare usually, so make sure you are putting all DX's that are appropriate for the visit on the claim
  6. M

    modifier help

    This is the book that I used while working at Medicare and I use it now as a coder, it is by Ingenix and is it called Understanding Modifiers, it is a must to have in any office. I also use the PalmettoGBA website. Good Luck
  7. M

    Medicare Patients

    You would not use the -76 modifier, but correct in using the GA on both codes with an ABN from the bene.
  8. M

    2 emergency room visits on same day

    I would also send the documentation of the times for example, 9:30 am, 5:00 pm
  9. M

    2 office visits on same day

    Two different specialties, so if should not be an issue in my opinion
  10. M

    Consult within Same Group

    They are two entirely different specialties, so I would say yes, no problem.
  11. M

    Hospice Patients

    I am a newbie, but worked at Medicare for 16 years and now a coder, and the correct way to bill is with the GW modifier for a non-hospice provider. Medicare has on file the start and end dates for Hospice and if your DOS falls within those dates without the GW modifer, it will deny. It is...
  12. M

    In complete colonoscopies

    I am a newbie and just getting caught up on reading all of the posts, I worked at Medicare for 16 years and the correct usage is 53 mod for incomplete procedure
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