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  1. T

    19325 vs 19340

    I have a patient that had bilateral mastectomies for fibrocystic disease. She needs her implants removed and replaced (one is ruptured). Would you code this as a 19325, because she didn't have breast cancer? Thank you in advance.
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    Billing ASC charges under physician

    Hi I have a few questions... I have never billed for ASC, I work for plastic surgeons and all of our cosmetic surgery patients are done in our Quad A surgery center. Any insurance surgery patients are done at the hospital because our surgery center isn't credentialed any insurance companies. We...
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    Coding for procedure

    I have never coded anything for ASC, I need some help PLEASE. Our physician did some breast surgery in our center that turned out to be workers comp. Normally we only do cosmetics in our center and all insurance go to the hospitals. So with that being said I need help on how to bill for the ASC...
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    Solu Medrol Coding

    Currently we are using 96365 and 96366 for the administration done in office setting. I have been asked to research this and make sure that this is the code we should be billing. Can anyone confirm this for me? Thanks
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    96365 physician supervision

    Physician supervision is required for 96365. If the physician isn't on site for the entire infusion can we bill for the hours he was present or do we need to no charge it. Any help is appreciated. Thanks
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    96365 clearification on physician supervision

    I know the code requires physician supervision. If the physician isn't present/on site during the entire infusion, can you still file a claim for the hours he/she was present or do you have to no charge the entire treatment? Thanks
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    Medicare Signature

    Does anyone know the time frame that a physician has to sign off on dictation. Do you know where I can find this. I have searched Medicare and can't find anything. Thanks
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    Auditing dept vs billing dept

    I need some help...Do most offices keep thier billing and auditing seperate? We are looking to move some things around. I feel that it would be better to keep the auditing seperate from billing and it should be seperatly staffed. Also if you know of any articles out there to support this please...
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    Multi use vial*****HELP

    Question... We have a medication that comes in a multi use vial, because of stock reasons we had to order two 20mg vials. We gave that patient 29 mg, code requires per 5 mg. Since we can't do a discard of the medication how would you suggest I bill this out? Would we round up to 30mg? Any help...
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    coding

    Hi I do physician coding and need some information on hospital coding/billing. My question is, if a patient would have a sleep study at a hospital and its outpatient is it billed under part A or B for the hospital?
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    Gilenya

    Has anyone had experience with billing an E/M code with a 12 lead ECG prior to giving Gilenya and a 12 lead ECG after giving Gilenya? I am wondering if we can bill for the ECG's along with an E/M and get paid? Thanks
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    Reading of X-ray

    :confused:I need some clearification..We are doing billing for a primary care physician that reads his own x-rays. I need to know if we can bill for that reading or does it have to be read by a radiologist? Also if he reads his own x-rays does he have to do an actual findings report or can he...
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    Charges

    I am wondering what formula or method everyone is using to determine what amount is charged to the insurance company. Example how did you get your price for CPT 99201?? Thanks Terri
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    DX code for Multifocal Neuropathy

    Hi I am new to neurology coding..With that being said I have been trying to research this diagnosis. I am coming up with two different codes 357.9 and 357.89. I am suggesting that we use 357.9, but am being questioned because it states unspecified and they are saying because its "Multifolcal" we...
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    HELP in house lab question TC and 26 modifier

    I am new to lab billing and need to clear up some confusion.. Here are few of the codes that are done in house. 85025 CBC 80053 CMP 84443 THS 80061 Lipid 86701 HIV Here is an example of how the physician wants to bill.. 85025 26 85025 TC This would be done for commercial carriers only. I...
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    Custom Mold

    One of my physicians is doing a Moulage custom implant on a Male that has Poland Syndrome. He wasts to use 19342, 19380 and 19396 for the codes. Can anone tell me if you think these codes are correct or is the 19342 and 19380 gender specific? Thanks Terri
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    Reconstruction codes that are allowed only for cancer

    I went to the ASPS Plastic Surgery Coding workshop 2 weeks ago. They were talking about certain codes that were allowed for Breast Cancer only. What I am a little confused on is Prophylactic reconstruction? Are we allowed to bill with 19340 or 19342 or do we have to use the 19325. Thanks
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    Procedure code of office OR

    We have a small OR (not an ASC) in our office and we only do locals for minor procedures. We are looking for a code that we might be able to bill with so that we can get reimbursed by the insurance companies for supplies. Any ideas?? Thanks Terri Diaz
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    Medicare Criteria Breast Reductions

    Hi I am searching the medicare website, this is for Ohio (Palmetto GBA), for Breast Reduction criteria. I have old criteria from 2005 and it was retired then, but I am looking for current information. So I can make sure what I am telling this patient, who is very upset, is correct. The info I...
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    Medicare Criteria Breast Reductions

    sorry I posted this in the wrong spot
  21. T

    atypical ductal hyperplasia

    I have googled this and searched encoder. Should I use an unspecified neoplasm code? I looked back and someone else used 611.1, but that doesn't really specify that its possibly premalignant???? Any suggestions... Thanks Terri
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    Can someone check a ICD-9 code with a CPT code

    I am getting denied from MMO for using ICD-9 894.1 and 709.8 with CPT 15330. I have checked with the Encoder cross coder and it states that these codes are billable with that procedure. Thanks
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    Tubular Breast

    We have a patient that has tubular breast 757.6 and pectus excavatum 754.81. The doctor wants to use code 19366 bilaterally. Has anyone billed for this procedure before? I am concerned because he is calling the breast reconstruction but she never had cancer and encoder states that you can't bill...
  24. T

    Neuroma

    Any suggestions on a code for neuroma of the finger? Thanks Terri
  25. T

    HeLP V45.71 and V10.3

    I am getting denials from several insurance companies that I have never got before this week. I bill any procedures after the mastectomy that are associated with a patients breast cancer with codes V45.71 and V10.3. I am getting denials because of the dx, I never got these before. I do know that...
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    HELP V45.71 and V10.3

    We have always billed with these 2 dx codes for any procedures that come after the masectomy for breast cancer. Just this week I have got 4 denials from 3 different insurance companies stating that we need a primary code. I know that if the patient is still on medication for the cancer that we...
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    Diagnosis For Cosmetics

    Hey I need some help. We just switched from PC's to MAC, so it is my job to enter all the dx and cpt's. When I started here over 3 years ago I was told what codes to use for cosmetic patients that came in for abdominoplasty's, thigh lifts, face lifts etc. We used 701.8 cutis laxa. Well now that...
  28. T

    Diagnosis For Cosmetics

    Hey I need some help. We just switched from PC's to MAC, so it is my job to enter all the dx and cpt's. When I started here over 3 years ago I was told what codes to use for cosmetic patients that came in for abdominoplasty's, thigh lifts, face lifts etc. We used 701.8 cutis laxa. Well now that...
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    MAC Practice?

    Anyone here use Mac Practice?? We are converting our practice to MAC's only! We go live on Thursday with MAC Practice. Just wondering if anyone has had experience with this program before?
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    Cast boot part of walking cast?

    Hi I have a friend that is trying to figure this out. Any help would be appreciated. Thanks I am trying to determine if a cast boot is part of a walking cast or should be billed separately. The CPT code for the application of the walking cast is 29425. According to what I read it says it does...
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    Inpatient only CPT's

    I am looking for a website that will give me a list of the 2008 Inpatient only codes. Can some please help :confused: Thanks in advance
  32. T

    Documenting Shave Biopsies and Kenolog

    Ok first question when my doctors do a shave biopsy they are briefly dictating that they did a shave biopsy and where it was done. Once in a great while they may list the size. This is very frustrating and I'm afraid if we ever get audited we'll be in big trouble. Can you please tell me how your...
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    Reconstruction questions

    Sorry, I'm a little overwelmed with all these reconstruction codes:confused: :eek: What procedure code would you use for a patient that had bilateral biopsy's done for fibrocystic disease. Now she has bilateral breast deformities. My doctor wants to use 19342 as her procedure code. Does this...
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    V45.71 and V50.41

    I have a patient getting that we are writing for pre approval for. She had bilateral mastectomy in 1976 for family history of breast cancer. I do all the billing and e/m coding for our office. I am starting to do the surgery coding as well so this is a little new to me:eek: I need to know can I...
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