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    Question 90849 multiple family group billing rules

    I'm having a hard time finding specific billing rules on 90849, specifically regarding the minimum and maximum amount of patients in a group. Can anyone point me to some guidelines? Thank you in advance!
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    Mental Health Assessment in 2 parts??

    Patient came in for MHA and plan from QMHP (H0031 & H0032) on two different days because the provider had to do the assessment and plan in 2 parts due to time constraints of provider's schedule. Provider is wanting to bill H0031 & H0032 twice, once for each day patient was seen (documentation is...
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    Psychotherapy twice on same day?

    I'm coding for a residential mental health facility. A patient was seen in the morning for a 45 minute psychotherapy session by an LPC, and because of his level of distress (not qualifying for crisis intervention coding), the LPC met with him again in the evening for 30 minutes to follow up. I'm...
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    Cognitive Impairment due to head injury

    I'm trying to find a code for cognitive impairment due to head injury, but G31.84 "Mild cognitive impairment, so stated" excludes "cognitive impairment due to intracranial or head injury (S06.-)". S06.xxxx only describes the actual brain injury, but that leaves me stuck on how to code the mild...
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    ICD-9 coding rate for contract?

    I was just offered a contract position for a billing company coding ICD-9's for diagnostic radiology. I have no idea what the pay rate is for ICD-9 only, as I've only ever done CPT or CPT *and* ICD-9 coding, so I'm lost on what to ask for in terms of reimbursement. Does anyone know what's fair?
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    Order of Modifiers PI/PS and TC/26

    When billing PET to Medicare we use the PI or PS modifier as required by Medicare as well as either a TC or 26 modifier depending on whether the service was technical or professional. Recently we've started getting rejections for "inappropriate/invalid modifier", and were wondering if the order...
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    Lung Screening CPT?

    My radiology practice is offering lung screenings to patients for a discounted fee, but we're not sure which CPT is appropriate. It would technically be a "limited CT of the chest", so would it be 71250, 76380 or 76497? We will not be sending these out to insurance, they will strictly be self pay.
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    re-displacement of fracture?

    if a patient fractures a bone and the doctor gets it reduced well, and then a month later it displaces again, would it be technically considered a malunion or non-union?
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    Advancement of Deltoid Ligament/Ankle Fracture

    I've been doing orthopedics for a few years but I am a little stumped on this one. I also didn't code anything for a while so maybe I'm a little rusty. But if someone could help me with this one I would be in their debt. I'm confused on the CPT for surgical procedure #3 below, the excision of...
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    Laparoscopic drainage of paraesophageal abscess

    Does anyone know what the CPT code would be for this? I'm about to pull my hair out over this one. None of the lap codes seem to fit and even the unlisted lap codes don't seem to fit. The scope was introduced through an abdominal incision. I can't even find a code for drainage of a...
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    Removal of silastic band through EGD approach

    Does anyone know what the CPT code would be for this? I have never heard of it. The doctor hasn't done the procedure yet but wants to know what the CPT code would be for authorization reasons. He is removing the gastric restrictive band through esophagogastroduodenoscopy approach.
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    dorsal capsulotomy and release of collateral ligament, thumb

    After some lengthy research it looks like the release of the collateral ligament may be included in the capsulotomy? Anyone agree/disagree?
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    dorsal capsulotomy and release of collateral ligament, thumb

    The release of collateral ligament part is what I'm having difficulty with. Op note as follows: ************************************************* PREOPERATIVE DIAGNOSES: 1. Late effect of tendon injury of left thumb. 2. Stiff interphalangeal joint, left thumb. POSTOPERATIVE DIAGNOSES: 1. Late...
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    challenging hernia repair... help please!!

    Patient had 4 hernias fixed within the same operative session, same incision. Would the CPT 49561 just be billed once since one incision? I am aware that I can use a -22 modifier but the doctor does not state in the op note how much more time he spent on the sx than if there were just one hernia...
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    incision & drainage of cervical cyst?

    The doctor didn't specify the type of cyst either, just that it appeared to be infected. OPERATIVE FINDINGS: A 3.5-cm cyst in the anterior lip of the cervix, which appeared to be infected and on cystoscopy, there were multiple petechial hemorrhages in all quadrants of the bladder after...
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    incision & drainage of cervical cyst?

    I'm new to OB/GYN and can't figure this CPT out. "Incision and Drainage of Cyst of the Cervix".
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    multiple hernia repair question

    Patient had 4 hernias fixed within the same operative session, same incision. Would the CPT 49561 just be billed once since one incision? I am aware that I can use a -22 modifier but the doctor does not state in the op note how much more time he spent on the sx than if there were just one hernia...
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    sinus mucosal thickening icd-9?

    This may be a dumb question but I'm coding MRI's, and alot of them mention thickening of the mucosa in the sinuses. I'm not sure which ICD-9 to use since it's not technically sinusitis. I understand that it's the inflammation of the mucosa in the sinuses.. I just can't find a code to fit. Any...
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    arthroplasty on a fractured toe?

    I'm coding for ASC's and a podiatrist just started working there-- I have ortho experience but no experience with podiatry, and I am stumped on this one. The doctor says he performed an arthroplasty, but I'm not finding the correct code for what he did. Any help is appreciated!! Here is the op...
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    resection of toe/arthroplasty?

    Can I use a bunionectomy code on a malunion of a toe fracture? The doctor says "arthroplasty" but I don't see where that was done. The closest thing I can find to a resection are the bunionectomy codes. I'm so frustrated over this one, any help would be much appreciated! PREOPERATIVE...
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    Avulsion of finger-- help please!!

    Yikes, ok I get that the ORIF code would be 26735 (right?) with 816.01 as the dx but how in the world do you code the avulsion? When trying to look up the dx I keep getting "see sprain" and I don't even know where to start with the avulsion repair CPT code!! PREOPERATIVE DIAGNOSES: 1. Fracture...
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    Removal/retained PE tube ear please help!!

    I'm coding ASC's and am completely new to coding ear procedures. I don't even know where to begin on this one... PREOPERATIVE DIAGNOSES: 1. Retained left PE tube. 2. Eustachian tube dysfunction. 3. Cerumen excess on the right side. POSTOPERATIVE DIAGNOSES: 1. Retained left PE tube. 2...
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    arthroscopic chondroplasty/synovectomy (help!)

    Can't code 29877 & 29876 together! How can I code so that we get reimbursed correct amt? PREOPERATIVE DIAGNOSIS: Internal derangement of the right knee. POSTOPERATIVE DIAGNOSES: 1. Grade III to IV chondromalacia of the superior half of the patella, patchy grade III to IV chondromalacia of the...
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    change of penile catheter

    I know that there is a code for placement of a uterine catheter (51701?) but is there a code for the removal and replacement of one?
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    52000 vs 52281 please help!!

    Ah, I just found this on the Urology Times website: Q In a case where it is necessary to dilate a patient in order to insert a cystoscope, we have been told that we can bill code 52281 (Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without...
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    52000 vs 52281 please help!!

    I'm new to urology coding and am having a hard time understanding the difference between these two codes. I understand that the 52000 is just the cystourethroscopy by itself, and the 52281 is "cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis" but what I'm...
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    definition of encounter??

    Thank you guys for all the responses. This was a company I used to do billing and coding for in office, but when I decided to leave a full time position there they offered me a contract job doing coding for a few of the physicians so I could still work with them. "Encounter", used as office...
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    Petersen's defect

    I can't find the ICD-9 for this & am new to gastro/bariatrics. Also the doc did a "laparoscopy & internal hernia repair" which was the Petersen's defect. I can't find this code anywhere!!
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    definition of encounter??

    thanks. yeah it didn't seem right to me that i get paid the same for coding 1 date of service or 10 dates of service.
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    definition of encounter??

    I'm working for a company who is paying X dollars per encounter that I code. I do coding @ home for an orthopaedic surgeon. When I started I took that to mean per date of service coded, or each seperate encounter that the doctor has with the patient, example: Mr. Jones is seen 4/1 for a...
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    surgery while under anesthesia for another sx?

    My doctor removed an external fixation device from a patient while he was under anesthesia by a different doctor for a hernia repair, outpatient procedure. Does this get any special sort of modifier?
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    Excision of distal pole of patella w/ repair

    I'm thinking 27424 or 27350 but I could very well be wrong. DX: Transverse patella fracture, comminuted, right knee Operation: Excision, distal pole of patella, with advancement of patellar tendon to proximal pole, with patella repair Knee was approached through a longitudinal incision...
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    Defined as "Fall from other slipping, tripping, or stumbling" in the ICD-9. It has a footnote under it that says " Fall on moving sidewalk" so the director of billing at my company is of the opinion that a fall in sports (patient "went to make a save [in a soccer game] missed the ball and fell...
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    help with op note needed!

    i just passed the exam (go me!) but i'm having trouble on this CPT and ICD-9. here's the op report: PREOP DX: Salter-Harris type 2 fracture of the right lower extremity, distal tibia and fibula with external rotation. POST OP DX: same. PROCEDURE: closed reduction and application of sugar...
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    23625 vs 23655?

    I coded as 23625 and the doc thinks it could also be 23655 and wanted to know which was better. I thought I'd get a second opinion just to make sure I'm correct before committing to anything!
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    23625 vs 23655?

    Please help. The doctor and I have different ideas about the code that should be used. Here is the op report: PREOPERATIVE DX: Fracture-dislocation left shoulder. Anterior dislocation with greater tuberosity fracture. POSTOPERATIVE DX: Same PROCEDURE: Closed reduction and application of...
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    Help w/ op note please!

    haha you said eww! :p at least i'm not the only one who thinks so! thanks for all your help.
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    Help w/ op note please!

    yes that's the whole note. dr thinks it should be 28120 or 28140.
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    Help w/ op note please!

    Well I'm stumped again. Osteomyelitis first metatarsal left foot Procedure: Ray resection of the left first metatarsal with complete removal of remnant of first metatarsal left foot Several fragments of sequestrium of the first metatarsal were found and removed, and the remaining first...
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    closed reduction, percutaneous screw fixation of lateral tibial plateau fracture

    I'm having trouble with this CPT code. Here's the op note: DX: Split compression fracture of the right tibial plateau laterally OPERATION: Closed reduction, percutaneous screw fixation of lateral tibial plateau fracture PROCEDURE IN DETAIL: The patient was placed in the supine position with...
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    bone lesion dx code help

    I have a patient who underwent bilateral trochanteric nailing of both femurs because of patholgic lesions of the femur. I'm having a hard time finding the dx code for the bone lesions. Can anyone help me?
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    Closed reduction internal fixation

    I'm new at ortho coding & need help with the code for closed reduction internal fixation of radius. Patient had a "closed reduction, intramedullary nailing of right radius". I can't find anywhere! :confused: