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  1. Chanke

    Fracture Care & DME Equipment

    The way we do it here (in a small rural hospital) is: we charge the appropriate E&M level and that is it. I use 3M and the walk thru asks if it is the intial provider or one who provides the aftercare as well. For the DME, all out of the box splints & casts we don't charge the splinting...
  2. Chanke


    We only charge the splinting for those that are 'built' by the phsyician. If it is an 'out of the box DME item, we do not charge the splinting codes.
  3. Chanke


    I'm an ER coder for a small rural hospital in the northwest. I am not a guru, but would be happy to help if I can.
  4. Chanke

    Help with code for anesthesiologist

    I would bill it out as usual, and append the modifier indicating the procedure was not carried out.
  5. Chanke

    recent fracture/unrelated

    I have a 9 yo male who has a fracture of the proximal humerus. He was diagnosed in the ED on 7/14. On 7/18 he wason his way to in to see ortho and was in a car wreck. He was transported by EMS to the same ED. He was diagnosed with multiple contusions/abrasions and had the humerus fracture...
  6. Chanke

    Consult visit in a Dr's office adjacent to a hospital

    If the clinic is sponsored by the hospital, then yes. What it is , is a split charge sitation. The "facility" portion is paid to the hospital and the "pro fee" is paid to the doctor. That is a common scenario. As for the copay situation, that is set by the insurance companies. The facility...
  7. Chanke

    + D Dimer

    :eek:Help needed - How can I code the following: I got an outpatient order for a CT scan with the DX listed as + D Dimer. How would you code this? I am at a loss.......:eek:
  8. Chanke

    No Fetal Cardiac Activity?

    Your responses both make sense. The order for the ultrasound states pregnancy, unsure of dates. The ultrasound report shows zero evidence of a pregnancy, uterine or otherwise. It specifically mentioned no fetal heart tones, no gestational sac, yolk sac, etc. It just kind of threw me...
  9. Chanke

    No Fetal Cardiac Activity?

    How would you code an Ultrasound for the following: Patient had a positive pregnancy test, unsure of dates. Ultrasound shous no IUP, no ectopic/adnexal masses. Can't really code it as an OB ultrasound.
  10. Chanke

    Medicare and the re-admittance into a hospital

    I beleive that you can have the consult again if it is on a seperate day. MCR usually allows onbe consult per specialty per day.
  11. Chanke

    ORIF following Closed Reduction HELP!

    Is the PA on salary or paid by RVU? If PA is salaried, I would give the physician the RVU's for fracture care, and just bill a hospital visit for the PA. Not my area of expertise, just an opinion.
  12. Chanke

    Radiology contract agreement

    I agree with Dawson and I would think you bill out under the IM practice and not the contracted radiologist.
  13. Chanke

    Diminished Bone Age?

    I have a patient who had bone age xrays done of the hand due to short stature. The radiologist stated diminished bone age. How would this be coded? I am totally at a loss..... Thanks!
  14. Chanke

    Respite care

    Thanks so much for the input!:D
  15. Chanke

    Respite care

    Thanks. I got the palliative care coding, but would respite care be coded any differently?
  16. Chanke

    icd9 s/p THA

    I concur with Lisa's codes :D
  17. Chanke

    Transition from Outpatient to Hospital Coding

    I am a hospital coder. I code outpatient ancillary services (radiology, labs, physical therapy). I currently hold a CPC credential. You can email me if you want any info. :cool:
  18. Chanke

    Respite care

    What code would you use for respite care? Our Rural Health Facility (a CAH) recently started inpatient hospice/palliative care and am unsure how to code respite care. Thanks!
  19. Chanke

    Radiology coding question -bonemineral density

    Medicare won't cover a screening code. The pateint MUST have one of the following criteria for Medicare coverage of a DEXA: 256.9 ovarian dysfunction 733.90 osteopenia 733.00 osteoporosis 737.30 Scoliosis other indicators that would be considered by MCR include vertebral abnormalities...
  20. Chanke

    Sexual Assault

    I am having trouble coding this one. Fortunately I haven't had to code this one before. Running an STD/HIV panel on a patient post sexual assault. No other details other than that are given. How do I code the DX on this? Need help, PLEASE and THANK YOU!
  21. Chanke

    PT/INR for Coumadin use w/ Afib

    That was my thinking as well, but then I didn't want to over code either......
  22. Chanke

    PT/INR for Coumadin use w/ Afib

    So, when you code a lab (PT/INR) for a patient on Coumadin and the slip says : Atrial Fib, Coumadin use..... would you use just the 427.31, or would you use the 427.31, v58.83, v58.61 or which combo of these? I am confused as to whether or not just the 427.31 is sufficient, or do we need to...
  23. Chanke

    Narcotic Contracts

    Along these lines.....what would you code for a DAU to insure the patient is compliant with the pain contract? All I get on the lab slip is "Med Compliance"....... would you use v58.83? Just curious what you would use. Thanks!:cool:
  24. Chanke

    NextGen system

    We have been using NextGen for a few years. Not the anesthesia, though. From a practice management standpoint, I think it is a worthwhile system. I find it easy to use and super quick to learn. It simplifies a lot of tasks both front end, and in the back office.
  25. Chanke

    code for habitual toe walking-7 yr old

    Since the autism etc is listed as 'suggestive of' and not definitive, maybe just 781.2 abnormality of gait or 719.7 difficulty on walking? I lean toward the 781.2 myself.... I would love to see what other input there is on this one.
  26. Chanke

    New job in outpatient coding

    Congrats on the job! :D My first 'real' coding job is as an outpatient coder. I love it. What type of facility are you at? How big is it? I'd love to keep in touch with you and we can offer each other advice!
  27. Chanke

    Occupational Therapy Help Needed

    Hi, I need some help and resources for coding Occupational Therapy. I know the conventions for physical therapy, but have never done occupational therapy. Any input or suggestions would be most appreciated. - Maybe some web sites or books? Thanks!:cool:
  28. Chanke

    SERIOUSLY, No one has an opinion on this??

    :confused: I posted this days ago and got no response. I was kind of hoping to have someone say something. I am trying to change the way things are being done and need some verification : For labwork done to clear a patient to receive contrast medium for a CT scan woould it more apprpriate to...
  29. Chanke

    Labwork before contrast medium for CT

    For labwork done to clear a patient to receive contrast medium for a CT scan woould it more apprpriate to use v72.63 pre procedural lab exam or v72.85 special exam? I think v72.63 makes more sense but the supervisor thinks 'procedural' means surgery....... BTW, previously everyone was...
  30. Chanke

    Chance to begin as CPC-A

    Keep looking! It is hard and it is frustrating to break into this field. I will share how I did it. I accepted a part time registration position with my local facility. I was able to move into a physician billing position full time, and then into hospital outpatient coding. It takes...
  31. Chanke

    Looking to start new profession as biller/coder

    Welcome to the club! Awesome that you passed your exam. Breaking into this field with no experience can be tough at times. You may need to volunteer your services, or try project Xtern, to get some experience. Another option is to get your foot in the door at a hospital in another capacity...
  32. Chanke

    Billing two ways for same patient?

    You have to bill the same for both carriers. You cannot change the codes for each carrier. If BC is primary they need to be billed first. Otherwise this is fraud.
  33. Chanke

    E&m visits plus dmv forms

    I would think it should be included with the E&M. As long as it is at the same time as the visit/work up.
  34. Chanke

    Facility charge

    On a serious note, you should be billing the office that is leasing out the clinic for the supplies that you are stocking them with. I do not beleive you can charge a facility charge to cover that.
  35. Chanke

    Facility charge

    :D Don't be angry with me, but your typo is hysterical! I can picture someone stalking around with supplies! :D
  36. Chanke

    OB outpatient observation NEED HELP

    :confused:I have the outpatient observation chart for a 37 week came in because she lost her mucus plug and was put on the floor for monitoring for a few hours. No ctx's, no loss of fluid, no srom. what would I use as the dx code on this?? I am really not good at the...
  37. Chanke


    There would be no billing of medicare at all under this circumstance. It would be payment arrangements between the patient and the provider. I just doubled checked with my medicare guru on this.
  38. Chanke


    The patient cannot submit the bill, the provider must always submit for Medicare. I think he can still do the procedures, but I think the patient may get the payment. Not sure on that part.
  39. Chanke

    Cardiologists and EP in same office

    Even with the same tax ID#, if they are different specialties, you can get a new pateint and/or consult. We have several specialties under the same tax ID#- orthopedics, OB/GYN, etc. :D
  40. Chanke

    Holiday office hours 99051

    It is my understanding that you only use it for patients seen outside of normal business hours. If you have scheduled patients for that day because you were planning to be open, regardless of the holiday, then I would say no. If your office was planning to be closed that day and you got a call...
  41. Chanke

    Charging facility fees

    I think there is more at stake here. Are you licensed as a provider based clinic? Are you Critical Access (CAH)? I think we need more details on this. In some cases yes you can, and in others you cannot at all.:cool:
  42. Chanke

    Outpatient Maternity Observation

    Dumb question.....How were you coding it previously?:confused:
  43. Chanke

    maternity outpatient

    How are (were) you coding it previously?:confused:
  44. Chanke

    Cardiologists and EP in same office

    um, this may be a dumb question but what is an EP ?
  45. Chanke

    E/M code with immunizations

    Is all he doing is a quick check of heart/lungs pulse? Or is there any time spent on other issues? What kind of documentation is there? IF there is no documentation and it is just a quick check of vitals I would say no.
  46. Chanke

    ICD-9-CM Code acute or chronic first?

    I could be wrong but I believe you code the acute first, if that is why they are being seen, therefore it is the principal diagnosis. Then you can add the chronic condition. Without further details that's the best I can do....:confused:
  47. Chanke

    Coding Pain with follow up healing fracture

    Code the pain, and then code orthopedic aftercare?
  48. Chanke

    99211 and Nurse Only Clinic

    :confused: Is there a doc overseeing them? Or a medical director? Are they nurse practitioners? Seems awfully odd if there is none of that in place.... and no way is that level acceptable if it is just a nurse......
  49. Chanke

    Help w/ pregnancy DX

    Thanks! OB is a weak spot for me and I am never sure how to go when I do get something out of the norm. I eventually came to the same conclusion that you gave me, but thanks so much for the help!:)
  50. Chanke

    Help w/ pregnancy DX

    :confused:I have an outpateint ultrasound on a mom, they found the fetus has gastroschisis. Do I code the gastroschisis, which is on the fetus, in the moms record?:confused: