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  1. K

    Question Vent Management & inpatient E/M

    Hi, Generally speaking no you cannot. However I would suggest you check the CCI edits for whichever codes are supported by documentation to be sure. Here is a helpful article that might offer more guidance...
  2. K

    Code for hypocalciuria

    Hi, Range E83.5- is for Hypocalcemia, which are low levels of calcium in the blood. Hypocalciuria is not listed in the ICD-10-CM Index. Have you tried looking under Abnormal findings? Something like code R82.998? Hope this helps, K
  3. K

    Question 33210 Pacemaker Lead through IJ vein

    Hi, I've been told by a former CRNA that when anesthesia performs MAC for ablation/pacemakers, anesthesia helps with checking the rhythms/ drugs as part of the procedure, but only the anesthesia coverage is billed. If your surgeon was insistant on billing for the procedure he first needs to...
  4. K

    Ureteral stent removal via ureteroscope

    Hi, With the given information try looking at codes 52310 and 52315. Verify your selection with the information in the operative report. Hope this helps,
  5. K

    95134 and 95115

    Hi, I am not seeing a NCCI edit for these two codes stating that they can't be billed together or that they need a modifier. Here are the lay terms for each, it might be helpful to check the documentation and make sure they fully capture the services. 95134- The provider administers stinging...
  6. K

    Neonate code H04.532

    Hi, A neonate is usually described as 28 days or younger. I would look at H04.55 or, if it is congenital, Q10.5. Hopefully this helps,
  7. K

    52640 w/52283

    Hi, According to NCCI edits these two codes can be billed together with a 59 mod on the 52283. The injection is documented in the operative report with total amount. Hopefully that helps.
  8. K

    Question ICD-10

    Hi, This depends on a few more factors, for example, was there a fracture with it or dislocation, was the avulsion at thigh level or lower leg, partial or complete? I would check the documentation to be sure, but you could look at a code in the S76.19-, or S86.20- range.
  9. K

    Question Tri West and modifier 59

    Hi, Per NCCI edits these do require a modifier. You could look at using one of the X mods instead of the 59. Documentation should support the procedures were performed in different sites of the colon and on separate lesions.
  10. K

    Question How do you bill for Ambulatory EEG's?

    Hi, If both services are performed in office and documented appropriately for both professional and technical components, you would not add the modifiers 26 or TC to the corresponding EEG code. The code with out those modifiers indicates both the professional and technical components were...
  11. K

    Question Billing for 84153-26 and/or 99212 ?

    Hi, Mod 26 is not a valid modifier for 84153. AAPC has an article that helps to answer this question. https://www.aapc.com/blog/32235-prostate-cancer-screening-essentials-for-codersbillers/
  12. K

    Question 11055-11057

    Hi, With the information provided 11055-11057 would be correct for callous debridement.
  13. K

    G0127 & 11719

    Hi, According to NCCI edits code G0127 is a column 2 code for 11719. These two codes cannot be billed together in any circumstance as they are bundled.
  14. K

    dx help

    Hi, If you look in the ICD-10-CM Index under melanoma, metastatic there are options for breast, genital organs or specified site NEC, C79.81-C79.89. Verify in the Tabular List your selection. Hopefully this helps,
  15. K

    Question Developmental Screening 96110

    Hi, You may want to check with your payers, as some will impose an age limit for this service.
  16. K

    Psychotherapy and depression screening

    Hi, When I ran these codes through the NCCI edit tool 90832-90838 cannot be billed with 96127, even with a modifier as they are bundled. However you can billing G0444 with 90832-90838 with an appropriate modifier.
  17. K

    Billing Screening Colonoscopy Work Up

    Hi, Have you looked at Z53.0-Z53.9?
  18. K

    Question Granulomatous lung disease code?

    Hi, Have you looked at D71 or J98.4 depending on the supporting documentation? Hopefully this helps,
  19. K

    Code for Neuropathic Pain?

    Hi, Neuropathy is damage to the nerves, either with pain or not. Neuralgia is pain in the nerve, sometimes caused by neuropathy. Documentation should help point to the correct selection, but if it is unclear, query the physician.
  20. K

    Urosepsis

    Hi, Here are some articles that help breakdown sepsis coding. Basically Urosepsis is not an acceptable diagnosis. Physicians should be queried for clarification. https://www.icd10monitor.com/facing-the-sepsis-conundrum-in-the-world-of-icd-10...
  21. K

    Question G0508

    Hi, Here is an article from TCI that might be helpful and another from AAPC knowledge center. https://blog.codinginstitute.com/compliance-regulation/new-telemedicine-options-from-cms/ https://www.aapc.com/blog/37488-telehealth-part-b-reporting-in-2017/ CMS provides some resources as well...
  22. K

    consussion and impact testing

    Hi, I found these articles, hopefully they are helpful. https://impacttest.app.box.com/v/BillingGuide2019 https://braincheck.com/blog/new-billing-codes-psychological-neuropsychological-testing-part-1
  23. K

    Question Remote Patient Monitoring

    Hi, According to NCCI edits 99091 is a column 2 code for 99453, 99454, and 99457 and cannot be billed together under any circumstances, these are bundled. Hopefully this helps,
  24. K

    Question aqua therapy

    Hi, I found an article with some information on these codes. Hopefully it is helpful. You may need to check with individual payers as well. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10176.pdf
  25. K

    96161 age requirement

    Hi, 96161 is for administering a questionnaire to a patient's caregiver. Here is an article I found helpful. https://www.outsourcestrategies.com/blog/health-risk-assessment-codes-and-how-to-use-them.html Clinical Responsibility The provider administers a questionnaire designed to help...
  26. K

    Injection Installation Codes

    Hi, According to NCCI edits these two codes can be reported together with the 59 mod on 96372.
  27. K

    Question DOS for radiology

    Hi, I found the following article helpful. https://www.acr.org/Advocacy-and-Economics/Advocacy-News/Advocacy-News-Issues/In-the-February-2-2019-Issue/CMS-Issues-Guidance-on-DOS-for-Radiology-Services
  28. K

    Question Osteoarthritis M15.0 vs M19.90 vs M19.91

    Hi, Default in coding when no other cause is specified is to Primary osteoarthritis. Generalized or polyosteoarthritis involves multiple joints, not just bilateral joints of the same site. Usually 3+ or 5+. The physician should be queried for clarity on site and type. Hope this helps,
  29. K

    Transesophageal Echocardiogram

    Hi, Below is the clinical responsibility for 93320 and 93325. These might help you in dissecting the documentation. Hopefully the physician is documenting more than what is provided here and that will help you determine. As he should be documenting words like, Doppler, or color-flow study etc...
  30. K

    GLAD SHOULDER LESION ICD 10

    Yes, I would agree S43.49XX is the most appropriate.
  31. K

    Question I83 bundled into I87

    Hi, Researching CVI it seems as though chronic venous hypertension leads to CVI; and varicose veins are a symptom of CVI. Here are a few articles that might be useful. https://my.clevelandclinic.org/health/diseases/16872-chronic-venous-insufficiency-cvi...
  32. K

    Transnasal KTP laser excision of esophageal stenosis with CRE balloon dilation and injection

    Hello, I too couldn't find a code for these procedures via transnasal approach. I would use the unlisted code with 43229 or 43220 for comparison along with 43201. I wouldn't use 43204 as that is for injection of a sclerosing agent to treat enlarged blood vessels, which according to the...
  33. K

    Question EVAR

    Hi, With the information given these appear to be the correct codes. But review the following lay terms and clinical responsibilities to help you decide as the documentation is slim. You may need to query the physician for clarification. I also included a link to a PowerPoint that might prove...
  34. K

    Question Plastics & Neuro

    Hi, Based on the information provided you may want to look at codes 61550-61559 and 62140-62141. Verify the documentation supports the code selection. NCCI edits state 62140-62141 will need a modifier if billed with those codes, but check your selections to verify. Hopefully this helps,
  35. K

    Productivity coding standards

    Hi, Companies that I have worked with in the past tend to follow AHIMA standards. See below for reference. http://bok.ahima.org/doc?oid=302649#.XQPP2LxKiUk
  36. K

    CPT 90832

    Hi, I cannot find any recent changes. You could call the insurance and see the reason for their denial and evaluate if the payer policy has changed. You could also check your local LCD, many payers follow these. This article below might also be helpful...
  37. K

    Question laparoscopic hysterectomy with laparoscopic biopsies of the omentum and peritoneum

    Hi, I would check your NCCI edits for the CPT codes you are going to choose to be sure. I checked 58570 and 49321, the biopsy would need a modifier to indicate it was separate.
  38. K

    Question need help coding this please

    Erik, you are absolutely right. I would recommend querying the physician for clarification on the ports/catheters before making a determination. I also forgot to mention the ultrasound and flouroscopy codes. Thank you for replying with them!
  39. K

    Stress test and EKG on same day, different provider

    Hi, I would review the codes and documentation for appropriate modifiers and NCCI edits; that is, if you are billing for both providers, same practice, group or hospital/health organization. For example, 93015 can be billed with 93010-59, if the documentation supports they are separate...
  40. K

    Stupid question on EKG

    Hi, First, code R94.31 is not appropriate to report when there is a definitive diagnosis given. See chapter specific guidelines. Secondly, are these diagnoses, i.e., I50.23 and I51.7, provided in the indications or on the order for the EKG? Because then they would be substantiated. I would...
  41. K

    Lab Split billing TC-26

    Hi, I don't think the employment status of a physician, i.e. part time or full time, effects the billing. I think it is determining what the physician actually did. Did he prepare the slide and interpret results or just read the results? AAPC has a great article on 26/TC mods that might be...
  42. K

    Need Help with Breast Procedure

    Hi, Have you looked into these codes? 19366, 19350, 15200, and 20926? Hopefully these codes can lead you in the right direction.
  43. K

    Question need help coding this please

    Hi, For the arteriovenous anastomosis have you looked at 36821? For the second procedure 36566. Hope this helps,
  44. K

    Pelvic Hematoma

    Depends on a few factors, like if it was an injury, postoperative or intraoperative complication etc. But if you start in the ICD-10-CM Alphabetic Index under Hematoma you can find many of these categories, including one for just the pelvis of a female. Under hematoma it directs you to see also...
  45. K

    Question Help with correct coding of DM, PVD, and Arteriosclerosis

    Hi, Under I73.9, peripheral vascular disease, unspecified there is an Excludes 1 note listing I70.2-I70.7, atherosclerosis of the extremities. AHA Coding Clinic 2018 Vol. 5, No.4 instructs that Excludes 1 notes should be interpreted to mean "not coded here". That would direct you to use codes...
  46. K

    Same Day Admit/Discharge by Different Doctors of the Same Group/Specialty

    Hi, Since the Hospitalist formally admitted the patient as inpatient you would code as such since you are coding for the Hospitalist only. That being said using the information provided I would look at codes 99234-99236. As long as the first hospitalist documented a full E/M and didn't just...
  47. K

    Question ADOS BILLING

    Hi, Have you looked into codes 96110/96111?
  48. K

    Specialty Fixation Suture

    Hi, From what I can find researching this topic, you will likely need to check with the payer if they prefer L8699 or C1713. Don't forget to check the payment and status indicators. Hope this helps,
  49. K

    Laparoscopic Gastropexy

    Hi, From the information provided 43659 is correct for Gastropexy.
  50. K

    Question Montgomery medialization Thyroplasty

    Hello, There is an article from CPT Assistant that is helpful on this topic. Larynx Repair. April 2017; Volume 27: Issue 4 In it they discuss how there are new codes since 31588 was deleted. These were revised when 31588 was reviewed because they found several inabilities to capture...
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