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  1. Kiana

    Robotic S2900

    I know that BCBS Federal plans pay for surgical techniques requiring use of robotic surgical system S2900. Has anyone seen a change as far as reimbursement on the facility side of charges? Claims falling on UB-04's.
  2. Kiana

    99211 for chemo teach

    Chemo Coder "Can a chemo teach be charged anything higher than a 99211? (A NP does these.)" I agree with OCD_Coder, "There is no E&M service inclusive to chemo or therapeutic administration codes as the NCCI manual clearly states that it only applies to minor procedures. The global status...
  3. Kiana

    ICD 10 Proficencey Assesment?

    Per AAPC Taking the ICD-10 non proctored 75 question exam will not give you additional credentialing. It allows you to keep the credentials you currently hold. If you do not take the exam you will lose all of your credentials.
  4. Kiana

    Chemo pre meds

    Pre meds such as Magnesium, Mannitol and Potassium to Cisplatin is billed w/ the V58.11 or V58.12 depending on what you're premedicating to what type of drug. Usually the prophylactic drugs is given to prevent the N&V during the chemo.
  5. Kiana

    V67.2 Following chemotherapy

    Is the person between treatments convalescing? V66.2 or is treatments completed and now you're just following up? V67.2 that's the difference. Hope it helps
  6. Kiana


    We hardly use the heparin and if we don't we just bill the port flush, heparin hardly ever get's paid. We are now using the cathflo J2997.
  7. Kiana

    Portable pump initiation/refill

    I agree w/ daisy3663. This is my understanding as well.
  8. Kiana

    Billing 96523....

    Per the AMA CPT guidelines: Do not report 96523 if any other services are provided on the same day. Therefore if other services were performed you need to bill what is the higher in RVU's. I will bill all the admin charges and medications and not the port flush. Hope this helps.
  9. Kiana

    How to bill???

    V58.49 vs V58.76 V58.49 is for after care following surgery that would be like changing or removin drains or other after care that does not have a classifiable condition. Since you have a specific dx for the surgery of the underlying condition 616.2 then you would use your V58.76 as your...
  10. Kiana

    Coding from home

    You should upload your resume into the HealtheCareers linked into the AAPC :)
  11. Kiana

    New CPC-A

    You could post your resume through the Healthecareers which is part of the link that the AAPC offers. Good Luck
  12. Kiana

    Question about OB visits and global billing!

    Antepartum visits only are 59425 & 59426 the 59426 is for 7 or more then code your high risk codes diabetes codes for your dx.
  13. Kiana


    Have you tried looking at the Cardiology Study Guide offered by the AAPC?
  14. Kiana

    19371 billed with 19380

    This isn't a bundling issue unless they think its being done on the same breast.
  15. Kiana

    Modifier 59 - injections and admin

    You would only use the -59 modifier if you're doing (2) distinct or independent procedures from other non-E/M services performed on the same day. Your (2) units is just letting them know I did (2) IM injections but if there was not another distinct procedure done on the same day you do not need...
  16. Kiana

    Labs done with CPE

    If you are performing labs to confirm or get a dx then it should be coded as a screening, if you have a dx ie diabetes or cholesterol and you're doing labs for tracking to titrate maintenance medications, which they are usually on, then you need to code the signs & symptoms and dx. If you don't...
  17. Kiana

    Employer & coding books

    The employer should supply the most current coding books for you. It would only benefit them that you get the most knowledge while working for them.
  18. Kiana

    Diabetic counseling

    Look at codes 98960 - 98962 or see if she could qualifiy billing 99078. :)
  19. Kiana

    discussion between co-workers

    you want to code the signs and symptoms of why you requested the CT.
  20. Kiana

    CPC-H help!

    I'm scheduled for the exam on 12/13/08 and the good thing is it's still multiple choice, so process of elimination is great. The main difference per my instructor is knowing the payment methodologies. You need to know what drives OPPS, APC etc also know the status indicators which you have...
  21. Kiana

    Deposition Billing

    We bill with a letter and a bill for services. There isn't a CPT code that you bill. Prices for services were dependent upon services rendered such as review of records and a straight forward opinion vs expert witness with the physician appearing on the stand etc. Billing was based on hours...
  22. Kiana

    IV Infusion code

    Couldn't you charge the 90760 IV infusion, hydration; initial? along w/ the E&M
  23. Kiana

    Appeal letters for patients

    Yes, then a appeal template is perfect.
  24. Kiana

    Appeal letters for patients

    Appeal letters for what? Is it for the patients to fill in the blanks to appeal to the insurance about reconsidering contract between provider and insurance in hopes that the provider remains contracted? :confused:
  25. Kiana

    Modifier 25

    The question is how would you code Dr. John's services. He did a consult sent a report back and in addition he performed a whole body integumentary photography. Same physician provided consult and procedure.
  26. Kiana

    Excision Coding - Intermediate Repair

    When more than one classification of wounds is repaired, list the more complicated as the primary procedure and the less complicated as the secondary procedure using the -51 modifier. Hope this helps.
  27. Kiana

    Iron Overload due to Blood Transfusion

    790.6 but I also think you're going to need the 999.89 ;)
  28. Kiana

    annual physical/school physical

    Oops, and I forgot, if it was just for form filling, you are correct. The information he collected at the annual could have been transferred to the school physical form.
  29. Kiana

    annual physical/school physical

    I believe one of those annuals will be denied. Was there anything found ie sign or symptom that one of those services be charged for an established E&M? Even though the diagnosis can be utilized as primary dx's, the insurance is going to look at why the annuals were done a week a part. May...
  30. Kiana

    New Patient Visit Vs Consult

    As long as the 3 R's were met the surgeon can bill for the consult if the decision was to go into immediate surgery use your -57 modifier.
  31. Kiana


    If this is all you have I'm looking at dx 658.90 Unspecified Other problems associated w/ amniotic cavity and membranes; unspecified as to episode of care or not applicable. This is my thought. :)
  32. Kiana

    Use of S0630

    I vote No as well, but if your physician wants to see it from Medicare, bill it then show him your denials. Physicians should be physicians, coders be coders. :rolleyes:
  33. Kiana

    Pacemaker Implant & Check

    Then they can charge a subsequent visit, if pt is being discharged on that day they charge the discharge. Subsequent visits must have 2 of 3 components and you can count your floor time &/or bedside time. Discharge is time spent by the physician for final hospital discharge of the pt and...
  34. Kiana

    ROS Guidelines

    If you send me your email, I can send it to you. :)
  35. Kiana


    Look at icd-9 658 section to see if any of those apply. :)
  36. Kiana

    82270 vs 82272 whats the difference?

    82270 would be used if pt has a personal or family history of colorectal neoplasm and requires that screening. 82272 is a revised code used for dx other than colorectal neoplasm screening ie annual screening, gross blood in stool etc. :)
  37. Kiana

    Two services, 2 doctors, same DOS

    You will need to appeal with notes. If it is different dx that by all means you should get paid, if the E&M physician referred the I&D to your physician, get that referral. Seeing (2) physician's are difficult, but whoever sent the last bill will need to appeal and show proof of your services.
  38. Kiana


    Consultation: Suspected problem Undetermined course of treatment Only opinion or advice sought. After the opinion, treatment may be initiated even if same encounter Written request for opinion or advice received from attending physician, including the specific reason the consultation is...
  39. Kiana

    CPT Code 99380

    Care plan oversight services does not require face-to-face services 99380 is for patients in a nursing facility 30+ minutes.
  40. Kiana

    Documentation of vitals in exam

    That would be counted as constitutional, but what is considered stable would be the problem, did the physician want pt to return for BP check? It would be safer to document that. Vitals stables is like stating all other systems negative, but that is what the physician would document. If the...
  41. Kiana

    Pacemaker Implant & Check

    33208 has a 90 day global, I would think coming in for a check would fall into this category but after the 90 days 93731 would be applicable. Unless the pt is running into complications.
  42. Kiana

    fracture fragment

    Is the bone fragment from an old injury? If so, use proper dx. As far as the CPT, if it's not a foreign body then he is treating the fracture. Your CPT would be the fracture code.
  43. Kiana

    screening mammograms

    Code your signs and symptoms 1st personal hx 2ndry.
  44. Kiana

    screening mammograms

    No, you go off what the physician referrs the patient in for the mammo. If it's truly a annual screening then you'd code the 77057, but if the pt states something else, we in administration can't change it to dx if it's not from the physician's order. If the pt wants they can phone the office...
  45. Kiana

    screening mammograms

    If you code the lump primary and personal history 2ndry then you can use 77056 w/ the add on code 77051 as a diagnostic mammo and not use the 77057 which would be used for annual, no signs or symptoms type of mammo.
  46. Kiana

    Possible AAPC 2009 ICD-9 Book Error??

    The 5th digits that Rebecca is referring to applies to codes 305.0, 305.2-305.9. Your AAPC icd-9 is correct Tobacco use disorder for tobacco dependence is 305.1 excludes history of tobacco use (V15.82) smoking complicating pregnancy (649.0) tobacco use disorder complicating pregnancy (649.0) I...
  47. Kiana

    post operative visits/when surgeon did not perform the surgery

    This sounds like a Global fee/split care: Per Medicare A surgeion who does not provide follow-up care would use modifier -54 (surgical care only). The doctor who provides pos-operative follow-up care should use modifier -55 (post-operative management only). You can get credit for giving...
  48. Kiana

    New Coding Books

    I purchased the 2009 Professional edition CPT from the AMA but have will not get that until December. I will purchase 2009 Expert ICD-9-CM Volumes 1 & 2and the HCPCS Level II Expert from Ingenix. I've gotten the ICD-9 and I love it. Volume 1 has tabs that you can insert before each section...
  49. Kiana

    Please help.......

    I get 238.1 Benign neoplasm connective tissue (arm)
  50. Kiana


    Maxim requires you to pass their exam and they will notify you if you passed or not but depending on your location and what you're looking for they will call you is what I was told.