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  1. abishard

    Springfield MO Seminar - Sessions in E/M!

    Good afternoon! The Springfield MO AAPC Chapter is excited to invite you and your members to our Fall Seminar on Saturday, September 19th! Our goal was to provide an experience similar to an AAPC Regional Conference to our members at an affordable price. (This is a BARGAIN DEAL!) The cost is...
  2. abishard

    Springfield MO Seminar - 18 sessions to choose from!

    Good afternoon! The Springfield MO AAPC Chapter is excited to invite you and your members to our Fall Seminar on Saturday, September 19th! Our goal was to provide an experience similar to an AAPC Regional Conference to our members at an affordable price. (This is a BARGAIN DEAL!) The cost is...
  3. abishard

    Springfield MO Seminar - Sessions in ICD-10-CM!

    Good afternoon! The Springfield MO AAPC Chapter is excited to invite you and your members to our Fall Seminar on Saturday, September 19th! Our goal was to provide an experience similar to an AAPC Regional Conference to our members at an affordable price. (This is a BARGAIN DEAL!) The cost is...
  4. abishard

    Springfield MO Seminar - Sessions in Auditing!

    Good afternoon! The Springfield MO AAPC Chapter is excited to invite you and your members to our Fall Seminar on Saturday, September 19th! Our goal was to provide an experience similar to an AAPC Regional Conference to our members at an affordable price. (This is a BARGAIN DEAL!) The cost is...
  5. abishard

    91035 - placement of Bravo by RN

    Hi Erin! What is the POS?
  6. abishard

    25 modifier with e/m and x-ray

    Is the physician providing the official interpretation of the x-ray or is he just performing an over-read? If he is providing the official interpretation, the documentation needs to include a written report of the interpretation. The 25 modifier is not appropriate on the E/M code as the...
  7. abishard

    Hospital patients being brought to office?

    If place of service is office, you must code office. Only time you could code inpatient is if it is considered an outpatient department (POS = 22).
  8. abishard

    IR doctor supervising RN performing PICC placement

    Is this performed in the hospital? If so and the RN is an employee of the hospital you cannot bill as the hospital would incur the costs for this. If it is in the clinic, you could bill.
  9. abishard

    follow up CXR

    Was the PICC line performed with fluoroscopic guidance? Also, is the provider who performed PICC line same provider who is reading x-ray?
  10. abishard

    Does anyone out there use place of service code 62?

    What type of facility is this? You need to find out the what your facility is classified as. This will determine your POS. Unfortunately, POS isn't determined by what type of providers are performing the services, it's all based on the type of facility.
  11. abishard

    Can I count as a bullet

    For the 1997 General Exam, this counts as alert and oriented.
  12. abishard

    Uncontributory!!!!

    It is probably better practice to state all other systems reviewed negative (instead of uncontributory). However, if the positives and pertinent negatives are mentioned in the HPI, there is no need to restate them. It is perfectly fine for provider to state ROS per HPI, all other systems...
  13. abishard

    Uncontributory!!!!

    As long as there are positives and pertinent negatives found in the HPI, I would count this statement as a complete ROS per Medicare Documentation Guidelines.
  14. abishard

    Need Help on 76140

    I'm not sure if MC = Medicare, but Medicare has not paid for this code in the past. Medicare does not pay for an overread on an x-ray as it is not considered medically necessary. This would be included in the E/M service if applicable.
  15. abishard

    MRI and XRAYS INTERPRETATION

    What setting are you in? Please provider more information regarding your scenario.
  16. abishard

    c-arm

    Actually, if the physician is using the c-arm fluoroscopy to obtain views, you would report the appropriate plain view x-ray code by the amount of views taken.
  17. abishard

    Manual application of stress

    Does anyone have any information regarding billing CPT 77071 (Manual application of stress performed by physician for joint radiography, including contralateral views if indicated)? Medicare has given this code a MUE of 1. If two different stresses are placed on the same joint, is it...
  18. abishard

    Cardiac Catheter Bundling Question

    Yes, a stent (CPT 92980) was also performed. What is their reasoning? I'm not comfortable simply appending a 59 modifier as that could be a red flag. Thanks for any help!
  19. abishard

    Cardiac Catheter Bundling Question

    Hello, Does anyone know why UHC would be denying 93540 with 93510? Thanks, Amy
  20. abishard

    Co-Surgery

    Thank you Rebecca. If only my Medicare carrier (WPS) would state something like that. I am trying to educate my surgeons on the difference between an assistant surgeon and a co-surgeon. CPT states, when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure...
  21. abishard

    Co-Surgery

    Co-surgery: Does anyone have anything in writing that states it is required for both co-surgeons to document their own operative note?
  22. abishard

    CPMA - CEUs

    Any ideas? I am definitely open to ideas for the CPMA as well. I need 4 CEUs by April. I am thinking any of the self-study modules from CMS in Medical Learning Network. Any other ideas?
  23. abishard

    CPMA - CEUs

    Medical Record Auditor by Deborah Grider Here is the response I got from the AAPC regarding CEUs for this book: Question: I recently passed the CPMA. I purchased Deborah Grider's book, Medical Record Auditor. Can this book be counted toward CEUs? Please advise. Thank you. AAPC Response...
  24. abishard

    Cpma

    My advice is to get Deborah Grider's book, Medical Record Auditor. I saw where a lot of information from the book was referenced in the questions. I would also review Joint Commission documentation guidelines and the OIG website.
  25. abishard

    CPMA - CEUs

    I will let you all know when I find out. I definitely recommend the book to anyone taking the test.
  26. abishard

    Cpma

    Congrats everyone!
  27. abishard

    CPMA - CEUs

    I read Deborah Grider's book, Medical Record Auditor. As I understand, this can count toward CEUs, correct? How do you report that?
  28. abishard

    Cpma

    I also took my test on 12/12.
  29. abishard

    Cpma

    YAY! Congrats all! I was glad to hear they threw out a few of the questions.
  30. abishard

    E/M template that can be carried over

    Anything related to the review of systems and past family and social history may be referenced to include a date and location so long as any changes are noted. This information is in CMS Documentation Guidelines. As far as the exam, this cannot be carried over unless it was actually performed...
  31. abishard

    Time of signature & date required?

    I do not think the Joint Commission rules apply in this case. The JC has the requirement for date, time and sign based on patient safety. On our local Medicare website (WPS), it does state that any ROS forms referenced must include a date and location.
  32. abishard

    Cpma

    Tessa, I appreciate your feedback. My question is then, how do you differentiate between whether an exam is expanded problem focused or detailed using the 1995 guidelines? Amy B. CPC, CEMC
  33. abishard

    Question on MDM

    I do not count problems that are not addressed as number of diagnoses. This could affect your risk though. \
  34. abishard

    Cpma

    I agree, I'm dying for the results! I do have one comment about the E/M portion of both the CEMC and CPMA. How on earth are you supposed to tell the difference between a 95 and 97 exam? According to the guidelines, you can have either one. My feedback is that any question that makes you choose...
  35. abishard

    Urodynamics - Our office does urodynamic

    Yes, this is video urodynamics. The 76000-59 bundles with CPT 51600 & 74455. From what I can tell, fluoroscopy includes radiological interpretation & supervision (CPT 74455). However, what about the other urodynamic codes? I just have a physician who is adament that we can bill together with a...
  36. abishard

    Urodynamics - Our office does urodynamic

    Our office does urodynamic studies with fluoroscopy. We get a lot of denials for CPT 76000-59 as it is bundled with the injection procedure for voiding urethrocystography. It does not show as being bundled with any of the urodynamic codes (51725-51798). Does anyone have an insight or information...
  37. abishard

    Injury to abdomen during pregnancy

    That's what I was thinking, but then I saw 665.X. I realize those codes likely relate to trauma from pregnancy, but could they also include my scenario? Thanks, Amy
  38. abishard

    Injury to abdomen during pregnancy

    I'm needing an ICD-9 for a pregnant patient whom was kicked in the abdomen.
  39. abishard

    Critical Care Billing 99291

    More than one physician cannot be providing critical care at the same time per Medicare guidelines.
  40. abishard

    Diagnostic Supervision

    I found my answer. If you look at the Final Rule in the Federal Register in 1997. Page 59058. They clarify that the supervision requirements apply to the TC (including when billed as part of the global charge). Here is the link...
  41. abishard

    Diagnostic Supervision

    I have a question regarding diagnostic supervision. Why is it that the physician supervision indicators are only for the TC component? I understand why they don't include the PC component (I think), but why not the global code? Why do they state concept does not apply? Any input is...
  42. abishard

    Need help!

    I am needing help with a procedure. FINDINGS: Markedly enlarged spleen with distal pancreas intimately attached to the tip of the spleen, accessory spleen approximately 3 cm in size (resected). DESCRIPTION OF OPERATION: The patient was brought to the operating room and placed in a supine...
  43. abishard

    2009 CPT - Modified & Deleted Codes

    Anyone? Thanks for the help.
  44. abishard

    2009 CPT - Modified & Deleted Codes

    Hello, Does anyone know where I can get information on the modified and deleted codes for 2009? Thanks!
  45. abishard

    Orthopedic Coding Workshops

    I am looking at attending an orthopedic coding workshop and would like recommendations from others regarding recommendations, experiences, etc... Thanks!
  46. abishard

    radiology incidental findings

    I would definitely code abdominal pain first. I almost always code the symptom, or reason for exam first, unless there is an extremely acute condition and/or the radiologist states that is the reason for the symptom.. I hope this helps... :)
  47. abishard

    radiology incidental findings

    In this case it would depend entirely on what the findings are...I usually code findings when they are something acute and the radiologist emphasizes the findings in his results... If they find diverticulitis or an obstructing calculus, then I almost always code that first.. What were the findings?
  48. abishard

    Mri & Ct Scans

    I code for a diagnostic imaging center. We are trying to find information in regards to billing for contrast for MRI & CT. We are trying to find out if we can actually bill for this if it is not payable? Does anyone have any information on this?
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