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    Infusion code for Actemra

    I am trying to find the correct CPT infusion code for Actemra infusions. Everywhere I looked on the internet just said to use 96365 or 96413. Does anyone have any experience billing this drug and it's infusion? I do not code based on payer guidelines or the type of insurance a patient has...
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    Help with magnesium infusions

    I was wondering if anyone can help me code the following scenario. I am having a hard time deciding whether or not to bill for all 4 hours that the magnesium was administered or if I should just report the hour that it ran prior to the chemo infusion. Here is how the start and stop times are...
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    Therapeutic Infusion Pump???

    Does anyone have experience coding for a therapeutic drug (Mesna) that is administered in a continuous infusion pump overnight? If the Mesna were mixed with Ifex, I would use the code for the chemo pump initiation, 96416, however, the Ifex is only being administered in the chemo suite/office...
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    Concurrent vs. Sequential IV Infusion

    I am "stuck" on a chemotherapy infusion encounter and wondered if anyone else has come across something like this: Mannitol - IV Infusion from 10:00 - 15:30 Decadron - IV Push at 11:00 Kytril - IV Push at 11:02 Pepcid - IV Push at 10:25 Cisplatin - chemo iv infusion from 11:40 - 13:10...
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    To bill a Pyloroplasty or not to bill.....

    Can anyone tell me, if a pyloroplasty is done in conjunction with a partial esophagectomy and we bill CPT code 43117, should the pyloroplasty be reported separately? The description of CPT code 43117 states, "partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal...
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    94150 -Peak flow question - Help!!

    I was wondering if a patient can have 2 peak flow studies done on the same day and if so, can it be billed twice or in units of 2? I can't seem to find anything that states whether or not it should be billed more than once/day. Does anyone have any documentation to support billing it once or...
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    94150 - Peak flow question - Help!

    I was wondering if a patient can have 2 peak flow studies done on the same day and if so, can it be billed twice or in units of 2? I can't seem to find anything that states whether or not it should be billed more than once/day. :confused: Thanks for your help!!
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    Denial by secondary insurance - HELP!!

    Hello. I have a situation where one of our psych docs saw a patient at a Comprehensive Inpatient Rehabilitation facility (POS 61). The patient was elderly and had Medicare as primary insurance so our physician billed a 99223 instead of a consult code which is perfectly acceptable for Medicare...
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    POS 61 and Psych Consults & Cigna

    Hello. I have a situation where one of our psych docs saw a patient at a Comprehensive Inpatient Rehabilitation facility (POS 61). The patient was elderly and had Medicare as primary insurance so our physician billed a 99223 instead of a consult code which is perfectly acceptable for Medicare...
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    44140 vs. 44160 HELP please!!!

    I have an op report that I am having a difficult time dissecting. I wondered if anyone would be able to give me some direction. I am looking at coding as: 44145 44139 44140/59 vs. 44160/59 44310 Will you please let me know what you think? the documentation is not very clear when it comes to...
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    HELP! Pacer and ICD Denials

    I am working on medical necessity denials for pacemaker and ICD insertions. I used to code these all the time but haven't since 2009 and at that time there were very specific guidelines and diagnosis codes that Medicare would cover. Now, Medicare just keeps telling the billers to look at the...
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    Yervoy billing - J9228

    Hello. I am trying to figure out hot to bill for Yervoy (J9228) and was wondering if any one else has billed this drug. It comes in a 200mg single dose vial and the patient received 169mg. Should we bill this drug as 169 units or is it just 1 unit for the entire SDV? Thanks in advance for...
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    Lead Replacement

    Hello! I used to dabble in Cardiology coding but am not up to par and really need some help with all of these new CPT codes. I am trying to code a pacemaker lead replacement but am not sure which way to go. Here is a copy of the op note: Following oral and written informed consent, the...
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    To use 22 or not to use 22, that's the ??

    I have a provider who wants to add a 22 modifier to their procedure but I don't think that the documentation supports a 22 modifier. There is nothing in the body of the op note to indicate that the procedure was more difficult or took extra time. The only part that states anything about the...
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    Neurostimulator analysis

    I am looking at charges for an implanted neurostimulator analysis and the physician billed codes: 95978 (for the first hour), 95979 (each addt'l 30 min.), and 95979 (for an addt'l 30 min.) all on the same DOS. The claim had each code on it's own line item and one of the 95979's was denied as...
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    Q2049 - Lipodox

    Hello. Are any of you billing for the drug Lipodox because of the national shortage of Doxil? If so, does anyone know what Medicare's pricing is or how much they pay for Lipodox? I've gotten conflicting answers when I asked for the price and the dose of the drug. I know that it comes in two...
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    Place of service 22 vs. 11

    Hello. I wasn't sure where to post this question so I'm posting in two places in hopes that someone can help me out. We have an oncology center that has physician offices (place of service 11)on one side of the building and then the patients get their infusion done across the hall in the...
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    E/M visit on same day as infusion service

    Hello. I wasn't sure where to post this question so I'm posting in two places in hopes that someone can help me out. We have an oncology center that has physician offices (place of service 11) and then the patients get their infusion done across the hall in the outpatient infusion center...
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    DOS for EEG Interpretation

    If a physician reads an EEG that was done on a inpatient, but he does the read on a different DOS than when the test was performed, what DOS should he use for his interpretation? I'm getting conflicting information and could use some clarification. Does anyone know if Medicare has guidelines...
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    Can a chiropractor bill E/M codes to Medicare

    I am searching for some documentation from Medicare about E/M visits and chiropractors. Does anyone know if chiropractors can bill Medicare for E/M visits and if so, is there a policy or documentation on this somewhere? Thanks in advance for your help! :confused:
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    HCPCS Code S9472 and Reimbursement

    Hello! I am doing some research on the Temporary HCPCS code, S9472 and was wondering if anyone has any experience billing this code and what your experience was like, who paid, who doesn't pay, how did you figure out how much to charge for it, etc. Any information would be greatly appreciated! :D
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    Procedures similar to TAVR (0256T)

    We have a new provider who is going to be performing the TAVR procedure and we are trying to find procedures that are similiar to the category III CPT codes 0256T and 0257T. If anyone can help lead me in the right direction in order to find CPT codes that are somewhat similar to these...
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    Arterial Catheterization with AVR

    Does anyone know if it is ok to code the arterial catheterization for monitoring (36620) along with an aortic valve repair (33405) and CABG (33533)? I am thinking that it is included in the primary procedures but cannot locate anything to confirm this. I am having a hard time reading the op...
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    Pap/HPV interpretation

    If our GYN doc bills out an 88175 for the thin prep part of the path and the laboratory does not bill the patient, they bill our facility directly, is it appropriate to also bill 88141 & 87621 if the GYN doc then interprets the pap and decided to test for HPV? :confused:
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    Sternotomy CPT Code?

    Does anyone know if there is a CPT code for just a sternotomy? :confused:
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    Surgical Documentation Guidelines - group of Oncologists

    I am trying to teach a group of Oncologists how to document op reports when they do bone marrow biopsies. Does anyone know where I can find any guidelines on how to document an op report? I come from a general surgery background but most surgeons know how to document what they did...
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    Nurse visit for chemo education

    Does anyone know if it is ok to bill a 99211 if a patient comes in for chemo education and talks with a nurse? Everything is documented in the chart, I just need to know if we can bill for it or not. Thanks for your help!
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    Phlebotomy and venipuncture

    Does anyone know if it is ok to bill a venipuncture if a phlebotomy was attempted but not actually performed? :cool:
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    Billing for EKG electrodes?!?!

    Does anyone bill for the electrodes that are used when a physician performs an EKG in his/her office? I think that the electrodes are included in the charge for the EKG itself but we have a physician who wants to bill extra for using the electrodes. Does anyone have any documentation on this...
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    93018 with a 93350-26???

    When a cardiologist reads and interprets a Stress Echo in the hospital setting, I have been using code 93350-26. Do I need to add a 93018 for the interpretation of the stress test as well? This is my first time coding these so I'm just learning all of the "ins and outs." Thanks in advance for...
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    Diaphragmatic Attenuation Defect ICD-9 Code

    Does anyone know the correct ICD-9 code for a diaphragmatic attenuation artifact that causes an MPI stress test to be abnormal? Do you use 794.39? This comes up a lot and I can't find any information on how to code this dx correctly. Please help!! :confused:
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    Diaphragmatic Attenuation Artifact

    Does anyone know the correct ICD-9 code for a diaphragmatic attenuation artifact that causes an MPI stress test to be abnormal? Do you use 794.39? This comes up a lot and I can't find any information on how to code this dx correctly. Please help!! :confused:
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    78452 - TC & 26 Modifiers??

    Our Cardiologists own their own MPI SPECT imaging equipment but we have a group who is billing code 78452 with a TC modifier. The office is telling us (we do our coding off site) that a tech does the test and a physician reads or interprets the test therefore, it is reasonable to bill the 78452...
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    78452 - (TC & 26 Modifiers)

    Our Cardiologists own their own MPI SPECT imaging equipment but we have a group who is billing code 78452 with a TC modifier. The office is telling us (we do our coding off site) that a tech does the test and a physician reads or interprets the test therefore, it is reasonable to bill the 78452...
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    Observation with Cardiac Cath on same day

    Does anyone know where I can find information on admitting patients to observation status and doing a cardiac cath on the same date of service? I know that this is not allowed unless the patient is admitted to inpatient status AFTER the cath but I need something in writing to show our...
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    Help coding an aortogram!!!!

    During a heart cath, an aortogram was performed because the physician was unable to "cannulate the ramus graft." I think that I can use code 76000-59. Does anyone know if this is correct? I was also looking at code 93567.....:confused:
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    Endolymphatic sac enhancement - HELP!

    I am not an ENT coder at all and am trying to code the following procedure; the physican used codes 69436 & 69806. I would really appreciate any help I can get!! "Left facial nerve monitoring was applied in perioral and periocular areas. On ce this was completed, preppeing of the ear was...
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    Echo M-Mode + 2-D (HELP!!)

    The physician I code for is reading a bunch of procedures labeled Echo M-Mode + 2-D and I initially thougth they were TEE's until he stated in his interpretation of one of these tests that a "transesophogeal echocardiogram could better delineate the interatrial septum." So, my question is, is...
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    Ejection Fraction Dx code?!?!?!

    Does anyone know if there is a dx code for "reduced ejection fraction" when the diagnosis is obtained by doing a TEE? :confused:
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    2 Day Nuclear Stress Tests

    I am coding 2 day nuclear stress tests and am not sure I am coding them correctly, can someone please help? I am using codes 78452 - because 2 (stress and resting) tests are being done 93015 - for the reading, supervision and testing A9500 2 units - it is injected after the stress test and then...
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    Need help coding 2 day Stress Tests

    I am very new to Cardiology coding. This is my 3rd day. :) I need to learn how to code 2 day cardiac stress tests but have no clue where to start. Can anyone help me? :confused: Thanks so much!
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    claudication/rest pain vs. embolism/thrombosis

    Hello and Happy Holidays! I was wondering if someone can tell me the difference between the diagnosis codes, 440.22 (atherosclerosis with rest pain) and 444.22 (arterial embolism or thrombosis of lower extremity) and which one is of higher specificity. I assumed that 444.22, the actual clot...
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    Please help...new to cardiothoracic

    I was wondering if anyone out there can lead me to some material or information that will help me better learn cardiothoracic coding. I started my job about a month ago and I have the CABG procedure down but I get so confused when it comes to Aneurysm repairs, Septal Defect repairs and post op...
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    HELP! Possible new job as Cardiothoracic Coder!!

    Hello! I have been a coder for 4 years and have coded General Surgery and Hematology and Oncology. I have relocated and have an interview next week but do not have a CPT book with me to look at. I was wondering if any of you who already code cardiothoracic would give me some hints as to what...
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    Experienced CPC looking for opportunity in West Chicago Suburbs

    I am a dedicated, experienced coder and am looking for a permanent employment opportunity in the West Chicago Suburb area. I love to learn, am a very quick learner and embrace all opportunities to further my knowledge of medical coding, billing and anatomy. I look forward to sharing my...
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    Breast Cancer in chest wall and axilla

    One of our surgeons operated on a pt who was diagnosed with breast cancer. Her original mastectomy was performed in December and she presented again in January with metastasis to the chest wall that involved the pectoralis and pectoralis muscle and the axilla. The physician then performed an...
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    Inguinal Neurectomy

    One of the physicians I work for did a neurectomy on a pt's inguinal nerves that were stuck to the mesh after a hernia repair he had done last year. Does anyone have any idea how to bill for this? I hate to use the unlisted code but I have searched the neurectomy codes and none of them pertain...
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    To use Mod. 51 or not to use....

    Please help! I recently heard that Medicare will not allow use of Mod. 51 anymore and I've heard some coders state that they don't even append it to CPT codes at all. I bill for general surgeons so we do a lot of "multiple procedures" and I am worried that I have been billing incorrectly...
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    Laparoscopic Removal of Foreign Body

    One of my physicians removed a toothbrush from a patient's stomach laparoscopicaly. He did a gastrostomy and then closed it after removing the toothbrush. Would I use a 43653, Lap Gastrostomy, w/out construction of gastric tube to bill this?
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    Excision of Infarcted Omentum

    One of our surgeons did a laparoscopic excision of an infarcted omentum. We found the code for an open procedure (49255) but were unable to find a code for a laparoscopic procedure. He began the surgery with the intent of doing an appendectomy but discovered the infarcted omentum upon entering...
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