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  1. V

    Appendectomy with negative path

    I have a patient who came in through the ED with a positive CT of the lower quadrant signifying possible appendicitis . The patient is taken to the OR , The physician does a laparoscopic appendectomy with abdominal lavage , he find the patient has a hemorrhagic ruptured ovarian cyst, this is why...
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    Melanoma down to the Fascia

    I have a few questions - I have a patient who had a 1.1 centimeters excision of melanoma insitu with wide margins up the upper arm Here is the majority of the OP report Patient taken to OP room , General anesthesia was done . An Elliptical incision was made and carried DOWN TO THE FASCIA ...
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    placement of balloon occlusion catheter

    I need help coding the urology portion of this. Patient is getting a nephrostomy tube/percutaneous nephrolithotmy done by the interventional radiologist My dr is doing the following Cystoscopy with removal of right ureteral stent , and placement of a right balloon occlusion catheter. How...
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    re-opening of mastectomy site to remove Pectoalis Major Muscle

    I am needing some help on this procedure. I have never had one like this before and I have researched and searched and I am not having any luck Patient comes in post mastectomy , path came back with positive deep margin in the left breast. Our Dr re opens the mastectomy site to remove the...
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    Brookesource is hiring for Louisville KY area

    I know it is hard to find jobs out there but there is a company right now that is hiring temp to full time hire for U0fL Physicians. If anyone is interested I would be happy to pass along Brooksource information. I was going to take a job with them but ended up finding one closer to my home. I...
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    review of systems - enlarged lymph nodes

    Can someone please explain to me a question I have about the ROS ? Here is the example I have : no fever, cough, respiratory issues or enlarged lymph nodes, all other systems negative. So when a Dr says ALL OTHER SYSTEMS NEGATIVE, does that COMPLETE the ROS ? My Dr says that completes it and I...
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    MVA question probably asked 100 times

    Ok everyone - I am having a disagreement with the MVA codes with the other coder. My patient was the driver and involved in MVA on the road with another moving vehicle. Would you use E812.0 or E819.0
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    ED turns into Observation

    I am new at ED coding. I used to do physician practice coding. BUT is it possible for a patient to be in the ED and turn into Observation care so that my ED drs can bill observation ( 99218,99219,99220,99217 ) and what has to happen in order for this to be billed? I had an alcoholic that came...
  9. V

    modifier 76 is bringing me stress

    I need some help . My boss feels when we do 2 ekg's in the ER that we should just multiply them by 2 . So this is what she wants us to code 93010 X 2 ( they just do the interpret ) I am new here so I try not to butt in with my advice ( I have coded for several years but I am the newbie and...
  10. V

    need some auditing advice

    I posted this on the auditing forum but I am going to post it on here to. If there is an auditor out there that would be kind enough to PM me. I have an auditing question in regards to Physician Services for Emergency Room . I don't want to waste your time but I am having a hard time finding...
  11. V

    auditing question

    Hello I really need an auditor that can maybe time out of their busy day to help me with an auditing question. It has to do with Emergency Department E/M levels. So if you have time to help me will you please private message me. Thank you Valerie
  12. V

    ED auditing help

    I am new to ED coding. I have coded for physician services 8 years and now recently got a new job in ED Coding. I need help with understanding some auditing for the ED. Can anyone give me a good resource or something to help me better understand ED auditing? From what I can gather from starting...
  13. V

    CPC to INPatient coding

    Can someone advise me on how I could go from doing Professional charges to INpatient facility coding? I am looking for a way to transition. I have worked n coding for over 10 years and I have no guidance on how to transition. I work for a hospital where I do the professional charges for...
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    Experienced CPC looking for job in Southern Indiana

    I have over 8 years experience in professional coding. I am looking for a job in Southern Indiana. If you are interested I can give you a full resume.
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    Med assets

    Has anyone out there heard of this company called Med Assets ? Our hospital is hiring ( or I should say spending lots of money ) on this company to come in and "observe" us to see what they can do to make our work go more "smoothly" They done this to our business office about 3 months ago...
  16. V

    Ureteral dilation

    Anyone have any idea on these 2 procedures? I am having a brain freeze Cystourethroscopy , bilateral retrograde pyelogram, right ureteral dilation, right ureteroscopy, with stent insertion I have the stent insertion part 52332 , but not sure what to use for the Ureteral Dilation ... I...
  17. V

    EXAM under Anesthesia,conversion seton

    I am very confused on the following operative note. The patient already has a seton in place, however the Dr is doing a conversion of it. Here is a sum of the note The Bivalve retracto was placed into the anal canal showing the seton located in the fistual tract located posteriorly. The...
  18. V

    job duties

    This might be a weird and stupid question but as a CPC what should my basic job responsibilities be? There is some tension here between Hospital coders and us. Hospital Coders get paid more than we do , but yet we went to school 2 years, took a cert exam, keep up with CEUS, and do a lot of...
  19. V

    injection denials

    We are having issues with the insurance companies denying therapeutic injections when they are billed more than once. For example ..they come in for a problem and then they additional need a testosterone and a B12 injection So we are billing 99213 mod 25 for maybe 401.9 , 250.00...
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    CCS-p and CPC problem

    Recently, my organization has decided to hire an additional physician coder. We have many phone calls from other departments wanting to transfer to the coding department(most of them with no coding classes or experience ) One of these girls we have known for sometime. FInally at the end of her...
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    vender vs medicare

    I have posted a thread about this before. It has come up at my employement again. We are a small hospital with about 50 providers with different specialties. I work for the physician side of the hospital. About a year ago we went to a new computer system, and in about 2 months they are...
  22. V

    The Future of the Medical Practice

    In my company we have been having a consulting firm coming in to inform us on some changes our practice/hospital is going to have to make within the next 3 years. I guess I am confused and would like to find some additional information. In one part of this meeting we discussed how the physican...
  23. V

    radiation oncology

    Can someone tell me when the radiation oncologist bills for 77427 - weekly radiation therapy , if you would use V58.0 as primary and the cancer code as secondary? Example: patient is here for radiation treatment for lung cancer. I would use CPT 77427 .... with DX V58.0, 162.9 When I look in...
  24. V

    radiation oncology help

    Hello I am in desperation... I have recently been given the task to do the coding for the professional side of radiation oncology. I have NO CLUE what I am doing. I have been trying to research things about it, but cannot understand what the sites are trying to tell me. The hospital I work for...
  25. V

    coding from home complication?

    Hello I posted this on the employment forum, but want to know if anyone on here can help me out. I did not get any replies to my question on the employment forum. There is some talk about our hospital sending all coders and transcriptionist home to work.I am a coder for the physician side...
  26. V

    working from home complications?

    Ok so our hospital recently told us with our new current computer system we should be working from home real soon. . . Here is the problem: I know some other places that has done this and they have basically made their coders contract out to them. When that happened the coder have lost all...
  27. V

    CPC-H Not recognized

    I have noticed most of the hospital/facility jobs never say anything about looking for a CPC-H. It always refers back to wanting a CCS or a RHIT. So is it worth getting your CPC-H through the AAPC if no employer will look at that credential? I am confused in general on what to do. I am looking...
  28. V

    coding Outlook

    Can someone tell me how the outlook for professional coders is? What I mean is I am a CPC working for physician offices. I am now in the process of looking for a new job but all the jobs I see are for Hospital Coders / facility coding. It seems to me like there are no jobs out there for...
  29. V

    buy out

    I just got wind that a bigger hospital is going to be buying out our hospital. I am pretty worried about my job . Anyone been through this situation where a Bigger Hospital buys out the smaller one. Guess there will be no need for a physician coder anymore.
  30. V

    outpatient coder versus physician coder

    This might sound a little stupid but what is the difference between an outpatient coder and a physician coder. I know an outpatient coder, codes for a lot of the facility outpatient services, but as a physician coder( that is what I do ) I code for the physicians for their office and hospital...
  31. V

    Will Coding be Obsolete

    So I have a question, does anyone think coding will be obsolete one day? I was talking to a few of my Dr friends...and they think eventually coding jobs won't exist. It kind of makes me wonder at times. I know that a lot of the new EMR systems are really pushing people like medical records...
  32. V

    The Sad Truth of training

    My employment just doesn't think ICD10 is all that important. Recetly, the physician coders have recently been put under the Hospital Coders. We are 2 diffferent worlds. With the combining of the 2 departments, the BUDGET has been cut. Now, my boss feels it is only necessary to send 1 coder to...
  33. V

    Specialty Exam

    I am thinking about taking the Family Practice Specialty Exam. Any tips or anything that really stood out that I should know ? Just looking for some pointers before I go into this blindly
  34. V

    counseling with family

    I need help, I have a Dr wanting to bill an E/M 99212-99215 for a patient's family coming in and talking regarding the patient for over 30 minutes. The patient was not present. NOW , we can't bill this to begin with because it is a Medicare patient and the patient must be present. However, is...
  35. V

    Auditing info

    Could someone please tell me where I could get my hands on some information about auditing. Our establishment usually has an auditor do all the audits, but our auditor has left and they have not hired a replacement yet. Therefor , I have been having to do some auditing on a few of the office...
  36. V

    Chronic Immunosuppressive therapy

    How would you code for someone that is on Chronic Immunosuppressive Therapy? I am confused? I have a few ideas. 1) 279.49 or 2) code for the chronic steroid use V58.65 ... or something else? Please suggest?
  37. V

    influenza a

    What DX would you use in an outpatient setting where the Dr documents the following: Influenza A positive, SUSPECT Swine since this is a suspect I cannot bill the 488.1...so what do I use? 488.0 ?:confused:
  38. V

    health plan

    Does anyone else think with Obama's new health plan, their job will be in jeopardy? I am so paranoid about this. I have been protesting the health plan because I don't want to loose my coding job. Any thoughts?
  39. V

    Today I laughed my BUTT off

    As I was looking through the new Coding Edge Oct 09 issue ,I saw they had the average salary information. Well when I looked at my state I noticed how Underpaid I really am. In fact our hospital tries to be "comparable" but I am way under paid. I even looked at the average of :"credential"...
  40. V

    Medical Coding Week

    Does anyone know if there is a Medical Coder week? I hear next week is Nurses week....which our hospital LOVES to recognize. I would like to know if there is a Medical Coding week so I can try and get the hospital to recognize us too.
  41. V

    Outpatient Observation 99234-99236

    Ok all my E/M friends, I need your help. I am having troubles understanding the 99234-99236. Here is my dilema. Now keep in mind I am billing for the physician, not the hospital. I have a patient that comes into the ER at 11:59PM on Monday 6th. The ER goes ahead and admits him to OPO on...
  42. V

    Observation 99234-99236

    Ok I am stumped. I have a scenario I am not real sure of. Here we go. I have a patient whom came into the hospital on 6/30/08. She was admitted into observation however, the Dr did not come in for her intial visit until 7/1/08 and that day she later discharged the patient on 7/1/08. It was...
  43. V

    E/M and Colonoscopy

    This might be a little odd but since I have been doing coding I always look at my mom's EOBs and Dr Bills for her. Well she went into the hospital for an outpatient colonoscopy; and the Dr also billed a 99213 with it. I asked her if he talked to her prior or after the procedure and she said , "...
  44. V

    ECG Report

    Does anyone know for CPT 93000 and 93010 what are the documention requirements for the report? Does the provider need to document a separate written report for the " interp and report" component?
  45. V

    Urology-CPT 64585

    Does anyone know on CPT 64585 if the nurse can remove the leads or does this need to be performed specifically by the provider? I also am assuming if the nurse can remove the leads, we would need to follow 'incident-to- guidelines'.........please advise and thanks!
  46. V

    April Coding Edge

    I have a question: In your April Coding Edge question number 10 ask: The cause or mechanism of clubbing is: A: Gout B: We Don't KNow C: Cardiovascular D: Pulmonary Can anyone tell me the correct answer. It sounds like it would be I don't know because they talk about it being in many...
  47. V

    unrecognizable

    This might seem strange but I thought I would write about it... I find it is a little humorous in a way... This past year I got a medical coding position for a hospital. I actually do outpatient coding. I am apart of a huge organization that has employed 50 + doctors who works for their...
  48. V

    my last resource

    I really need someone's help. I have bene doing ambulance billing off and on for about 4 years. Well basically all I do now is check the EMT's work to make sure the billing is correct based on the details they give me on their runs reports. Our director wants us to bill specialty ( A 0434 )...
  49. V

    2 E & M's / seperate carrier

    I have a NEW patient who came in for an office visit. This office visit is to be billed under a Third party insurance. While the patient was here for that visit, she had another problem UNRELATED to the first issue. Therefor, the 2nd complaint needed to be billed to her private health...
  50. V

    Coder Ratio to Physicians

    Hi I have a question that has been bothering me for a while. We have 2 medical coders for a multi speciality physician practice. There are approximately 40 physicians in this practice. So basically we have 2 coders trying to keep up with 40 doctors with approximately 8 different specialtys. The...
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