1. D

    Wiki Nerve conduction tests. 95885

    I have a question 95885 when dr. performs this on both sides would I bill 95885 with 2 units, or Lt and RT I am not sure I am new to this kind of testing thank you
  2. E

    Wiki New Drug Codes for 2016

    How is everyone handling the new codes? We do a five panel so we have replaced the G0434 with G0477, but my question is, how do we bill for the independent test that used to have a Gcode? for ex.alcohol (G6040), salicylate (G6038) acetaminophen (G6039) Would we use the G0480-G0483 dependent on...
  3. D

    Wiki 93970 vs 93971 - bill cpt code

    Can someone tell me exactly what is required to be scanned to be able to bill cpt code 93970? We have been billing 93970 for ALL bilateral duplex ultrasound and I think this has been incorrect. I think some should have been coded as 93971. With that said if we are doing a limited bilateral...
  4. D

    Wiki 93970 vs 93971

    Can someone tell me exactly what is required to be scanned to be able to bill cpt code 93970? We have been billing 93970 for ALL bilateral duplex ultrasound and I think this has been incorrect. I think some should have been coded as 93971. With that said if we are doing a limited bilateral...
  5. K

    Wiki 96413 verses 96365

    Can someone explain the difference between 96413 & 96365? We administer infusions of drugs such as Remicade, Actemra and Orencia. We have always been told to bill 96413 to Medicare and 96365 for all other insurance companies, but we are now having some debate about whether we should be using...
  6. T

    Wiki Colonoscopy -know this has probably

    I know this has probably come up several times, but here goes again. A pt came in Aug 2011 for colon w/biopsy 45380 at the age of 62 with UHC insurance and dx for diverticulitis. In 2008 he also had 45385 with UHC for dx blood in stool. He is now 67 and has Medicare and has no symptoms. The...
  7. M

    Wiki Instument Based Ocular Screening - Smartphone Mobile app and Billing?

    Does anyone know if there are any reimbursable CPT codes that I can bill when a provider is using their smartphone mobile app to analys data for an eye test? Or is their a reimbursable CPT code that can be used to bill for conducting the eye exam via the smartphone?
  8. D

    Wiki Facility ESI Billing-I need to bill

    How do I need to bill hospital charges for an independent CRNA?
  9. D

    Wiki Facility ESI Billing for CRNA

    How does a hospital facility bill for an ESI done by a CRNA? Does the facility bill under the referring provider or the CRNA, this is an independent CRNA we just bill facility codes, however the referring provider is getting the precert for the facility and using the surgeon as the rendering...
  10. S

    Wiki Standing Orders

    I have a situation where a practice has nurses see patients under standing orders for immunizations, TB tests, and some labs. They want to bill these services under the chief of staff NPI number (due to the standing orders). The situation, I feel has gotten out of hand. Nurses may triage a...
  11. B

    Wiki Trigger Point injections

    Good Morning! Can anyone tell me whether or not you can report the HCPCS injection code in addition to the trigger point injection codes (20600, 20610, 20552)? I know that you can't bill for the lidocaine, but we also in many cases inject depo medrol and wondered if we could be billing for that...
  12. A

    Wiki Billing Medical Supervision for CRNAs - NOT Medical Direction

    We're having quite the discussion in our office over proper use of anesthesia modifiers for billing CRNAs practicing without medical direction but with medical supervision. We are in a state that did not opt out of the medical supervision requirement for CRNAs. There are two lines of thought...
  13. S

    Wiki No billing for Pap smear

    I have an np that wants to bill for Pap smear. What code should we use and can we bill with an office visit? We send the pap out to the lab.
  14. K

    Wiki Simple Coding Question

    Is a transection of the isthmus code 60200 included in 31603 emergent tracheostomy code or can you bill these 2 codes separately? Thanks
  15. T

    Wiki Non global package

    We had a patient (she has Molina insurance) seen on 7/15, 8/15, 9/8 and 9/22 and then 4 more times in October. How are we suppose to bill for dates of service before October 1st?? Do we bill as a low office visit. Insurance companies want ICD-9 and ICD-10 codes on different claims. I don't think...
  16. C

    Wiki JW mod for KS

    Our office is trying Botox therapy, and we are trying to determine if the JW is used in KS? If not - do you go ahead and bill a used line and a waste line? Thanks, Cyndi
  17. M

    Wiki Bill for radiologist's interpretation of fluoro images?

    01/19/16 Folks, Does anyone bill for the fluoro images interpretated after the fact by a Radiiologist? Wondering what other facilities do with respect to fluoro spot images and views.
  18. D

    Wiki 29827 rt 29822 rt

    I know these codes use to have edits but when I put them together in medicare cci edit it says stands of medical surgical practice with 1, does that mean its okay to bill without modifier also McKesson says its allowed without any issue, I would appreciate anyones help thank you
  19. G

    Wiki G6024 and PT modifier.

    Okay, we know that Medicare is denying G6024 with a PT modifier. So my question is, how do I bill this so that they pay it?
  20. J

    Wiki Help!!!! Ortho coding

    I have a patient that was seen in ER on 12/2/15 and then went directly to the office to be seen. The PA saw him and billed 25600 and then on the same day he went back according to the notes and was admitted for outpatient Surgery, The dictated operative report on 12/2/15 by the physician is...
  21. K

    Wiki E/M with a 25 when doing an injection?

    Hello, I am fairly new to orthopedic coding and our docs do a lot of injections! I am struggling with when it is okay to bill an office visit with the 25 modifier. The guidelines that I was told to go by was that we always bill a new patient (99202-99204) with the 25 when an injection is...
  22. D

    Wiki 2 ICD 10 codes that are the same code different meaning

    When billing out a claim and they have the same diagnosis code but with different meaning, can you bill for them both even though they are the same?
  23. P

    Wiki How to bill when one Provider in practice opts out of Medicare

    I need some advice on how I would bill Medicare for the Nurse Practitioners who still participate in Medicare but the Doctor has opted out of Medicare? And all three are in the same group practice that the Doctor owns. I would appreciate any information I can get...
  24. D

    Wiki 80300 - give a prescription

    drug screening, they bill this in the new office I am in before they give a prescription, but its not getting paid, they said they never pay for this does anyone know the facts on this ? thank you
  25. N

    Wiki "Not payable due to coordination of benefits"

    Please help me to understand this. We bill Medicare and many patients have secondary. My question is below. Example: BlueCross EOB says "This amount is not payable due to coordination of benefits with the member's other carrier. " In this case, can we bill patients (Medicare allowed...
  26. T

    Wiki 69209

    Can this be billed under the doctor if a medical assistant is doing the procedure? Our MA's do a lot of the ear lavages. We stopped billing 69210 for them since it had to be done with "instruments". We would just bill a 99211 for them. Thanks
  27. S


    We had a patient scheduled for MVA follow up injury to his back. However, we he was seen he had very high blood pressure which was also treated at visit. Not sure how or to whom to bill. He is scheduled to be seen 3 days from now. Should I bill MVA only?
  28. D

    Wiki 26720 fracture coding help

    patient has two broken fingers on the same hand would I bill 26720 by itself or 26720 with 2 units
  29. L

    Wiki Discharge and Readmit on same DOS

    I have a patient that was discharges from OBVS and came back into ER an hour later admitted to OBVS again. Dr. 1 discharged, Dr. 2 readmitted both from same hospitalist group. Can I bill the discharge and admit on same day with a modifier? or how would that work? Thank you.
  30. R

    Wiki MUE of 1 but a bililateral procedure

    If Medicare has a MUE of 1 but the CPT can be billed bilaterally, can you bill this with a 50 modifier and get paid for both sides?
  31. M

    Wiki New Patient Who Was Once Established

    If we have a patient return to office that hasn't been seen in 3 years- we bill them as a new patient. Does this mean they also have to complete all new patient paperwork? Or can we obtain all information verbally? Such as, insurance, address, phone number, past medical history, surgeries and so...
  32. G

    Wiki E & M injections only

    Patient comes in for an injection performed by the nurse are we able to bill 99211
  33. T

    Wiki Coding

    Can you bill together 20610 with 20611 or do you just bill 20611 alone to state an ultrasound was used for the injection?
  34. D

    Wiki injection of Supartz

    hi im new to orthopedics we have a few doctors that keep injecting Supartz into the hip, this drug is used for the knee, of course they are not getting paid, i will look further into this since I am new, but does anyone have or no any information on billing Supartz, J7321, i beleive they bill...
  35. K

    Wiki How long is too long?

    I am new to the industry and am hoping someone out there can give me some guidance. The clinic where I work has a provider who is way behind on completing her notes and closing her encounters out. Some of her encounters are up to a year old. Now she is leaving so she is finally closing them and...
  36. N

    Wiki The new date of service rule for billing transitional care management

    Hello all, I was wondering if anyone had any insight on this new ruling for the TCMS. I am aware that the 30 day wait is no longer and we can bill the TCM on the date of the face to face, however, do we bill the office visit and the TCM? Or do we bill the TCM in place of the face to face? Thank...
  37. B

    Wiki Billing software

    I am needing help in choosing the best software for our Diagnostic Radiology business. We have 1 radiologist who reads for 5 hospitals, 3 family practices, 1 orthopedic practice and 2 Mri Imaging centers. We have a ton of work that comes through our office everyday, and we bill about 300 to 400...
  38. F

    Wiki NP's and treadmill stress tests

    Question has come up today.... can an NP bill for a stress test?
  39. A

    Wiki 2016 rule for Mental Health CPT code 90838

    I was wondering if anyone has any information about there being a new rule for the CPT code 90838? How the new rule applies. Here is the question presented to me. *can we bill two separate clinicians as long as one is the MD/NP the second being a ph.d./lcsw as long as same day same location...
  40. I

    Wiki Billing for continuing care paperwork?

    I am employed at a Pediatric office. We receive numerous request for paperwork to be filled out, signed, etc.. on patients(mostly special needs). My ? to anyone is if we are able to bill for this paperwork as continued care. Medicare does have coding for their patients just not sure if this...
  41. M

    Wiki New Patients for Pain Management

    A new patient is referred for evaluation and treatment, and based on imaging and medical documentation from the referring the provider performs an epidural steroid injection. Is it appropriate to bill a new patient E&M with modifier -25 in addition to the procedure to establish patient care or...
  42. F

    Wiki How to bill for subchondroplasty

    Looking for references on how to bill subchondroplasty
  43. C

    Wiki code help

    what would you code for vestibular nerve resection done with an ENT they want to bill 61616 thanks
  44. C

    Wiki ENT/Neurosurgery

    Can someone tell me what you bill for vestibular nerve resection. The ENT office wants to bill 61616 what would the ENT bill and what would the neurosurgen bill? thanks!!
  45. K

    Wiki Drug Testing Coding

    Hello All- I am completely new to pain management, other than coding for epidural injections. We recently hired a Pain Management doctor and he started doing in office drug testing with "point of care" cups. I am not entirely sure how to bill them, the rep said we can bill medicare with code...
  46. J

    Wiki Premedications before chemotherapy infusion

    Does anyone know if it would be applicable to bill for premedications (benadryl, zofran, etc) given prior to the start of chemotherapy? This would be for facility coding. Please send any references you have and cpt's to bill. Thanks!!
  47. N

    Wiki ASC Billing for Gastroenterology surgery

    I just started working for an outpatient facility. I don't know how to bill for the times, when they do Pre-op- 20 min Anesthesia - 35 min During surgery 1 hour Post-op - 55 min. Does anybody know how to bill for this times. Is there any formula to calculate this. Anybody please help ? Lena
  48. S

    Wiki Breast Bx- Dx code

    When billing for a breast bx, is it best to wait for the pathology report to come back to be able to bill with final dx, or can we bill with the reason the bx was done? Thanks
  49. J

    Wiki Knee manipulation w/ MAC

    Hello all, I can't find my notes...can't bill 27570 since general not used....unlisted in this case?? thanks Jamie
  50. C

    Wiki diagnosis coding for biopsy

    Patient comes in and has a biopsy I was taught in class to wait until the Path is recd back to bill with the correct dx. The physician I work for states we should bill with d48.5, Neoplasm, uncertain behavior. Which is correct and what do you do? If anyone knows where I can find it in black...