1. T

    Wiki Critical Care Question

    If the provider documents under the plan that the patient is not expected to have a neurologic recovery, and he's recommending palliative care consult, consideration of CMO, and documents 32 minutes cc time would that support a critical care 99291
  2. T

    Wiki Fracture care - ATV accident

    Hi there! I have a billing question.. Patient came into our office after a ATV accident. He did not go the ER or anywhere else. The Patient Hurt is left arm Dr noted a Distal radial fracture nondisplaced. He did put a Don joy cast on his wrist but the Patient had to be sent out for Xrays since...
  3. T

    Wiki Occupational Therapy Plan of Care

    Is there a code that I can bill for an Occupational Therapy Plan of Care? I have researched and have not found one. thank you, Trish
  4. J

    Wiki Advance Care Planning - We use time based billing

    We use time based billing in our office. Does this make us exempt from using a CPT code and advanced care planning code together? IE: (We see nursing home patients) 99310 and 99497 is what's I'd like to use together - with all the proper documentation. If we are billing based off time can I use...
  5. J

    Wiki Advanced Care Planning-We use time

    We use time based billing in our office. Does this make us exempt from using a CPT code and advanced care planning code together? IE: (We see nursing home patients) 99310 and 99497 is what's I'd like to use together - with all the proper documentation. If we are billing based off time can I use...
  6. C

    Wiki help with total contact cast (29445) and unna boot (29580) in wound care

    can anyone give me a circumstance when it would be appropriate to code both debridement 11042-11047 and total contact cast (29445) since they bundle, this is in a outpatient wound care place of service
  7. D

    Wiki Wound Care

    Does anyone know if codes 97605 and 11042 can be billed together for the same dos and same site? Thanks!
  8. F

    Wiki Inpatient Care Conference

    I have been asked to bill a 99213 (inpatient visit) along with 99358 (prolonged service) and 99359 (prolonged add on). The note reflects a hospital visit and 1 1/2 hour care meeting comprised of time with other providers and a one on one with the mother of the child (patient). Is this correct...
  9. T

    Wiki Critical care visit requires chief complaint??

    I have a physician that sees a hospital patient and lists his time to bill critical care, but he does not give a chief complaint. If this permitted for critical care since it time driven?
  10. L

    Wiki Ob billing for midwives and home births

    I have a group I am consulting for and working on credentialing for them. The midwives perform OB care and deliveries (which are primarily home deliveries), they bill globally and for the OB care and delivery. However they hire a birth assistant which is a 1099 contractor to assist at the...
  11. C

    Wiki Advance Care Planning 99497

    Good Afternoon: I am curious if anyone has used the following code(s) 99497- 99498 during an E/R Encounter. Code(s) 99497-99498 are used to report face-to-face service between a physician or other qualified health care prof and a patient, family member, or surrogate in a counseling and...
  12. M

    Wiki RN, CPC-A seeking local or remote HIIM position (Nashville, TN area)

    RN with a Master's in Nursing Informatics with a CPC-A seeking a leadership position locally in an HIIM department. STEPHANIE CLARKE-MAHONEY REGISTERED NURSE, BSN, MS, CCM, CPC-A 812 COLLIERS BEND ROAD CHARLOTTE, TENNESSEE, 37036 RNCODERCCM@GMAIL.COM (615)495-2265 OBJECTIVE Registered Nurse...
  13. A

    Wiki ED vs Urgent Care

    When can you append rev code 450 to an Urgent Care facility instead of rev 516
  14. C

    Wiki Fracture care documentation

    My physician diagnosed a fracture however all he indicated on his report that the patient is to wear a locking knee hinged brace at all times is required and he wants to bill fracture care. Can anyone guide me to more documentation so that I can educate my provider? I know the AAOS is a huge...
  15. C

    Wiki Sequencing ICD 10 Code Z51.5 Encounter for Palliative Care

    The ICD 10 code Encounter for Palliative Care Z51.5- does this need to be the primary code for the visit? Does this differ for Inpatient and Outpatient Visits?
  16. S

    Wiki Bill established then bill new patient code?

    Is there any documentation that addresses whether you can bill an established code prior to billing a new patient code? This seems counter intuitive however, we have a situation where we have an Immediate Care clinic that is modeled after an Urgent Care (without the Urgent Care designation.)...
  17. L

    Wiki Critical care

    How much critical care time would you bill in this situation. Provider initiates care 02:30 he signs his note at 03:43. Never says critical care time spent anywhere in his note. Patient was seen in the PICU - which I know doesn't necessarily mean critical care. He does an addendum starting @...
  18. kathymoon

    Wiki Wound Care

    I have been coding for years but I've just become responsible for our Wound Care Clinic. Does anyone have any good reliable resources for wound care coding?
  19. S

    Wiki Fracture Care

    One of my doctor's saw a patient in the office for a suspected fracture. In his note he diagnosed her with a left supracondylar fracture. He decided to treat this nonoperatively and planned to see the patient back in a week. I charged out fracture care for a closed treatment of a supracondylar...
  20. J

    Wiki CPC-A Looking For Work

    Hello I am currently enrolled at FTC in DeLand,Florida. I am a CPC-A. i have passed both the ICD-10 and ICD-9 test. I am currently looking for any available coding jobs in the DeLand,Florida area thank you here is my resume i hope to hear from you soon thank you Jeremy Padgett 150 Lake Mamie...
  21. R

    Wiki Transitional care and smoking cessation

    I have billed 99496 transitional care with modifier 25 and 99406 smoking cessation. New 2016 guidelines have stated that transitional care can now be billed on the day of the face to face visit that's why they were billed together on the same day. I received a denial saying the procedure code...
  22. J

    Wiki billing for 93922

    Can a RN bill for all ABi testing and Doppler scans for Dm foot care using this code 93922?
  23. J

    Wiki Can a RN Bill 93922

    Can a RN bill for all ABi testing and Doppler scans for Dm foot care using this code 93922?
  24. M

    Wiki Seeking entry level position to gain enough experience SO I CAN CERTIFY!!!! RN for 25

    MARGARET KATHLEEN SOFFOS 7 Pine Tree Road, Cabot, AR 72023 SUMMARY: Seasoned RN with more than 30 years of experience in fast-paced acute care setting. Now disabled and seeking a position in Health Information Management. I have recently completed courses in CPT, ICD9 and ICD 10...
  25. T

    Wiki Injections with no provider on site

    Hi there! Can an RN, LPN, CMA or RMA give an injection (Haldol, Abilify, Risperdal, Invega Sustenna) without a supervising physician on site at the time of the injection? If yes, please give me a resource that I can give to our clinical team that supports it. CPT states "Do not report 96372...
  26. F

    Wiki Long Term Acute Care Hospital Billing

    When a physician performs outpatient services in a Long Term Acute Care Hospital, are the services billed using the NPI of the facility with a POS code of 22 (outpatient)?
  27. S

    Wiki post op care only

    could someone refresh my memory on how we follow the format for post op care only. My provider is caring for a patient after she had a fx hip surgery done at other facility and is now in our office for fu care.
  28. A

    Wiki Prolonged services

    Hello all, I need more guidance or help into the process of billing for prolonged services along with an E/M office visit. My specialty is a pediatric neurology and my provider spends additional time on reports and such for the patient care on autism patients. Please if there is anybody who...
  29. L

    Wiki A vs. D for wound care

    Wound care clinic. For a debridement, skin graft, or negative pressure wound treatment, what would be the appropriate 7th character be... A or D? I think it would be A because it is active treatment. Does anyone else have thoughts. What defines as "active treatment."
  30. T

    Wiki Facility charging ED critical care discharge to hospice

    we have pt who came from outside nursing home to ED S/P fall. DX subdural hematoma, trach was suctioned, extended neuro eval done by nurse, bedside radiology done by nurse, PT came did blow by oxygen. PT was a DNR, from a facility charging stand point time in care was over 30 minutes can we...
  31. 1

    Wiki What is considered beyond the usual preop care of 20610

    I am struggling to define exactly what all needs to be done in order to bill an EM with 20610. Modifier 25 is a (Significant, separately identifiable E&M service by the same physician on the same day of the procedure), indicates that the patient’s condition required a significant, separately...
  32. J

    Wiki Advance Care Planning - Is anyone out there reporting

    Hi, Is anyone out there reporting either of the 2 new CPT's for advance care planning (99497; 99498)? CMS doesn't have allowables listed for either code so I'm assuming they're for date collection purposes & will not be reimbursed if reported. I'd like our physicians to get into the habit of...
  33. N

    Wiki establishing a patient

    how do you code an encounter when the patient came in to establish care. No problems are documented. Basically it a meet and greet thing..
  34. C

    Wiki Claims submisison - With Rendering or Without for Urgent care

    We have this big dilemma over Urgent Care claims (CMS 1500). It comes up in other specialties as well. We have some Urgent Care groups stating they don't need to submit a rendering provider and can leave box 24 J blank. We have some that are putting a rendering physician on the claims but are...
  35. T

    Wiki Subsequent injury codes versus aftercare codes

    If there is subsequent care for injuries, monthly PT treatment, should I continue to code the injury code with subsequent healing code or switch over to aftercare codes since the injury has been treated and the care is now for rehabilitation. Any help is appreciated!!
  36. B

    Wiki 99401-99404 Preventative medicine counseling and/or risk factor reduction interventio

    Has anyone used these codes 99401-99404? If so, can you please share how the payer reimbursing the service? Is this being counted as Preventative care on the patient's benefit and if patient only has one preventative care service (99391-99394) in a year, how does 99401-99404 affect the...
  37. E

    Wiki Urgent Care/Walk-In Clinic Incident-to Billing?

    Question: For a walk-in/urgent care clinic, the rendering provider is a PA and there is a physician on site that is the supervising physician. The claim is billed out under PA rendering and Doc supervising. The supervising doc does electronically sign the note, but the supervising doc is not...
  38. D

    Wiki Critical Care Laminented pocket tool

    Does anyone have or know of a reference for a critical care laminated pocket tool? I looking for one specific to ONLY critical care. Thanks! Diana
  39. C

    Wiki Long Term Acute Care Hospital

    I would appreciate if someone could guide me with the coding and reimbursement guidelines and rules for Long Term Acute Care Hospitals (LTACH). Regards, Chithra
  40. B

    Wiki Initial Newborn Coding

    The newborn was fine at birth, but developed problems 3-4 hours later. Our provider wrote his note at age 6 hours and said the baby had respiratory distress. Another provider from the same group saw the baby and wrote her note at age 8 hours, describing critical care treatment. She felt the...
  41. Lynda Wetter

    Wiki Subsequent hospital care

    Does the below statement fulfill the requirement for a subsequent care code 99231? Seen and examined. Left leg lesion is raised around hair follicle. There is some fluctuation. I believe he would benefit from I & D. I called Dr. X, acute care surgery service who would evaluate him for possible...
  42. T

    Wiki Critical Care Codes

    To be able to use critical care codes the time must be documented specifically by the physician, correct? This is for a pediatric patient who was transferred to another facility after being worked on here for a few hours. The critical care time is not documented by the physician. So I would just...
  43. A

    Wiki Z code followup after orthopedic care treatment is

    Patient comes in for follow up no complaints for Total knee replacement. It has been almost a year. I think you use dx Z09 for the visit the problem he performs x-rays on the knee. I stumped on what dx code can I pair with x-ray Do I take previous dx from older notes? 73560 ? 73565...
  44. L

    Wiki Ankle Fracture with Sprain

    Hello, Just wanted to see what is the proper way to code the following: Patient fractures medical malleolus and has an ankle sprain (both occurred at the same time, same ankle). Would code everything under the fracture care or would you code the fracture under a fracture care code and the...
  45. 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...
  46. D

    Wiki Radius Fracture

    We saw a patient who was in the ER where they reduced his radius. When he came into our office the radius was still displaced. The dr had to do a post reduction. Is this billed separately or part of the fracture care? thanks :-)
  47. L

    Wiki Fracture

    Hello, I have one where the patient was seen in the hospital as a consult on 11/3/15 for a distal fibula fracture by our doctor. Then on 11/16/15 the patient comes to the office for a fallow up on that fracture, first time we have seen them in our office. The hospital did not code a...
  48. V

    Wiki delivery

    Good morning! Has anyone ever had to code for delivery 59409 in the ED?? Our ED delivered baby at 39 wks vaginal delivery and then was transferred to another facility for OB care. No complications etc. Can I bill out 59409?? Do I need to add modifiers?? Thanks for your help! Vicki, CPC
  49. M

    Wiki Care plan oversight charges

    I feel so dumb. Does anyone know the location code for the care plan oversight charges? :o
  50. M

    Wiki OB Global Billing

    Hello Joan Smith started her insurance coverage shortly after she found out she was pregnant. Joan saw the same doctor throughout her pregnancy, delivery and postpartum care. The catch is, Joan's health insurance covers antepartum and postpartum care, but imposes a preexisting condition...