1. K

    Wiki Revenue Codes that require a CPT or HCPCS

    I am auditing Revenue Codes to ensure that there is CPT or HCPCS correlating to charge. Is there a list that says what Revenue Codes require a CPT or a HCPCS. I have a good idea but just wonder if there is a master list. I have read that these types of Revenue Codes referred to as non-exempt...
  2. A

    Wiki Non Hodgkin Lymphoma

    What is the appropriate code for Non-Hodgkin Lymphoma Diffuse Large B cell with liver and spleen involvement? Thanks!
  3. R

    Wiki L5-S1 ADR Coding

    We recently took on a new orthopedic spine surgeon and are having some issues coding. He ordered a L5-S1 Artificial Disk Replacement. I believe the main code is 22857 but I do not know if anything else is normally billed with it. Please help!
  4. W

    Wiki Vascular surgery

    I was wondering if anyone have heard of aortic relining. Looking for CPT Code.
  5. T

    Wiki Poisoning codes T36-T50

    Can someone please confirm if poisoning codes can be used as the first diagnosis? The section instructions state to use the code first and then additional codes for any manifestations. Some insurance companies are denying claims if a poisoning code is used first.
  6. J

    Wiki Looposcopy with removal of right ureteral stent

    Does anyone know the code for this procedure?
  7. K

    Wiki Breastfed baby needing Vitamin D drops

    I am a new coder and I was wondering if I can get some advice on a diagnosis coding issue. A newborn patient was recently seen by one of our providers and the doctor wanted to prescribe Vitamin D drops to prevent any Vitamin D deficiency within the baby. His reasoning is that because the baby...
  8. T

    Wiki Help with CPT Code - greatly appreciated

    What would be the best CPT code for debridement of 4 porokeratosis lesions on the plantar aspect of the left foot? I was looking at the 17xxx code range, but I don't see where they support the dx code Q82.8. Any suggestions would be greatly appreciated. The provider used trichloroacetic acid...
  9. E

    Wiki Wrong procedure code was precerted

    Can someone please clarify this for me. Our front desk employee precerted a pts sx with code 58570...hysterectomy without BSO. After I got the op note in the billing dept I didn't realize the wrong code was precerted so I coded it correctly with 58571 with BSO. So we got the denial from the...
  10. A

    Wiki Consult code inpatient

    One provider from our group did h&p for admission, brought in cardiologist they consulted pt then requested another provider from our group see pt for consult on the day after can we bill for h&p by the one provder and a consult for the other provider or does it have to be a f/u code. H&p was...
  11. T

    Wiki Non-injury coding for Meniscus tears

    I would appreciate some help understanding how to code for Meniscus tears that are NOT INJURIES..... Since we don't have the old ICD-9 codes for over exertion, etc would you code for ex: S83.242A S83.241A Patient states knees started hurting 6 months ago.... I understand how to code...
  12. T

    Wiki Modifier U2

    Can someone explain the purpose of the modifier U2 on cpt 59514. When I look it up it only says Medicaid level 2, I want to understand so I will know to code with them or not.
  13. M

    Wiki Uncontrolled Diabetes

    Does anyone know the appropriate code to use for Uncontrolled Diabetes? Much appreciated!!!
  14. K

    Wiki 25310 vs. 26480

    Hello all! I am wondering what tendon transfer code you use for a CMC joint arthroplasty? I always thought we code from where the tendon is taken, so if Doc is harvesting the FCR tendon from the wrist/forearm we would code 25310. However, the doctor has a really old hand code book that has a 1...
  15. B

    Wiki Fracture - regarding this code

    Hello, I am a new biller and have a question regarding this code: 28510. I have a case where we billed this code along with 99203 for the initial office visit. The office visit is getting denied due to the fracture code. I did not think this should be an issue since it is the initial office...
  16. J

    Wiki 99053 and on call Orthopedist

    Can anyone tell me if a Hospital employed Orthopedist who is on-call can bill code 99053 for after hours in the ED? Our Orthopedist is insisting that he bill this code (which we have never billed) so that he can get the RVU credits for being pulled out of bed at night for a patient in the ED...
  17. M

    Wiki Caresource (Medicaid product in OHIO) denying claim due to dx?

    Hi~ I have been told by one of our billers that he was told by a rep from Caresource that a particular claim has denied due to a diagnosis (but of course would not give him the exact 2dx in question). I have researched and could only find the following codes (that state needs additional code)...
  18. P

    Wiki DVT vs History of DVT/Pulmonary Embolism

    I am a HCC coder and we are having a debate in my office about coding DVTs and pulmonary embolisms. Most of the physician notes we review just say something like "DVT - on Coumadin" I have been told not to code a DVT or Pulmonary Embolism unless the patient is presenting to the hospital or...
  19. K

    Wiki How to code for discontinues surgery

    During a recent attempt to perform a total laparoscopic hysterectomy, it was found that the trocar had perforated the bowel. A general surgeon was called in for consult, the hysterectomy was discontinued and the general surgeon proceeded with a bowel repair. Should I still bill 58571 with a...
  20. V

    Wiki Emg/ncv

    Can some one clarify for me please if Dr does 4 muscles and 3 paraspinals muscles do I code as 95885 or 95886, my question is do I count paraspinals muscles or not ? Thank you
  21. M

    Wiki Diabetes type 2 with other Complications

    Does anyone know if when a provider chooses "DM 2 with other Complications" E11.49 and the complication listed is Peripheral Vascular Disease, is it appropriate to code the I73.9 code also. I believe I should be picking up all complications that the provider lists, in addition to the E11.49 but...
  22. A

    Wiki Please help answer a dispute.

    Me and a co-worker of mine have disputed with each other and the billing office about the code for Mycoplasma Pneumonia. I feel that it should be coded J157 and she says B960. The billing office is saying that code B960 is not being accepted. The coding guidlines state that the underlying...
  23. 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...
  24. 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...
  25. V

    Wiki Appropriate code for billing UDS - BCBS and AETNA

    Hi all, Recently we are receiving denials from AETNA for 2016 claims as " Need to bill with appropriate HCPCS" , currently we are billing 8-series codes for confirmatory tests. The same issue for BCBS. Please help on the above cases as we need to bill HCPCS/CPT code for BCBS and AETNA...
  26. C

    Wiki Dx code for determination of gender of fetus.

    Does anyone know the ICD 10 diagnosis code for having an ultrasound to determine the sex for a fetus?
  27. T

    Wiki Staph infection at specified site?

    I can't find a code for staph infection at specified site. The one I find, A49.01, says of unspecified site. I may be going about the coding of this incorrectly. Help! Provider describes area on forehead, just below hairline, where pt has a bump and crusted area. Dx: Staph infection of skin...
  28. T

    Wiki Anesthesia billing

    already received anwer
  29. L

    Wiki Well Visit/ Well Woman

    Hello! I am wondering, I know the patient can have a preventive visit with her normal pcp and then a well woman with her GYN, but what if a patient comes to her pcp for a well exam (preventive visit) and then comes back few days later to have a routine pap smear; can we bill the pap as...
  30. V

    Wiki Needs assistance pls. - HCPCS

    Hi All, Is there a HCPCS CODE FOR CPT 99173 as per MEDICARE GUIDELINES? Thank you, IM
  31. C

    Wiki observation codes for cardiologists

    We are a cardiology practice that is called for services provided in the hospital. I am having quite the issue understanding exactly how to bill observation codes. When our group is consulted to see the patient what code should we be billing if the patient is already admitted to observation...
  32. K

    Wiki Cd30+ peripheral t-cell lymphoma

    Can anyone confirm that the correct code range for cd30+ peripheral t-cell lymphoma would be c84.40-c84.49? I know that c86.6 is the correct code for primary cutaneous cd30+ t-cell lymphoma as well as lymphomatoid papulosis. But i'm trying to find the correct code for cd30+ peripheral t-cell...
  33. 0

    Wiki Outpatient Allergy shots........................

    I have had this question sent to me -- What cpt code do you think is appropriate for an outpatient allergy shot CPT 95115 for one and 95117 for two or CPT code 95120 one shot and 95125 two shot? Actually what is the difference? I’m a little confuse.
  34. K

    Wiki Level 5 E&M with Oral Challenge

    Good Afternoon, I am looking for confirmation of my assumption regarding this scenario more than I am an answer to the question. Is it appropriate to bill a level 5 E&M in addition to the code for an Oral Challenge if the patient does not require physician intervention for anaphylaxis or...
  35. T

    Wiki ED E&M code please help

    emergency room visit with a problem focused history comprehensive exam and MDM of high complexity would the code become a 99283 or 99284
  36. T

    Wiki E & M coding help please

    Please help with correct E&M code new patient office visit an expanded problem focused history, comprehensive exam MDM of high complexity what will the E & M code become
  37. K

    Wiki coder liability

    can a coder be held liable for using an incorrect cpt code, my doc wants to always code 32557 even when the catheter is not left in place. I have provided him with education and he insists that he wants 32557 always coded. I am concerned that if there is an audit could I also be held...
  38. B

    Wiki holiday codes

    Our physicians want to bill cpt code 99051 (open during federal holiday code). I know insurance companies are not always going to pay, but I was wondering if anyone has had any experience in billing this code and do you notify the patients before their visit that there is an additional charge...
  39. T

    Wiki Leukemia, Multiple Myeloma in CR

    On occasion a patient with leukemia or multiple myeloma may go in and out of clinical remission while on chemotherapy or after transplant. Would it be appropriate to code the remission code for these patients at the time of service or is there some other requirement(s) when this code would be...
  40. B

    Wiki CPT code for holiday hours

    Our physicians want to bill code 99051 (open on Federal holidays). Has anyone had any experience in bililng this code. I understand that insurance companies are not required to pay for this code. Also, do you notify your patients before being seen that there is an additional charge? Any input...
  41. N

    Wiki 2wk c/s incision check

    Not sure what the best code would be for the incision check. Thanks for the suggestions.
  42. M

    Wiki Travel Consultation ICD-10 Code

    Does anyone know which ICD 10 code works best for a travel consultation, and has actually received payment for it. We will be using Z23 for the immunizations, but would like to use a more defined code for the consultation CPT code 99211 that we will be using.
  43. P

    Wiki Help!!!! Strapping code 29240

    When billing strapping code 29240 and I have to put modifier LT or RT ??? We provided services on both. Please help!!
  44. D

    Wiki J06.9

    Can J06.9 be used as a primary code?
  45. D

    Wiki Medicare payment of Code 29581

    Is anyone having difficulty getting payment from Medicare on this code post-op or after fx care management. Our clearinghouse instructed us to use a 58 modifier and a LT or RT modifier but they are still being rejected.
  46. T

    Wiki Bone marrow aspiration for graft

    If my surgeon is performing a surgery and aspirate bone marrow at the facility, can we code for the bone marrow aspiration or is this something the facility will bill for???
  47. YBVON316

    Wiki Coding of Type II Diabetes with polyneuropathy

    Info on my idea... if the patient comes in and is diagnosed with diabetic type 2 neuropathy i believe the appropriate code should be E11.42. This is in reading the tabular noes, excludes one notes and the chapter rules and guidance. My reasoning is that excludes 1 note excudes (E08.42) and...
  48. 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?
  49. P

    Wiki CPT code for Rast Testing

    What is the CPT code for Rast Food Testing (Lab Work) or a Peanut Panel
  50. M

    Wiki HELP -- billing for adminsitration of intranasal narcan

    Hello, I am working on a claim where one of our Walk-In clinics administered narcan to a heroin overdose victim. I am not able to find any help in how were are to bill for this. HCPCS code J2310 is for injection method, but our patient received it via intranasal. I reached out to our HIM...