codes

  1. E

    Wiki Billing Add On Codes on One Claim that Span Multiple Dates of Services

    Hello, I am a new medical coder and biller, and I am trying to understand if primary codes and add on codes must be billed on the same day when there is a span of dates of services on one claim. Please help. Thank you, Hilliard Emmanuel McDonald
  2. P

    Wiki ECMO Management codes with subsequent care

    I have a question regarding ECMO: Can Dr. Smith bill ECMO management 33949 in addition to subsequent hospital care 99231-25 for the same date of service (as long as documentation supports both codes)? Thanks in advance!
  3. B

    Wiki orthopedic surgery

    I have a new client who still thinks we can use pre 2015 cpt codes. I have explained that a lot of the codes have been bundled and he wants to unbundle them anyway. Could you help in coding the procedures below? 1-caudal epidural steroid injection 2-lumbar sine epidurogram 3-left sacroiliac...
  4. 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.
  5. L

    Wiki Coding from Codes

    Hello, I am very curious to know if we can code from codes that the provider has written down. Is there a coding clinic on it? Thank you!
  6. M

    Wiki Billing 93306 & 93880 In Office

    Hello just a little confused as how to bill these codes. I work for an Interventional Cardiologist. He contracted a tech to come out and bring the u/s machine to do these procedures in our office. Is there any modifier I should be adding since he doesn't actually own the equipment? Or is...
  7. J

    Wiki Billing Observation Codes

    My Cardiologist see's patients as observation at the hospital frequently and is not the admitting/attending Dr and he bills 99212-99215. Some insurances state that 99212-99215 is an OV and charges the patients a copay. If I can not bill a new patient code 99201-99205 or a consult 99241-99245...
  8. A

    Wiki Home health POS question

    Hello Does anyone have an CMS information that states physicians cannot bill E/M codes 99211-99215 with POS 12 (home). I have seen some doctors bill with this POS and E/M codes and I am not sure if CMS will allow the location to bill with office/outpatient. thanks
  9. J

    Wiki Goals and A Path

    Hey guys, I'm Joe, new to coding/medical/healthcare field So I took a coding course with Career Step, completed it and I am going for the CPC test this Saturday!!! I was told to look at jobs and even apply now. I am currently working in registration a local hospital near me. I am in MA west...
  10. D

    Wiki Medial meniscus tears

    I'm billing for the radiologist for an MRI knee and the diagnosis given is medial and lateral meniscal tears. The report doesn't say anything about an injury so I don't think I can use the diagnosis codes S83.241A? Correct? The report must state injury or current injury to use these diagnosis...
  11. C

    Wiki Sports physicals

    Is it common practice to bill sports physicals with em codes (99201-99215)?
  12. D

    Wiki ICD-10 for DCIS breast

    Can a DCIS code (D05._ _) stand alone as a primary diagnosis or is a C-code still needed. I have a coworker who refuses to use the DCIS codes for breast. Thank you.
  13. 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...
  14. W

    Wiki Ischial Tuberosity Injection

    We have a Pain Intervention Physician who is injecting the Ischial Tuberosity. I have found several codes that would be appropriate per what he is injecting: 20610, 20550, 20551 and if the pudendal nerve is injected - 64430. Curious to know if any other facilities are performing these and if...
  15. M

    Wiki Category II codes

    I know these codes are optional, but I am interested in learning more about when to report them. I'd appreciate hearing about anyone's experience.
  16. A

    Wiki Cpt 20610 - Is anyone having issues

    Is anyone having issues with getting paid for 20610 from United, Humana or Aetna?? Looks like they only have knee Dx codes listed on their policy, but not taking into consideration of the other major joints.
  17. C

    Wiki Testosterone Suspension Injection HCPCS

    Does anyone know what happened to the testosterone suspension injection codes in HCPCS. Is this drug not used anymore? I can't find a new code for this and all of the testosterone codes I have found are 1mg.
  18. M

    Wiki PQRS in ED

    I know PQRS will be changing in the next coming years. But I wanted to see what PQRS codes other ED's report to CMS.
  19. A

    Wiki New EBUS CPTs for interventional pulmonology

    I have received two articles (ATS and AABIP both February issues) that state we can no longer use the 31629, 31628, 31633 or 31632 with the new codes... although there is not a CCI edit for them. Does anyone know more detail about the proper billing for these codes? CPT is not exactly clear...
  20. J

    Wiki Help coding laparoscopic cystectomy

    One of our providers did a laparoscopic cystectomy with bilateral pelvic lymph node dissection and ileal conduit urinary diversion. The codes he selected are 51999, 58571, 38571 and 50820. Now, I thought we might be able to use 51595, 58571 and 38571 but the provider was concerned that 51595 was...
  21. ljones88

    Wiki New CPT codes being denied by commercial carriers

    Hi all, We recently came across a few claims denials with Coventry. They are denying 92537 and 92538 as non-covered. Of course we have reached out to our provider reps to inquire when Coventry will have their systems updated but we are still pending a response from them. For now, we're sending...
  22. A

    Wiki Robotic-Assisted PCI

    I cannot find any guidance on how to code robotic-assisted PCI's. Is there a special way to code or do we use the same codes as with "regular" PCI's? Thank you, Allison, CPC, CCC
  23. mdm58

    Wiki Coding for bi v defibrillator relocation +++

    Dr Is moving ICD to other side of pt's chest doe to recent dx of Lung CA. But the existing leads will will have to be extended so extenders for the leads have been ordered. I have looked and for the relocation looks like the code would be 33223. But what codes would be used for the extenders...
  24. M

    Wiki Coding of Locum Tenem in the Emergency Setting

    I have always been under the impression that when a Locum is working that we are to put the Q6 modifier on anything that they do. Am I correct in my thinking? Where I work they now after 3 years of putting the Q6 on the codes that they have always overridden the Q6 to bill to the doctor that is...
  25. jkyles

    Wiki Drug screen claims on hold

    It's not you, it's the edit. https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2016-01-28-eNews.html#_Toc441643998 "CMS discovered systems errors affecting claims with new drug testing laboratory codes (HCPCS codes G0477 through G0483)...
  26. A

    Wiki I am doing CPC prep course and need Help!

    Hi, I am struggling and am only working on ICD 10 codes right now. Anyone got any advice on how to study for this? I cant seem to remember the order and rules for all the codes. Thank you!
  27. N

    Wiki external cause

    anyone have any recommendations or tips on how to quickly code the external cause codes. , place of occurrence, and activity codes. these are kicking my butt.
  28. V

    Wiki Breast Reconstruction - reviewed Medicare

    Hello everyone, I work for a Plastic and Reconstructive Surgeon in Birmingham, MI. We just reviewed Medicare CCI edits and it is including 14301 (adjacent tissue transfers) in the breast reconstruction codes along with 15734. Our practice is primarily breast cancer patients, so these bundled...
  29. L

    Wiki ICD 10 coding - COPD with emphysema and multifocal

    Patient discharged: COPD with emphysema and multifocal atrial tachycardia. what codes would you use?
  30. E

    Wiki Telemedicine

    Has anyone had experience coding for Telemedicine? Looking for any input and codes that you have used.
  31. J

    Wiki Hospitalist OP ICD10-CM assignment question

    I am doing the billing (99221-99239) for our hospitalist that see our patients in the hospital and am unclear when deciding the ICD-10CM codes to use... if the patient's admitting diagnosis are different than the subsequent visit diagnosis and different than the discharge diagnosis, how do I...
  32. A

    Wiki Tetanus Codes

    Which code(s) should be used to report Tetanus when an injury is involved, i.e., stepping on a rusty nail?
  33. S

    Wiki Need Help with ICD-10 CODES

    The patient has developed a stage II pressure ulcer on the sacrum and reports pain from the ulcerated area. Examination reveals that the wound is covered with black eschar and is surrounded by chronic inflammation with dark pigmentation. It is determined that the patient is not a candidate for...
  34. K

    Wiki expected due date

    What if the patients due date is on their birthday and they are turning 35. Can I still use the primigravida/multigravida codes?
  35. H

    Wiki Z code sequencing

    in the use of z codes, I do understand there are some that are first position, and it certainly depends on the documentation. in ICD-9, V codes, unless in first position, went after regular codes, and before E codes, in my experience and understanding. So, I am trying to find a definitive...
  36. 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...
  37. C

    Wiki Hip xrays denied for codes no longer valid

    All hip xrays that our office is submitting are being denied, stating no longer valid as of 1-1-2016 cpt 73500, 73510, 73520 are there new codes for 2016? Definitely not aware of any of this??? Can someone share their knowledge on this? Thank you cwilson orthopaedics
  38. T

    Wiki Coding E/M with NST

    Can E/M codes be coded with a non stress test?
  39. R

    Wiki dermatology

    Does anyone know if cpt 11101 or 17003 which are add on codes can be modified with 59? Thanks
  40. L

    Wiki Change in the Global days for Ophthalmology Laser Procedures for 2016

    Two of our surgeons are questioning the decrease in global days from 90days to 10days for all laser eye procedures. Have found nothing to indicate a 10 day global period for codes 67210, 67220, 67228,67145, 66762, and 66821. Have found only two codes which indicate a 10 day Global Period 66761...
  41. A

    Wiki Inpatient Coder II Salary Range

    Good Afternoon, I am doing some research on coder salaries and was wondering if anyone would be interested in sharing salary ranges for an Inpatient Coder II position. This would be someone who codes BOTH inpatient and outpatient accounts in a facility setting. Thank you!
  42. E

    Wiki Routine Foot Care

    My group has started receiving denials for 11055-11057 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus)). I've reviewed the updated LCD with ICD10 diagnosis listed and was very surprised to find that L84 (Corns and callosities) is not listed as a covered diagnosis anymore...
  43. S

    Wiki CPT codes for PHP for chemical dependancy

    My office is expanding to PHP for chemical dependancy from only IOP for behavioral health. I need help with CPT codes please. Any assistance would be greatly appreciated. Sue/LBHS
  44. L

    Wiki HCPCS codes

    I am still fairly new at coding and was wondering, when are the HCPCS codes used? I know for injections, I use them but in what other scenarios and what Payers cover the codes? My brain is trying to get soon much information because I do want to be a great coder, lol. Thank you!!
  45. L

    Wiki bialteral modifiers with 31297, 31295 and 31255

    Can these codes be used with modifier 50? and on the same claim as 31296?
  46. L

    Wiki Hospital Outpatient facility coding

    Hi everyone --I am looking for some feedback from any coders who work for a hospital and do facility coding. Are you required to code the ICD-10-PCS codes on your accounts or just the CPT codes? I am trying to gather some data to assist in decision making for my organization. Thanks in...
  47. J

    Wiki Strep throat

    Provider Gives the code J02.0 , positive strep test, group A streptococcus as the cause of diseases classified elsewhere Would you change the code to J02.8 with the B95.0 code as the infectious agent ? What about if a provider saw a Pt with a negative strep test but still codes J02.0 ? Our...
  48. J

    Wiki Lower Endoscopic Ultrasound and Anorectal manometry

    Kindly help me to check if these codes are correct. The procedure done on an Outpatient Basis in the Hospital: The radial echoendoscope was advanced with ease to the rectum. EUS Findings: The internal anal sphincter demonstrated anterior thinning with mild posterior hypertrophy. The external...
  49. G

    Wiki Coding guidelines ICD 10

    Are there any guidelines in the ICD 10 book stating when to use chronic or acute codes?
  50. K

    Wiki z34 and gestational codes

    In the 2015 icd 10 book I have it says that gestational codes go with only Chapter 15 codes. Someone has brought to my attention in the icd 10 2016 book it's says you can have gestational codes with z34 codes? Is this correct. Thank you, April
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