codes

  1. M

    Wiki Z29.2 Chemoprophylaxis

    We are looking at using this code to indicate our patients that are taking Neulasta injections with chemotherapy. The code looks correct and the description on the WHO website is clearly there and the code is active. However, it is NOT in my coding books. The codes jump from Z28.___ to...
    • mblaine
    • Thread
    • books code codes neulasta z29.2
    • Replies: 1
    • Forum: ICD-10
  2. D

    Wiki End stage liver disease

    Would you code cirrhosis and end stage liver disease as two separate codes? Or is cirrhosis included in end stage liver disease?
  3. S

    Wiki New Technology Procedures/Services

    Hi, I'm wondering if its appropriate for a provider to offer new technology services and materials to patients on a cash pay basis if codes and fees have not yet been assigned? I know unlisted codes are available but with no set fee you run the risk of insurance reducing reimbursement sometimes...
  4. B

    Wiki 2016 Novitas Fee Schedule for new drug screen codes

    Does anyone have a link to the fee schedule for the new drug screen codes? I have looked on both the Novitas website and the CMS website. I remember seeing it towards the end of December 2015 but I can't find it now. Thanks in advance!
  5. C

    Wiki PAcemaker IMplant denials due to claim having ICd-10 code R55 on claim

    I realize the NCD 20.8.3 for Pacemaker implants CR9078 states the syncope (R55) is not a covered dx for pacemaker implants. It also goes on to state that claim will be denied if R55 is present even with a qualifying covered DX code. I have some concerns regarding this and I am curious if any...
  6. A

    Wiki New CPT Codes for 2016?

    Hi, I was wondering if anyone had any websites listing new CPT codes for 2016? Thanks!
  7. E

    Wiki Consult with POS ER for Medicare

    I have been coding ER visit codes 99281-5 for the crosswalk for Medicare Consults when the POS is the ER and not crosswalking to OP visit codes new or established for Hospitalist and Orthopaedic consults ;I use those when the POS is Obsrv. Can anyone tell me if I am correct to bill the ER codes...
    • Ethanzoe
    • Thread
    • codes consults day medicare pos
    • Replies: 1
    • Forum: E/M
  8. M

    Wiki In Home Billing by a Physician

    I wanted to get information on In Home Billing by a physician. I have a physician that wants to partner with a hospice company and treat the patients that are unable to leave home. I want to confirm that for a Physician I would use codes 99341-99350. Also, I want to know if the physician...
  9. M

    Wiki Medicaid denials per announcement 976

    We are having a problem with Medicaid denying secondary claims per CMS announcement 976 stating that "history of ..." diagnosis codes are not acceptable as primary diagnosis codes. In these cases Medicare has paid the claim with a hx code but Medicaid is denying. I am not sure how to fix them -...
  10. J

    Wiki Billing vaccines for a fqhc

    Our clinic is a FQHC and I'm trying to find out how other clinics bill Medicare for influenza and pneumoccal vaccines. If a patient is seen for an office visit the provider will code a routine office visit (i.e. 99213) along with the codes for the vaccine and its administration code (90670...
  11. A

    Wiki Diag codes to be used with 99497 and 99498

    Does anyone know what ICD-10 code can be used with the new End of Life Care CPT codes 99497 and 99498? I believe the HCPCS code might be S0257. For non-medicare patients Z02.89 looked like it might be suitable, but I'm not sure. Does anyone have advice? I have also received mixed messages on...
    • amoneill118
    • Thread
    • 99497 99498 code codes minutes
    • Replies: 18
    • Forum: E/M
  12. B

    Wiki N.C. Mediciad Denial for preventive visits on children

    We just recently went to ECW and we cannot get reimbursed for preventive care visits on children. We are using the EP modifier with the CPt codes. our denial reason states attending provider not eligible on service dates. and B7=This provider was not certified/eligible to be paid for this...
  13. A

    Wiki Breast Reconstruction with serratus fascia flap

    I have a physician who has been using a serratus fascia flap in lieu of alloderm on certain patients. He wants to bill 19357- for the insertion of the tissue expander and 15734- serratus flap. Now I know that there is a conflict with theses two codes without a modifier. I thought 19357 included...
  14. J

    Wiki Language Barrier

    I work for a multi-specialty practice, We take care of many patients who do not speak English. Right now we are torn between using a code or not. currently we are using code Z60.3 - acculturation difficulty. We are trying to figure out a better code or if there even is one ? Does any one know of...
  15. M

    Wiki New Radiology Codes - HELP !!!!!

    Absolutely do not see any new radiology codes that replace 73500, 73510 or 73520. All new codes include pelvis view. What do we use if we do NOT take AP pelvis? If we just take one view of hip, what is the correct code?? Also, with new code 73501, how do you take a unilateral hip with...
  16. D

    Wiki 2015 Tomosythesis Codes

    Is it appropriate to charge CAD (CPT 77051) along with the 77061 and 77062? There is a CCI edit that says that CPT 77052 is a component of the tomosythesis codes but it does not indicate that 77051 is? Anyone know??
  17. 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?
  18. S

    Wiki Denial for 97597

    I have tried billing CPT code 97597 and keep getting it denied. I have used several ICD-10 codes and NONE seem to work. Help!
  19. H

    Wiki new codes for 2016

    does anyone have a cheat sheet on the new codes and deleted ones for this year that you can share please
    • heart123
    • Thread
    • 2016 codes deleted share sheet
    • Replies: 2
    • Forum: Cardiology
  20. P

    Wiki Low birth weight codes after day-of-life 28

    I have read the guidelines that the codes in Chapter 16 can be use throughout the life of the patient if the condition is still present, but all of the codes for low birth weight also have the "N" symbol, which indicates that they should be used from age 0-28 days. Any ideas on whether or not...
    • psallings
    • Thread
    • birth codes low symbol weight
    • Replies: 1
    • Forum: ICD-10
  21. P

    Wiki Workers Comp vs Commercial Insurance CPT pricing

    Need some advice: Can a clinic charge different pricing for WC CPT codes vs. Commercial Insurance? Basically, have two fee schedules for our CPT codes. Thanks PK
  22. N

    Wiki 3m Encoder

    When coding using the 3m encoder how do you pick up all the use additional codes and guidelines like when using the book? I am missing a lot of additional codes because of this . thanks
  23. 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!!
  24. K

    Wiki L4 to Ilium instrumentation

    My physician only placed wires and screws from L4 to ilium. The instrumentation codes I normally use are "add on" codes. Can anyone tell me what I should use here?
    • kellit21
    • Thread
    • add codes ilium instrumentation physician
    • Replies: 5
    • Forum: Orthopaedics
  25. T

    Wiki Denial Help!-Amerigroup Medicaid

    Amerigroup Medicaid denied procedure code 59160 stating it was part of the primary code 59410, but I didn't get a CCI edit, so not sure how to fix this. Patient had a SVD at 16 6/7 weeks for fetal demise. She had immediate post partum hemorrhage and retained placenta, so the provider did a...
    • TMB1965
    • Thread
    • 59160 59410 code codes edit
    • Replies: 1
    • Forum: OB/GYN
  26. K

    Wiki z34 codes and o09 codes

    If you are given z34.01 and o09.511 codes for lab work. If I'm reading the code book correctly you can't use them together. If they are given together are you allowed to not use one or do you need permission to drop one of the codes?
    • karmista
    • Thread
    • allowed code codes drop permission
    • Replies: 1
    • Forum: OB/GYN
  27. I

    Wiki Urology coding

    I have a question regarding CPT codes 50432 and 50435, can someone explain what the difference is between these 2 codes? Thanks
  28. L

    Wiki Hematology Oncology Clinic in Baton Rouge hiring for a Medical Coding position

    Looking to hire immediately. Medical Coding specialist needed for high volume medical oncology practice. Medical Coding specialist works to obtain accurate and efficient reimbursement for healthcare claims. Coder is responsible for all codes to meet required legal and insurance rules. Working...
  29. D

    Wiki 99050/99051 Codes

    I have a question, I have an Urgent Care Clinic with the hours of operation 8a-9p M-F and 8a-6p Sat. and Sun. I have looked at the charts and there are no additional services being done. However they are billing the 99050 and 99051 codes for anything after 5 and on weekends. I don't believe...
  30. D

    Wiki Cardiac Resynchronization Therapy for treatment of Heart Failure

    I am needing some help with Cardiology practice billing CPT 33249 and 33225 for POS 22 to Medicare Part B J5. The claims are being denied as not medically necessary, decision based on NCD policy online. The policy I found is 20.4 NCD for Implantable Automatic Defibrillators. This policy does not...
  31. H

    Wiki Multiple Medicare Denials for Medical Necessity

    I apologize ahead of time for my ignorance, I am still new to coding/billing and have learned on the job through trial and error. I received 3 pages of denials from Medicare for " these are non-covered services because this is not deemed a "medical necessity" by the payer". But the codes used...
  32. T

    Wiki Alcohol codes: with intoxication

    Do the ICD-10 alcohol codes that state "with intoxication" mean that the patient is currently intoxicated? I need help determining the best code for this visit. Pt had presented with chest pain, but provider also addresses alcohol issue as below. “He is a somewhat anxious male today. He...
    • tag60
    • Thread
    • alcohol cessation code codes intoxication
    • Replies: 1
    • Forum: E/M
  33. S

    pulmonary hypertension codes

    I find myself confused when coding echos with the pulmonary hypertension codes. When do I code secondary vs primary pulmonary hypertension?
  34. E

    Wiki Toxicology codes

    I'm confused on the drug screen codes. Medicare deleted g6030-g6058 but they are still in hcpcs book.
  35. J

    Wiki Placeholder?

    I thought I posted this the other day, but it disappeared, so pardon if it is a repeat. This may be a basic question, but I am new to PCS coding. Is there a placeholder option to abbreviate a list of codes that have almost all he same characters? For example, rather than write out the...
  36. N

    Wiki non-healing surgical wound ICD-10

    Can someone please tell me the proper codes for a non-healing surgical wound of the abdomen? There is active treatment, so is it T8189XA? What other codes should I code? open wound of abdomen? what are the injury codes?
  37. J

    Wiki G6021 for EMR needs 2 codes

    Can you please help me how to enter the charges in the HCFA form if we have to use those 2 codes like 45378 and G6021 to indicate this is and EMR colonoscopy for medicare patient, how would you enter the $ amount, as we know we cannot bill CPT45390. Medicare will not pay new codes for DOS in...
  38. P

    Wiki Ceretec labeled white blood cells used with 78805 & 78806

    When using indium in-111 labeled white blood cells with codes 78805 & 78806 I assign A9570. What would I code when they use Ceretec instead? A9521 is not allowed with those cpt codes. Can I use A9570 when using Ceretec? Thanks
  39. A

    Wiki Bcbsnc, 99000 & 36415

    For the last few years we have been billing BCBSNC 99000 lab handling fee & 36415 venipuncture. BCBS would pay 99000 but deny 36415. In the last few months, both codes have been getting denied. I just found out that BCBS changed their Corporate Reimbursement Policy to say that 36415, 36416 &...
  40. J

    Wiki nasal stenosis repair and advancement flaps

    Our md is billing cpt code 30465 with cpt code 14060- for advancement flaps. Are these 2 codes inclusive of each other. Please help!!!!!!!!!!!!
  41. D

    Wiki Coding

    I have a company that has been contacting me about there programs. One of the options is it allows you to enter in your codes and it will tell you the error you could possible have and the order they should be in for higher payment. Does anyone have any opinions on this or a cheaper company...
    • DBARON
    • Thread
    • cheaper codes company opinions payment
    • Replies: 0
    • Forum: Orthopaedics
  42. M

    Wiki Observation versus ER vist and in or outpatient E/M

    We are a private practice specializing in Orthopedic Surgery, with on call duties at the local hospitals. Recently we hired a new coder, who believes our physicians should be using the observation codes when called into ER or when the patient has been admitted by Hospital Medical Services. We...
    • MARY K
    • Thread
    • admitted codes e/m observation outpatient
    • Replies: 4
    • Forum: E/M
  43. L

    Wiki OBGYN - gestational age Z codes

    Does anyone know if the gestational age Z codes are listed last on a claim. For example, say a patient had a normal vaginal delivery of a single liveborn at 39 weeks. Would you code the DXs as O80, Z39.0, Z3A.39 or O80, Z3A.39, Z39.0? I can't find anything in the guidelines specifying if the...
  44. D

    Wiki 2016 IR CPT Crosswalk

    By chance, has anyone created a crosswalk for the new Biliary and Urinary CPT codes that they would be willing to share? Thank you in advance!!!
  45. R

    Wiki NDC Codes

    I have some NDC codes that I cannot find on the internet or using the Medicare crosswalk to HCPS codes. These codes are only off by the last 2 numbers. The NDC code 0641-0928-21 is no where to be found but there is a 0641-0928-25. Has anyone else experienced this issue?
  46. J

    Wiki new to spinal coding - arthrodesis question

    Hello everyone, Could you please help me? I am trying to precertify an upcoming surgery and want to make sure that I have the correct codes. He is doing posterior/ posterolateral technique arthrodesis from L2 all the way to the ilium. Would this be 22612 for the first then 22614 for the 3...
    • jeskla
    • Thread
    • arthrodesis codes posterior posterolateral technique
    • Replies: 2
    • Forum: Orthopaedics
  47. T

    Wiki New To Behavioral Health Billing

    Hi, We have a new Clinical Psychologist starting in a PCP office and I have no idea how they bill. Any tips on what CPT and ICD codes they can use. Would love to communicate offline with an experienced biller that bills for a CP. Thanks.
  48. C

    Wiki physical therapy - joint repleacement surgery

    We have prehab visits, which is 1 session for preassessment, education and instruction in PT HEP before joint repleacement surgery. Can someone give me an idea of what codes are used for their Prehab programs?
  49. T

    Wiki 97597 vs 11042/11045 codes

    Hello I just started coding wound care charts on the facility side and the APC coordinator keep asking me for missing procedures (debridements) that I think should be coded on the physician side. Should she know this? Those codes are usually already there sometimes. When to use 97597 vs...
  50. L

    Wiki Modifier 79-Osteoarthritis

    Hello, Can anyone tell me if I have a fractured toe (still in global period) but the patient comes in for a bilateral routine knee injections do I put the modifier 79 on both injection codes or just one. Ex: M17.0 - B/L Osteoarthritis 20610 RT - 79 20610 - LT - 79 of do you only...
    • LLRodgers
    • Thread
    • 20610 codes injection modifier osteoarthritis
    • Replies: 2
    • Forum: Orthopaedics
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