coding advice needed

  1. J

    Question Coding Pressure Ulcers in the same area

    I'm need of clarification. When a patient has 2 pressure ulcers in the same area (ie. 2 separate ulcers on the left buttock, stage 2), would the code be used twice since the guidelines states "assign as many codes ... to identify all ..."? Or would coding it once suffice since both ulcers are...
  2. M

    Question TRIBAL FQHC

    I work for a Tribal FQHC and have some questions regarding procedures not associated with a G code under FQHC guidelines. It has been our directive to split out the procedure codes (for example I&D, wart removal, etc) and submit those to Medicare B. However, when I am researching FQHC...
  3. X

    EndoPat Coding

    Is anyone performing the EndoPat? If so, what code are you using and are you getting paid by the carriers, especially Medicare.
  4. L

    D22.5 and D22.39 coded togther on OV?

    We had some claims rejected by IBX (we are in PA) and when we called they said they were denied because the provider coded D22.5 (nevus on trunk) and D22.39 (nevus on face) both on the Office visit 99213. They said those codes cannot be used together. Dr states pt came in for DN on the trunk...
  5. J

    Tech Testing

    Hello - A patient comes in for testing with a technician ordered by Dr. B. Dr. B does not review the results until the patients appointment a few days later, can you bill globally for the test on the day the test was administered? Or do you have to bill with a TC modifier on the day of testing...
  6. A

    Urgnet Care Setting using Ammonia Salts

    Hello - Has anyone ever had a situation where an Urgent Care would be using Ammonia Salts? If so is that included in the E/M or can that be billed separate. I am unable to find any information on this topic. Thank you, Aimee -CPC
  7. A

    Resection of carpal trapezium w/internal brace stabilization for thumb base arthritis

    Hi all, I would like an expert opinion on which CPT code is most appropriate for what looks like a "suspension version" of a CMC arthroplasty. Per op report: "...A marked amount of arthritis at the trapezial carpometacarpal joint was identified. The trapezium was osteotomized in 3 places...
  8. S

    7th character for re-repair

    I work at an orthopedic specialist facility and came across a patient who re-ruptured her Achilles and came in for a re-repair. It looks like we are using the CPT code 27650 and the ICD 10 is T81.32x. However, I'm not sure which 7th character to use? Do we treat this as a initial care (since it...
  9. A

    Medically Necessary Contact Fit and Materials

    Trying to figure out the best way to bill and receive reimbursement for scleral contact lenses. My doctor wants to use 92313 with H18.59 diagnosis, but Medicare allowable reimbursment is only $90.71. With contact lenses the total charge will be $2500.
  10. K

    administration for oral Dexamethasone

    Our pediatrician wants to bill J8540 for the oral medication; which I believe is accurate, but he also wants to know if there is a CPT / HCPCS available for administering the oral medication. I've reviewed the HCPCS 2018 book, and have only come across H0033, but it's under the Mental health...
  11. A

    What code to use after 90972 for follow-up services with same doctor

    I am seeking guidance on which code to use the day(s) after 90792 for a follow-up with the same doctor that did the 90792. We were once instructed to use 90791 for the follow-up and now that I've helped my supervisor to understand that this is not appropriate, I'm having a hard time figuring out...
  12. L

    Pulmonology-- A7003 with 94060

    I have a group that is billing an A7003 Which is the disposable nebulizer kit with a 94060 which is **Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration **. Since this is part of the test I would think that the A7003 would be inclusive as...
  13. M

    Confused about Billing-Need Help

    HI, I have a few questions and hope someone here would be a great resource with some help! My first question is about contractual obligations/adjustments. Normally practices/providers have their charged/billed amount as above the medicare allowable. So say they bill 99214, $125 is their...
  14. N

    New at the industry need advice

    Hi! I am a makeup artist and a mom of a smart, vibrant boy. In the search for a better life for my son, I started a medical records certificate. I am three classes away from completing my Medical Records Certificate. I have to admit that now that I can see the end of this journey I am...
  15. J

    Atherosclerosis and Angina

    I was researching the code for atherosclerosis with angina. Per the ICD-10 manual appears the correct diagnosis code would be I25.9 Chronic Ischemic heart disease, Unspecified which is not associated with an HCC. Is that correct?
  16. C

    coding help zygomatic arch biopsy

    For the below op report my physician coded 20205 and 21034 -52. The CPT 21034-52 denied as an invalid modifier. How would you bill for the biopsies of the soft tissue of the zygomatic arch. Would you use 20200? Procedure: Op-Biopsy of the RT masseter muscle and the RT zygomatic arch...
  17. H

    Workspace/Computer Lens billing

    I am wondering how other offices bill a Workspace/Computer Bluetech Lens with AR. I think it should be billed with V2200 code for bifocal, V2782 for Trivex material, V2745 for tint and V2799 for Near Variable Focus upgrade. This is how it works with VSP but I am having trouble with my commercial...
  18. L

    Help with Immigration Green Card E/M billing

    I'm still new to my place of work. I've recently run across charts where the patient is being seen only for immunizations/Green card immigration paperwork. Currently, patient's are only billed for the administration of the immunization(s). I believe a PE specific to immigration requirements...
  19. L

    Oct 1 2017 change to L57.0 code-needs additional code??? HELP

    Hi we are in Pennsylvania we regularly treat and bill L57.0 code under the 17000/17003/17004... I saw in the proposed changes and deletions upcoming is one that states that you need to use an additional code to identify the source of the ultraviolet radiation? We have never had to do that ever...
  20. L

    History Codes used as DX for F/U Office Visits????

    I have recently seen several of the following scineros and I just wanted to get some clarification: Patient comes in and has a full skin exam and Z12.83 is used as well as all applicable history codes (say Z85.828 hx of BCC or Z85.820) on the office visit that day and maybe the patient has...
  21. A

    Coding for Complete Abdominal Ultrasound

    I have CPT 76700 and it was sent to my office with the diagnosis of Z71.1 - Person with feared health complain in whom no diagnosis is made. The patient presented for evaluation of possible gallstones. Our study concluded the patient did not have gallstones. Is this diagnosis still acceptable...
  22. M

    Bronchoscopy Coding -- HELP PLEASE

    I am very new to coding for different bronchoscopies and I wanted to post this report and see if I could get some feedback as to whether or not the community thinks I am doing this correctly. I coded the following reports as: 31652 and 31624. DX: R59.1 and R91.8. Description: Patient was...
  23. C

    consult or new patient?

    1. If physician sees a patient who has paperwork that says “referral” or “transition of care” on it from the PCP or other referring provider, is this a consult or a new patient e/m? We have seen some of this paperwork have “referral” and “consult” on the same pages and my physician wants to...
  24. K

    possible limits on billing 96127 emotional/behavioral assessments

    My new boss says that we can only bill for these assessments once per patient. I see that we are allowed only 2 units on a claim but I can't see anywhere where it says bill only once per patient. Anybody out there have any other info on this?
  25. K

    Correct coding/billing of a CDL physical

    I have a new job at a clinic where they are coding CDL physicals as a sick visit -99214- with the dx of Z02.4 and billing it to the patients insurance and most of our contracted insurances are paying for them. They also have patients who come in for a pre-travel visit when they are going out of...
  26. A

    Lucentis Injections

    Hello Everyone, My administrator has asked me to verify payment of a Lucentis Injection for a patient who has a MediCal HMO. The facility has an authorization for the procedure, which includes the J2778, as well as the 67028. The IPA for the HMO is stating as long as I have the approval, it...
  27. B

    Revenue Code 200 ICU

    Hello thank you in advance to any response I receive to this question. I am CPC who deals primarily in Professional coding and billing for my daily work. I'm trying to learn a little more about facility coding to aid a friend who had spent some time in the hospital recently. This individual was...
  28. M

    Since when does Medicare bundle 76942 with 76872

    For years Medicare has accepted these codes for a prostate ultrasound and biopsy with no bundling issues. This is the order we billed them 76872, 55700, 76972. Since July I have been getting flagged that 76942 is a component of 76872 and a modifier is allowed to differentiate between the...
  29. C

    Strapping & supplies

    Are supplies (99070 ect) allowed to be billed w/ strapping codes? (29540 ect):confused:
  30. F

    Coding Question, Please help

    Can I code for a synvisc injection in the right knee and a synvisc injection in the left knee on the same day for the same patient and put a lt and rt as the modifier with the cpt code for a medicare patient and his secondary is tricare for life? Please help. Will I get reimbursed for the full...
  31. T

    Coding from doctor's notes

    I am a new coder, and still have trouble coding from the description in doctor's notes. I need more practice in what is coded and what is not. I try to look at the description of the code, to see what it includes, but I still need some help. Any hints? I keep being told I just need to practice...
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