coding guidelines

  1. M

    Coding PKD after kidney transplant

    Hi all, Need some assistance please. Have a provider who has a patient with polycystic kidney disease and ESRD....or should I say had these. She received a kidney and is doing well. My question is, I understand we should not still be coding the ESRD as pt no longer receiving dialysis, but...
  2. N

    Incident to billing/coding

    At my facility we are going to start billing "incident to" for a PA that is going to be working in our urgent care and possibly eventually move into our family practice. I have been researching the guidelines and brought them to my CEO. My question is: do the guidelines only apply to Medicare...
  3. B

    PT Coding Question

    Hi! We're billing the following PT codes: 97163 97014 97010 97140 97535 All are affixed with a GP modifier for Medicare, however is a -59 needed? All of our notes seem to indicate that it's only required if billing CPT 97164 (Re-Eval). Can someone please confirm? Also, for Medicare, please...
  4. 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?
  5. 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...
  6. N

    ICD 10 coding guidelines clarification

    Hello all, I recently ran into a situation in which I would like some other's input on the coding guidelines. In regards to inpatient coding, when looking at the ICD 10 rules you still have the same additional diagnoses (AD) guideline - not going to reiterate it for the sake of this post...
  7. M

    coding surgery on foot-PLEASE HELP!!!

    I was wondering if anyone could help me code the following surgeries: Operative procedures left foot 1. first metatarsophalangeal fusion 2.Bunionectomy 3.second toe hammertoe procedure with partial exostectomy of the proximal phalanx of the 2nd toe(resection arthroplasty of the 2nd proximal...
  8. C

    Risk Adjustment Coding - Inpatient Coding Guidelines

    Hello, Can uncertain diagnosis such as r/o, probable, suspected, questionable etc. be captured for HCC risk adjustment purposes on consults, h&p's, progress notes, in an inpatient setting? My thoughts are no; they can only be captured at the time of discharge on a discharge summary...