1. K

    Question IV billing in an Office setting

    Hi all! My office does surgeries from POS 11, we are not surgery center. Can we bill for the IV for fluids and/or drugs that are being adminstered? Thanks in advance! Kim
  2. Z


    We are an Infectious Disease group. The doctors see patients at the hospital. Due to the supply shortages (protective equipment and testing kits) at the hospitals in NYS at the moment some visits with the patients being seen for COVID-19 r/o are not able to undergo a proper physical. The doctors...
  3. N

    Pre-Procedure Psychiatric Clearance Questions

    I work for a pain management doctor who is now performing procedures in office and also in an ASC that payers are beginning to require pre-procedure psych evaluation and clearance for. The physician would like to contract a LCSW to work in the office part time, under our group NPI, to perform...
  4. M

    Guiaic done in office for colon cancer screening

    There does not seem to be a code for a guiaic test done in the office for colon cancer screen. 82270 sounds like the patient is sent home with cards, and 82272 states "performed for other than colorectal neoplasm screening" When the sample is collected by the physician and test performed in the...
  5. stephanieannec

    Question Reliable Coding Resources for FFS???

    Hi! I'm primarily a risk adjustment educator and recently I was asked by my organization to reach out to a provider who also has a large FFS panel to provide general CPT "cheat sheets." I'm really rusty on this aside from E/M and Category II and I'm wondering if there's any reliable material I...
  6. C

    2019 CPT Code Electronic Check-in

    Hello! With the start of the New Year we can no longer bill our patient electronic check-in pad with 96103 (computer administered, computer graded, psychologic assessment). If anyone else was billing 96103, have you found any appropriate alternatives? Thinking of 96146 OR 96136. Greatly...
  7. K

    Oral biospy cpt code

    Hi, I am new to Oral & Maxillofacial Surgery. I gave codes for the vestibule of the mouth and was told it is not the vestibule of mouth it's an oral biopsy Right retromolar area excision. So I found CPT 41826, Under Excision and Destruction Procedures on the Dentoalveolar Structures under...
  8. A

    90696 for patients outside of 4-6 years old

    Hello, The nurse at our clinic who administers vaccines sometimes admins a 90696 for kids outside of the 4-6 age rage. She says it's due to patients being behind on their vaccines and circumstances like that. Can I code this a a DTaP 90700 and IPV 90713 separately? Or do I have to use the...
  9. K

    HELP Well woman Prev Visit vs Office Visit coding

    Need to understand when to code for Prev Visit and When to stick to new patient, all the ICD vs CPT feel backwards from primary diagnosis to visit billed ...TIA New Pt 36 Here for well woman with pap, STI and HIV ICD consists of Z11.3 STI screen Z11.4 HIV screen Z01.419 GYN routine exam...
  10. T

    Care Management codes

    Recently the care managers in my office have started team conferences (G9007). They want to know if they can bill G9007 with a telephone call (98966) on the same day. I can't find a lot of information regarding this, so I'm hoping someone here can help. Basically; can G9007 and 98966 be billed...
  11. I

    Total Time allotments for CPT Codes (Pre, Intra, Post - Service time allotments)

    Hello everyone, I'm looking for an excel spreadsheet I can download with all the breakdowns for CPT services (i.e. pre/intra/post minutes for each CPT code). I believe this information came from CMS...? My brain is fried today...I know I have downloaded this information previously, but can't...
  12. T

    Pathology Coding

    Hi fellow CODERS! I hope this message finds you well. I am in need of some clarification around lab billing. I am not very familiar and would like to get some feedback. our office is billing multiple CPT codes in the Microbiome area. One being 87798, as we know this is an unlisted code...
  13. 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...
  14. K

    EEG coding in hospital setting

    I work for an outpatient neurological clinic, where the doctors will interpret EEG's done at the local hospital. My question is, one doctor always states in the report "Recording time consists of 30 minutes over an hour." While also stating "patient was recorded while awake and asleep." Now...
  15. R

    CPT Checklist

    Hi all, I've been looking for some sort of coding checklist that I might be able to give to my Physicians. For example a document that nudges them to use the correct verbage when dictating i.e. if we do a fistulagram with PTA what CPT codes does this entail, so they can go through their...
  16. C

    CPT Online

    Is the CPT published online? If not, how can I get the code descriptions online, guidelines, etc? I always cite my sources when I give providers advice on documentation and I'm getting tired of typing everything. I wanna copy and paste. I didn't see a link in the manual.
  17. A

    Jejunal tube conversion to a Gastrojejunostomy tube

    I am having a hard time finding the correct CPT for this procedure. Coder has coded 49446 which I see how they got this by going through our encoder. But I see that it isn't correct. I keep getting an unlisted CPT. needing a little help as to which CPT to use. Here is the note: The existing...
  18. M

    Residential Program Billing

    Does anyone know the appropriate CPT code for a Residential Program, per diem (supportive living) for TBI patients, billed to a no-fault auto insurance company?
  19. L

    Debridement and Unna/Compression CPTs for different wound conditions

    I'm hoping you all can help me find some documentation that I've lost. My research found that if I have a Venous Insufficiency ulcer, I can code Debridement AND Unna/Compression with a -59 modifier because the Debridement is for the ulcer and the Unna is for the separation condition for the...
  20. S

    Seeking an Outpatient Coding Position

    I am looking for a secure position where I can use everything I have learned. I am so ready to go :o Will re-locate.
  21. A

    I want to apprentice under hospital coder

    Hi! I live in Orange County, CA. I've really been wanting to become a stronger coder and I would love to sit and learn from a hospital coder. I'd love to work for a hospital but they require so many years under the belt. I'm willing to pick up the workload for free in exchange for an extended...
  22. K

    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...
  23. K

    An independent and self-motivated CPC-A with accurate and efficient coding skills

    15+ years of experience coordinating projects, administrative duties and processing large volumes of data in diverse office environments. • Certified Professional Coder-AAPC • CPT, HCPCS Level II and ICD-10-CM. • Knowledge of anatomy, physiology, and medical terminology. • Electronic health...
  24. C

    Prolonged Services

    Hello I have a patient who after his E/M visit was admitted to hospital by Dr. but stayed in office for 4 hours under supervision until an open room was available at hospital. Would I use prolonged visit codes? Or not include at all. Any advise would be helpful. thank you
  25. S

    Revenue code crosswalk

    Does anyone here have access to Revenue Code crosswalk tools like Uniform Billing Editor or Revenue Cycle Pro? I need a help with 6 codes.
  26. D

    97602 is there another code like this that is not an e&m

    I am trying to answer a question on a test and can't use E&M, only CPT, ICD10CM and Modifiers. 97602 is the best match I can find but it's not scrubbing. All that was done was a dressing change in the ER. Can anyone point me on the right path, I'm at a loss.
  27. B

    Help Needed: Project and Research Question-Correct an Edit

    Hi everyone, I am stumpt on this preoject/research question below, any assistance would be so greatly helpful :) Thanks so much, Brittany- CPT code 77003 is present under revenue code 320. CPT code 64490 is present under revenue code 360. An NCCI edit is present on code 77003 and reads...
  28. aimeeread

    CAR-T cell infusion

    Hello, I am now receiving direction that I should be billing for CAR-T cell infusions. Has anyone else ever seen these? If so, what code(s) did you use to bill for this procedure? I have read everything I can on this trial...and the closest thing I can come up with is 36511 (apheresis for...
  29. K

    Radiology CPT Coding

    When it comes to radiology coding, where do you get the CPT from, the order or the report? Example: Ordering Physician states to do a Pelvic Ultrasound (76856/76830) but in addition to this the Radiologist also does a complete Doppler (93975). Would you code directly from the order (which is...
  30. 5

    New CPT coded 2017 VS CPT 2016 codes

    in 2016 62311 was used, but in 2017 we have new codes. I have a patient that had a LESI in December of 2016. Do I use the 2016 CPT codes or the new 2017 codes? I have not been able to locate the answer to this question and I know I knew the answer at one time, but it has left my brain! Boy...
  31. C

    CPT 2017 Changes

    Good morning, Does anyone know where I can get a comprehensive list of ALL of the 2017 CPT code changes? Thank you
  32. A

    LCSW In home E/M and psychotherapy

    Trying to get an LCSW to provide in home psychotherapy/counseling to a patient who is covered by Cigna primary and Medicare secondary. Cigna advises that they do not accept CPT codes 90791 or 9083x for in home psychiatric assessments or psychotherapy and advised me to utilize E/M codes...
  33. N

    Cpt code globulin

    HI! How will you CPT code GLOBULIN alone term? Thanks in advance for the answers.
  34. J

    Rating code for an out of state (CA) workers comp patient? Help?

    We typically use the 99455 rating code for our patients. One of our patients has an out of state California workers comp case. And the rating, ( as well has the nurse case manager conference 99366 ), are getting denied. We were told to re-bill with CA RVS codes ? And that those codes we used...
  35. K

    Medcare ONLY covered CPT/HCPCS

    Hi! I've been searching everywhere on the net for Medicare ONLY covered CPT/HCPCS codes. Does anyone know a useful place I can obtain this information? Thank you, Katie
  36. A

    left thumb metacarpophalgeal arthrodesis & trapezium excision w/ suture suspension

    left thumb metacarpophalgeal arthrodesis & trapezium excision w/ suture suspension I need help coding this surgery for accuracy and maximum reimbursement. Should I use 25320, 25210, and 26850 or 25447? The skin was incised with a 15 blade along the preplanned mark. Hemostasis was achieved...
  37. P


    Hello everyone, In what instance would you bill CPT codes on a UB04? I've never done this and it doesn't seem normal. Also, what is the difference between billing on a UB04 VS a CMS1500? Any guidance would be greatly appreciated. Thank you in advance!
  38. D

    99221 or 99223????/Neuro Inp Consult

    HPI comp PFSH Comp ROS Comp Exam GA no acute distress HEENT mucus membranes moist, no conjunctival injection Fundoscopic exam-optic disc sharp on L, unable to see R CARDIO carotids-no bruit Heart-regular rate and rhythm+cardiac friction rub, no murmurs or...
  39. D

    Consult/Hospital Visit/Subsequent ???

    For inpatient neurology consult coding. HPI ROS PFMSH EXM MDM My question is that there is also a Neuro Exam which consist of Gen app-(1), Vitals 3 vitals (1), Fundus (optic disc exam (1), CV (pulses, bruits, or auscultation of heart (one point Maximum), Mental status (5), CN (8), Tone...
  40. P

    Code 46716 is a female procedure only??

    Hi, My denial defender on a bill I'm trying to submit is telling me that 46716 - (Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula) is a female-only code. I can't find anything in the description of this code that designates it as female-only. Is...
  41. W

    Vascular surgery

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

    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...
  43. N

    Federally Qualified Healthcare Centers

    Since FQHC's don't always bill a traditional CPT code, do they still have to follow the CPT guidelines when obtaining HPI? Example: FQHC's will bill Medi-Cal an "01", this is an office visit. They do not use a 99211-99215 as most traditional offices. So, when it comes to meeting all the of...
  44. L

    CPT 78299 and CPT 78278

    When Nuc Med Spect CT is used to pinpoint the exact location of a GI Bleed, can unlisted code 78299 be billed? If so can it be billed with 78278?
  45. R

    Looking to Expand our Coding Team

    Apply at http://www.neighborcare.org/ Description Neighborcare Health offers high quality health care through its medical, dental and school-based clinics, and is the leading provider to low-income and uninsured patients in the Seattle area. Our purpose is to improve health by engaging...
  46. V

    Needs assistance pls. - HCPCS

    Hi All, Is there a HCPCS CODE FOR CPT 99173 as per MEDICARE GUIDELINES? Thank you, IM
  47. 0

    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.
  48. M

    IHC staining confusion (88342, 88344) - please help!

    Could someone please help me with this? The pathology report supports ONE specimen. The report states "IHC stains are performed with appropriate controls & reveal strong & diffuse positivity for CK5/6, CALRETININ, & WT-1 (Nuclear). Focal positive staining is seen for CK 7, MOC31, & BEREP4. The...
  49. B

    Cpt for cardiopulmonary bypass support only

    Does any one know if there is a CPT for Cardiopulmonary Bypass Support only? One of my surgeons had to put a patient on Cardiopulmonary Bypass for another surgeon doing a Nephrectomy & I cannot for the life of me find a stand alone code. The only ones I have found are the add on codes for the...