e/m codes

  1. A

    Nephrology Level of Risk help

    This is my nephrology provider's portion of the split-share assessment/plan on an in-patient hospital progress note. Based on his documentation how would you level this and why? I've been especially struggling with defining what constitutes a high level of risk and how specific the provider...
  2. A

    How to bill Pre-employment Physical exam?

    Can someone explain how to bill for a pre-employment physical exam? Do any insurance companies cover this? I have a patient who came in for a pre-employment physical exam required for her admission into a nursing program. Is it appropriate to bill using code 99499 with diagnosis code Z02.1?
  3. K

    Wiki E/M Service Rendered at Non-medical Community Center

    I have a provider who works for an Indian Health Service that will go to the reserve and render services at their local Activity Community Center. There are no permanent medical facilities and it's not a residence. What E/M CPT code would you recommend? I'm struggling to find the code as this is...
  4. J

    Wiki AFTER HOURS WORK BY DOCTOR

    Hello, I am trying to figure out the best way to capture middle-of-the-night work being done by the Neurosurgeon. He is being called for chart reviews, etc late at night by the Emergency room doctors and he is giving recommendations. He does see the patient for a face to face consult the next...
  5. P

    Wiki Office Visits via video

    First question, is an office appointment that is conducted via video still considered a face-to-face appointment? Second question, the patient is in the office, but the physician is in another state conducting the appointment via video. I believe this would still be billed with modifier 95, but...
  6. P

    Wiki Initial Prescription of OCPs following a IUD removal

    Our provider sees a patient for an IUD removal. On the same day, provider started oral contraceptives. Is it appropriate to bill a separate E/M code for this reason? Appending modifier -25 to this E/M code. Appreciate the reponse!
  7. N

    Wiki Preventative visit with additional coding

    I have a medical chart where patient came in for "well woman" exam; however medications were ordered for Asthma, Anaphylaxis, and Seasonal allergies. Provider goes over the asthma briefly in the subjective part of the encounter - then goes over all 3 within the "plan" part of the encounter -...
  8. C

    Wiki special Ophthalmology codes and modifier 25

    I'm new to Ophthalmology and the company I'm working for doesn't have any credentialed coders on staff - I'm the first one. I'm questioning the use of modifier 25 on the ophthalmology codes 92002-92004 & 92012 - 92014. If the provider does a comp exam and a foreign body removal, should we be...
  9. H

    Wiki Palliative Care coding

    Hi, I’m aware that there are no specific E/M codes that are dedicated to Palliative Care at this point. However, I was wondering if anyone would be willing to share what codes they typically use. I have pulled the clinician home visits and advanced planning codes but would anyone be willing to...
  10. S

    Wiki How do I determine E/M level for prenatal visits for Texas Medicaid

    Texas requires us to bill "the most appropriate level E/M" for prenatal visits. How do I determine the level of E/M though? Do I use the 3 key components (history, exam and MDM)? My company audits on 1997 guidelines, but with an prenatal visit, there is no "real" physical exam, other than...
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