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guideline

  1. A

    Wiki Is this fraud, abuse or common practice?

    I am a new Charge Capture Specialist for the Emergency Department (ED), responsible for processing patient encounters, including observation services. I have a question regarding billing compliance for patients who transition through multiple statuses. My understanding is that when a patient is...
  2. S

    Wiki 21248/21249 Guidelines

    Looking for guidance on CPT codes 21248/21249. I am searching for a specific policy or guideline that states how many implants are billed for each code. The code description states 21248 as a partial reconstruction and 21249 as a complete reconstruction. My providers and I have always billed...
  3. L

    Wiki Diagnosis order

    I am having a hard time trying to understand the pecking order for diagnosis codes that have -use additional code to identify under a chapter then also -use additional code to identify underneath the code you are choosing. For example: Hypertensive diseases (I10-I16) -it says to use additional...
    • lymanj1
    • Thread
    • diagnosis diagnosis coding guideline help please icd-10 rules
    • Replies: 0
    • Forum: ICD-10
  4. J

    Wiki Interoffice procedure

    I have just started coding for a OB doctor who does interoffice procedures. He only states that this CPT code was completed with no other documentation. I am having trouble finding information which states the requirements for billing for a procedure. I am pretty sure it comes from Office of...
  5. A

    Wiki Cva with deficits in icd-10

    Can anyone tell if there is a guideline stating to report neurologic deficits associated with an acute CVA? Is it found in ICD-9, but I can't seem to locate it anywhere in ICD-10. Maybe it's no longer there??? Thanks for the help!
  6. W

    Wiki Ambulance

    Is the pick up and drop off location AND the modifiers required on an ambulance claim for Anthem and/or Noridian electronic claims? If so where can I find this documented? like a billing guideline?
  7. D

    Wiki new to Path question on Icd10 Z codes

    I haven't coded path since ICD10 was implemented. I don't have a ICD10 Lab book. Question: When coding and billing for any drug test for pain management is there a guideline that you have to have an encounter code or Z code billed? To add to that is there any guideline to any other ICD10 code...
  8. K

    Wiki Electrocardiogram

    I work for a Cardiopulmonary Clinic, that is owned by the hospital. I was told that Insurance will not pay for a new PT visit (99204) with ECG (93000 or 93005). Is there a guideline or rule that states why? Where can I find it? Also, is it ok to code 93040 Rhythm ECG with a New PT visit? Thank you!
    • kizzyvw
    • Thread
    • 93040 ecg guideline rule visit
    • Replies: 3
    • Forum: Cardiology
  9. R

    Wiki Immunizations at the same time as Prevent Med

    We have an insurance company telling us that we have to put a 25 modifier on the prevent med codes 9938? - 9939? in order to get paid for the immunization administration code 90471-90472. They tell us that it is part of the CPT coding guidelines, page 369 of the professional edition. I have not...
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