1. E

    Wiki Why was I marked wrong? (Practicode Case ID: OPD7205)

    The documentation: Why is 96372 reported in addition to J0696, which already specifies that the drug was injected?
  2. E

    Wiki Why was I marked wrong? (Practicode Case ID: OPD7259)

    The documentation: Why aren't the external cause codes reported here? Why isn't the 80 mg propofol (Diprivan) injection reported? And why isn't the X-ray reported? There's no mention of it being provided by anyone other than the reporting physician.
  3. S

    Wiki Billing for temozolomide (temodar) prescription

    How do you bill for a temodar prescription? I can only find J8700 for 5mg tabs but the company makes tabs in many other strengths... but you can't bill for the total prescribed in 5mg increments because then the J8700 goes way over the practitioner MUE. Any advice?
  4. K

    Wiki CPC-A with strong data entry skills ready to work full-time | Remote | CRC Exam next month

    Hi! I am a newly certified CPC-A that is seeking full-time remote employment. I scored 89% on the CPC exam two weeks ago and am currently scheduled to take the CRC certification exam on July 23. I have exceptional data entry skills from a computer programming degree and strong analytical skills...
  5. L

    Wiki Type of service codes for HCPCS

    I am trying to find information on what TOS code to put on my claim form for Q4159. I was only able to find the BETOS. Does each HCPCS code have a specific TOS assigned or I'm thinking that it could be the same TOS as the parent CPT. Would that be correct? Can anyone point me to some resources.
  6. J

    Wiki Billing Ensure (Enteral/Nutrition products)

    I work for a company that has started supplying nutritional products, like Ensure, for patients. There are so many different codes that can apply for billing the HCPCS. Can anyone offer me some guidance on which code to bill with? Is there anything notable I should know about billing this?
  7. J

    Wiki Quality Measure

    Hi Everyone! Is there a CPT2/HCPCS or any code for that matter that identifies when a referral has been made for a diabetic retinal exam? Or any that we can use under the auspices of diabetes management that we can isolate for a referral for this test?
  8. T

    Wiki 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...
  9. C

    Wiki use of HCPCS code Q0163 when it's not chemo related?

    I'm coding for urgent care and the providers often give oral Diphenhydramine HCL to handle other symptoms that are nothing to do with chemo. Web MD lists all kinds of uses for the drug, non of which are chemo related specifically, yet the only oral HCPCS code for the drug specifically states for...
  10. M

    Wiki Billing DME

    I'm pretty new to using HCPCS level 2 codes. The code E0114 (crutches) has an indicator that says "Bill DME MAC" can anyone tell me what this means? Can I bill this to Medicaid?
  11. rpatterson

    Wiki Is there a HCPCS code for nebulized lidocaine?

    There are many documents that address the benefits of nebulized lidocaine, what it is used for, and how much to give. I cannot, however find a HCPCS code to charge for the lidocaine? When a physician uses lidocaine in a nebulizer, is there a HCPCS code that can be used for the lidocaine, or...
  12. J

    Wiki Clinical Documentation Requirements

    Hello, Billing for Arizona Medicaid for Substance Use IOP. I understand updating treatment planning, but in doing the treatment planning, would your counselors do an assessment or an individual therapy session to update it? My other thoughts lean to IOP being per diem. If they do IOP class and...
  13. T

    Wiki Billing CPT application of off-the-shelf splint.

    Does anyone have the literature on why the Emergency department physician can not bill CPT codes in the 29xxx series if the splint is off-the-shelf or pre-fabricated?
  14. S

    Wiki 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.
  15. T

    Wiki Newly certified CPC-A seeking FT/PT employment in St. Paul/Minneapolis

    I am excited to put my coding skills to use in my new career. Though I have a medical background, when I decided to become a medical coder I had no previous experience in it. Through determination and very hard work I have recently completed my training with an AAPC accredited program and passed...
  16. K

    Wiki 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...
  17. K

    Wiki Billing S codes to the VA?

    Hello, I do billing for a home health agency and I am rebilling some old claims to the VA. I found some claims that are for home health aide services. Some of the claims are being billed as S9125, respite care in the home, per diem, and some are G0156, services of home health / health aide in...
  18. K

    Wiki 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...
  19. S

    Wiki 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.
  20. P

    Wiki CMS Deletion of HCPCS G0477 thru G0479

    Does anyone have any information on replacement codes for the drug testing codes G0477 thru G0479 that CMS deleted? Having a bit of a hard time finding information. Thank you! Jody
  21. D

    Wiki Medicare/Medicaid secondary: HCPCS services non covered by Medicare paid by Medicaid

    Hi, I work for a community mental health center and most of our services that we render are HCPCS and covered by Medicaid. My question is: Since the services are not covered by Medicare do we bill Medicaid directly or do we still need to bill Medicare as primary? I have asked this question...
  22. A

    Wiki -59 Modifier on HCPCS codes

    We are having an issue where Regence is denying the second line of J9055 because "modifier -59 is not valid with HCPCS code J9055." We are billing separate lines to bill 2 different NDC#s. How are we to code the two lines without modifier -59? Do we bill without a modifier or just lump the 2...
  23. K

    Wiki 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
  24. P

    Wiki Substance Abuse Facility

    Hello everyone, I had a few questions regarding HCPCS and TOB. Does anyone have experience billing HCPCS code S0201 or H0035? When checking the HCPCS manual, H0035 is mental health oriented but I've heard many substance abuse facilities are using this code regardless. The HCPCS book says...
  25. N

    Wiki NDC/HCPCS Unit Discrepancy for OCs

    Hi all, Longtime reader, first time poster! I am trying to help a Montana provider fix a billing issue with BCBS. The payer states that the NDC and HCPCS unit numbers for oral contraceptives (S4993) should be per pill. This is inconsistent with how they've billed BCBS in the past, as well as...
  26. B

    Wiki Need modifier

    Hi Here I am getting wrestle to fix the below mentioned claims... Now I am frequently getting denials with the CPT H0023 as “missing modifier” from Medicaid insurance. I am new to see this HCPCS code, please give me your suggestion on this
  27. H

    Wiki CPC-A and ICD-10 Proficient Candidate Seeking Remote Part-Time Medical Coder Position

  28. K

    Wiki HCPCS book and CPC EXAM

    Good Morning, I am scheduled to take the CPC EXAM in a few weeks and I don't have the HCPCS book. The exam layout states that 5 questions are designated for this book. Did you find this book helpful for the EXAM? The reason I ask is because its over $50 and I'm not sure if it would be worth it...
  29. C

    Wiki Testosterone Suspension Injection HCPCS

    Does anyone know what happened to the testosterone suspension injection codes in HCPCS. Is this drug not used anymore? I can't find a new code for this and all of the testosterone codes I have found are 1mg.
  30. L

    Wiki Need HCPCS code for Tissue Breast Expander

    I am needing a HCPCS code for a tissue breast expander. There is one website that says to use C1789 and then there is another website that says to use L8600. Is there anyone that has billed this product before and would know which code would be correct?
  31. L

    Wiki Need HCPCS code for Tissue Breast Expanders

    I am needing a HCPCS code for tissue breast expanders. I have found one website that says to use C1789 and one website that says to use L8600. Is there anyone that has billed this product before and knows which code to use?
  32. L

    Wiki HCPCS codes

    I am still fairly new at coding and was wondering, when are the HCPCS codes used? I know for injections, I use them but in what other scenarios and what Payers cover the codes? My brain is trying to get soon much information because I do want to be a great coder, lol. Thank you!!
  33. B

    Wiki CPT code for application of stem cell autograft

    We have been trying to find a CPT code or HCPCS code for application of a stem cell autograft. The orthopedic surgeons are doing this during joint surgeries. Has any one found a code for this? Thanks for the help!
  34. B

    Wiki Trigger Point injections

    Good Morning! Can anyone tell me whether or not you can report the HCPCS injection code in addition to the trigger point injection codes (20600, 20610, 20552)? I know that you can't bill for the lidocaine, but we also in many cases inject depo medrol and wondered if we could be billing for that...
  35. A

    Wiki drug codes

    Does anyone bill for drugs visipaque 270 or Isovue 250 if so what hcpcs code would you use and how would I find out reimbursements. Any thoughts appreciated. Thanks.
  36. K

    Wiki Campath (alemtuzumab) HCPCS change

    On 1/1/2016, the HCPCS code for Campath (alemtuzumab), a monoclonal antibody used to treat CLL, was changed from J9010 to J0202. Can it still be billed with chemo admin codes?
  37. E

    Wiki Toxicology codes

    I'm confused on the drug screen codes. Medicare deleted g6030-g6058 but they are still in hcpcs book.
  38. G

    Wiki job

    hello, my physician group(UROLOGY) is looking to fill a medical charge entry/coding and billing position, also a position to do A/R appeals and work denials. we are located in downtown Albuquerque full time positions only, no certification needed. CPT, ICD-10, HCPCS II, CMS-1500 is required if...
  39. O

    Wiki Anyone ever used the CR modifier?! (Catastrophe/disaster-related)

    Hey, y'all. Has anyone ever seen or used this 'CR' modifier?! I'm in Texas and even with our tornado and hurricane disasters, I've never seen this one before. I can find CMS info but would like to hear from someone who has actually used this and what was the result? Catastrophe/disaster...
  40. D

    Wiki E codes and DMEPOS modifier help!

    I'm instructing my first class in coding and my students are having a tough time with E-codes (when to use them) and HCPCS Level II modifiers (so many from them to choose from). I'm trying to find an easier way of breaking this down to them. I've searched the internet and can't really find...
  41. A

    Wiki HCPCS Modifiers

    I'm having a difficult time using these modifiers, because I don't know where to locate the correct ones I need for the service. Is there an instruction or index on finding them that I'm unaware of? (I'm a student).
  42. D

    Wiki HCPCS Help needed!!

    I am looking for HCPCS codes for the following medications that our doctors dispense to the patients and we bill to their WC carriers. Ketoprofen / Orudis - 75mgs Prilosec / Omeprazole - 20mgs Paxil / Paroxetine - 10mgs and 20mgs Ibuprofen / Motrin - 600mgs & 800mgs Hydrocodone / Norco -...