high risk

  1. G

    Does anyone code for Medicaid of WA RHC?

    We are an RHC and we are having issues getting OB claims processed by MA WA. Biggest issue at this time is MA WA does not accept our billing of high risk DX codes and only wants to pay on normal pg DX codes. ????? Any help or pointing to references that actually can help would be greatly...
  2. J

    Vancomycin and High Risk MDM

    I'm curious if IV Vancomycin would generally be classified under "Drug therapy requiring intensive monitoring for toxicity" in the table of risk? From what I've read in trying to do some research, trough levels are monitored for concentration of the drug in the patient's system for efficacy...
  3. L

    Identified Risk Factors in High Medical Decision Making for a Potential Malignancy

    There is a debate between the doctors and our department: An ultrasound was done and the patient has a 5 cm mass near her ovary. The MD is planning surgery to remove the mass, it is not known for certain whether or not the mass is benign or malignant. The MD believes that the mass is an...
  4. rpatterson

    Delivery dx code for uncomplicated delivery with high risk pregnancy

    ICD 10 Code O80 shows Encounter for full-term uncomplicated delivery. There is a note that states: ...This code is for use as a single diagnosis code and is not to be used with any other code from chapter 15. I have an OP Note for a patient that was induced at 39 weeks. She had a diagnosis of...
  5. E

    Coding Clinic States use Z12.11 on High Risk Screening Colonoscopy???

    I reviewed documentation from a recent AskMueller seminar of GI coding and billing and it states to assign Z12.11 screening for malignant neoplasm as the primary diagnosis code for high risk screening colonoscopy, stating a surveillance colonoscopy is a screening colonoscopy. I had never heard...
  6. A

    Opioid Management

    Do you consider opioid management with regular drug screens to be in the high risk category or does it just qualify as moderate prescription drug management? Palmetto GBA's list for "Management Options: Drug Therapy requiring Intensive Monitoring for Toxicity" leaves them out. Anyone have a good...