1. G

    Wiki 15853 Suture Removal

    If a PCP provider is billing based on time, they have an appropriate time statement but says something like I spent XX minutes of total time on the encounter today .... including suture removal would you accept the time statement? AMA states total time does not include any time spent in the...
  2. S

    Wiki Rapid COVID Nasal Swab

    Hello All, I wanted to confirm there wasn't a new code to be used for the RAPID COVID-19 test. All I've seen this far was CPT 87635 for the actual COVID test. The other CPT that were added were for the Antibodies test from what I am reading. This will be coding for an Urgent care as well as a PCP.
  3. E

    Wiki CMS/Medicaid Pay To Provider Question

    Hello, We have been having problems with our billing system where MEDICAID claims are paying to the member's PCP, not the rendering provider. Before going to the manufacturer to get changes to our billing system, is this a Medicaid or CMS rule/regulation? I have searched their website through...
  4. H

    Wiki Family Medicine offices

    Does anyone do xrays or in house bloodwork in PCP offices? How does it reimburse?
  5. S

    Wiki Medicare code for "squeezing" a Medicare patient into an already busy schedule

    Medicare code for "squeezing" a Medicare patient into an already busy schedule Hello all, I have a kinda off question: My Provider seems to think that there is a code out there, to be billed to Medicare, for "fitting/squeezing" a Medicare patient into an already full schedule (ie: double...
  6. C

    Wiki Medication Managment

    Hello all! I currently work at a PCP office doing medical coding. We often have this debate and I was wondering what other coders thought. Do you count giving a simple RX of an antibiotic for sinus infection, yeast infection, cough, etc as medication management? Usually, when an acute issue...
  7. M

    Wiki Billing for MNT

    Hello, I work in an office with PCPs and RDs and I am looking for some guidance. We are billing MNT, ordered by our clinicians and billed by our RDs. How important do you feel that the order/referral from the PCP with DX is to the DX billed by the RD? Do you see any issue with the RD adding...
  8. L

    Wiki Well Visit/ Well Woman

    Hello! I am wondering, I know the patient can have a preventive visit with her normal pcp and then a well woman with her GYN, but what if a patient comes to her pcp for a well exam (preventive visit) and then comes back few days later to have a routine pap smear; can we bill the pap as...
  9. 1

    Wiki Preop HP billing

    If a surgeon in a group schedules a patient for a major surgery, but sends the patient to their PCP for the HP, what is the correct way of billing both services? The global package includes payment for some pre op work. So if PCP in another group does HP, what is the correct way to bill?
  10. M

    Wiki HELP PCP keeps doing Trigger Point Injections and feels ORTHO codes same way

    Will someone who codes ortho please help me... I'm in serious need of direction for steroid injections that are given in the office. One of the PCP continues to give injections that fall under trigger point injection rules and doesn't understand that he must document the muscle group where...
  11. E

    Wiki medicare auditing for payor

    When coding charts for Medicare audits: If a pcp is coding cancer as current and the specialist is saying the patient is in remission can we change the pcp code to hx of cancer?
  12. Y

    Wiki Inpatient Hosptial Follow Up with PCP --HELP!!!

    Hello my coding friends, Will some please help me? What is the CPT code do I assign when someone was released from the hospital (inpatient) and the go the PCP for follow up? Is is just a regular established E&M code? Thanks for your support!!!
  13. S

    Wiki Physical vs New PT visit

    My husband went to the Dr. and I have questions regarding the coding because I am so close to this I wanted the opinion of others before I question the office. Pt called up and requested physical examination due to being new in the area and needed to establish a PCP. Pt received bloodwork and...
  14. N

    Wiki PCP vs Specialist

    Perhaps this has been presented before, I am unable to find it. When is a pediatrician considered a primary care provider versus a specialist? Some insurance companies have different copay amounts for specialists. This is for a new pediatric clinic opening soon. Thanks