1. E

    Office Visits with Z01.419

    Hello! I am a new OB coder, and was hoping to receive some clarification. Can the "Encounter for gyn exam (general) (routine) with/without abnormal findings" diagnosis codes be used for a regular office visit, or are those codes reserved for the Annual Exam? I had a situation where a new patient...
  2. K

    To bill Preventative or Not to bill Preventative???

    I'm running into issues billing for several of my sites... The doctors will have the CC as "follow-up" or "routine" sometimes even "dm check 6-months" and there is always a full workup but the doctor puts like, 7-10 diagnosis codes in there, usually insignificant things like HTN, DM, obesity...
  3. T

    Compliance violation

    I have an incident that violates our compliance program. What is the best way to write this up? Is there a form of some kind? This is the first time a violation has occurred so it needs to be addressed so that the compliance committee is aware of what has happened to take action and try to...
  4. A

    Critical Care and Mid Levels?

    Would like opinions... At a recent ACEP seminar I heard that mid-levels could bill for Critical Care, just not for Medicare. It was stated that the CPT rules differed from CMS on this, and that if the commericial insurance didn't prevent it, it was ok to bill. But when I look at the CPT...
  5. R

    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...