procedure

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    Wiki Hospital E&M Repeat Procedure Question same visit

    If a patient came into the ER w/ a fractured elbow. The MD decides to sedate the patient and perform a manipulation and reduction. Procedure went well but when the patient went for X-Ray, somehow the elbow dislocated again. So they brought the patient back to the room, sedated him a second...
  2. D

    Wiki Intracranial Artery Angioplasty

    I have a denial on this procedure stating it is experimental. Has anyone had any luck with getting this procedure paid? The angioplasty was performed for cerebral vasospasm. I would love to get a copy of an appeal letter if possible. Any help would be appreciated! Thank you!
  3. K

    Wiki Intact Fundoplication

    I'm a newer coder. . .and had a question that may seem easy to some. For one of the "postoperative diagnoses", 'intact fundoplication' was mentioned. From what I see that looks more like a procedure than a dx. Just needed some clarification. Thank you!
  4. M

    Wiki Procedure Titles

    When a procedure is being done in the office does the procedure note need a title? Example: Nasal Endoscopy. We are having conflicting issues with this, stating the procedure note done does not need a title for a procedure. I believe if you do a procedure you should have some kind of title...
  5. S

    Wiki Burr Hole PCS

    Patient was taken to the OR for burr hole drainage of subdural hematoma. Small incision made in the right temporal area and then burr hole with drain placement. We didn't code this to an open procedure because the skull didn't have to be opened prior to the drill. Are we correct? Or would...
  6. L

    Wiki Urostomy procedure in the ED

    Urostomy procedure in the ED Can anyone help with this procedure? It was done in the ED facility and I'm not really sure about what procedure to capture. We were thinking CPT 51710 but it doesn't seem to fit exactly. "lubrication applied to the stoma, and a 16 French coude catheter was...
  7. L

    Wiki Urostomy procedudre

    Can anyone help with this procedure? It was done in the ED facility and I'm not really sure about what procedure to capture. We were thinking CPT 51710 but it doesn't seem to fit exactly. "lubrication applied to the stoma, and a 16 French coude catheter was advanced into the stoma, try...
  8. P

    Wiki Humana not paying for WCC when immunizations billed

    Even though we have modifier 25 on the preventive visit line, lately Humana has been denying it saying, "This procedure code was not reimbursed because the service was included in another service provided at the same time." Any suggestions?
  9. D

    Wiki 73564 denial

    hi I am new to orthopedic and I keep getting a denial for 73564 RT with diagnosis S80.01XA indicating diagnosis inconsistent with procedure, any advice would help, thank you Laura
  10. A

    coding dispute between CPT book and Anesthesia code

    I work for a group of Anesthesiologists and I had a case where a patient had implanted plates removed from her ribs. I coded 20680 and the code crosswalks to 01360 for anesthesia. On the EOB that the patient received the procedure description said she had work done on her femur. She called the...
  11. A

    Wiki anesthesia coding

    I work for a group of Anesthesiologists and I had a case where a patient had implanted plates removed from her ribs. I coded 20680 and the code crosswalks to 01360 for anesthesia. On the EOB that the patient received the procedure description said she had work done on her femur. She called the...
  12. A

    Wiki CPT Coding for Anesthesia

    I work for a group of Anesthesiologists and I had a case where a patient had implanted plates removed from her ribs. I coded 20680 and the code crosswalks to 01360 for anesthesia. On the EOB that the patient received the procedure description said she had work done on her femur. She called the...
  13. M

    Wiki New Patients for Pain Management

    A new patient is referred for evaluation and treatment, and based on imaging and medical documentation from the referring the provider performs an epidural steroid injection. Is it appropriate to bill a new patient E&M with modifier -25 in addition to the procedure to establish patient care or...
  14. K

    Wiki Denied for procedure incidental to another procedure

    I billed 32551 and 99255 on the same day and it denied. Should i have billed 99255/25 with 32551 to pay. I am new to hospital in pt billing. Thanks
  15. M

    Wiki Ear wash

    I billed 69210. Pt had bilateral procedure. The guidelines state to use modifier 50 for bilateral. It rejected stating "procedure is inconsistent with modifier." Do I bill each one separately with modifier 50 on one of line items? I first filed w/modifier 59, then saw that 50 was needed. TIA Judy
  16. Y

    Wiki Coding Question

    Can someone tell me what does it mean at the end of a chart note when it states "patient was seen in the absence of a Dr.?" The report shows cc, HPI, Physical exam, Procedure, and plan Do I need to bill an E&M code with when it states the patient was seen in absence of a dr?
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    Wiki Magnified laryngoscopy with KTP laser ablation of vocal fold lesion - DV

    Hello, I need confirmation for the following 2 notes. How would you code for the notes below? On example 1 CPT code 31599 EXAMPLE 1 Pt with recurrent papillomas causing dysphonia. Preoperatively, the patient was counseled on the options and has chosen to undergo a laser office procedure to...
  18. B

    Wiki lung radiofrequency ablation 32998

    code 32998 does not give an option to use fluoroscopy guidance. Should I use 76496 as an unlisted procedure with 32998? code 32998 only gives options to use 76940-us,77013-ct,77022-mri
  19. J

    Wiki Post procedural admit

    I don't code a lot of surgery stuff so my apologies if this is really simple. Patient has a procedure in the ASC at a medical facility. Patient then has to be admitted for post op pain control to the hospital as an inpatient. (2 different facilities). will the admit be billed and paid? Or is...
  20. M

    Wiki Discontinued Procedures

    Quick question - If a procedure is discontinued/cancelled due to contraindication do you use a modifier when billing the anesthesia for this procedure? Thanks Missy Heuer CPC
  21. D

    Wiki Da Vinci Prostatectomy

    Can anyone help me in coding a robotic DaVinci Prostatectomy? I'm a newly graduated CPC, and so far can find no code referring to this procedure. My brother is having this procedure, and Ins. is coding it with 55866, and only paying 50/50. Any help/discussion/advice is sincerely appreciated...
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    Wiki Mohs Reimbursment

    I am having trouble with Health Net Federal Services reimbursing Mohs procedures when multiple units are billed on one line. Also they are still applying modifier 51 to the first repair procedure. It's obvious their system edits are not correct and they have told me it does not matter what...
  23. K

    Wiki BMI index measurements

    Good afternoon, I have a question about BMI measurements, and how they are obtained. I thought the way to calculate is by mathematics. I cannot find a procedure code that this represents. I have an office that wants to use procedure code 93720 as a way of determining BMI. I cannot find any...
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