1. A

    PT &OT CPT for billing education related to orthotics/orthosis? What CPT is used for ortho fitting and education when brought in by the patient?

    IF a PT/OT provides education on orthotics, is there an appropriate way to bill for the education time under a specific CPT code? Example: PT/OT may educate patient on either the need for orthotics for the feet or my suggestions on them. Education on bracing for the back, ankles, knees, etc...
  2. P

    Wiki Should I leave my comfortable but monotonous low pay job for something better? What would you do?

    So, I'm a full time risk adjustment medical coder approaching my two-year work anniversary. This is the first job I've been able to keep this long so it feels weird that I'm happily bowing out and not desperate to quit immediately like previous jobs ive held. It's a relatively easy and...
  3. B

    Wiki Incomplete Colectomy

    My provider attempted to perform a Lap Partial Colectomy with end colostomy- 44206. They also performed over 90 minutes of adhesion removal and a take-down of the splenic flexure. However, when they went to do the colectomy, the disease was too active and they decided to not do it, and no...
  4. M

    Wiki Coding Echos-dilated IVC

    Hi, When coding an Echo I keep seeing the following 2 statements: IVC is dilated with abnormal (<50%) collapse and IVC is dilated with normal collapse Can someone advice if and how they would code the ICD 10's for this? I am having some confusion, upon researching this. Thank you
  5. M

    Wiki Coding Echos-systolic function

    Hi everyone, I am now coding complete echos (93306) at my job and have a question in regards to coding systolic function. When the estimated LVEF is greater than 70% and documented as “hyperdunamic systolic function” would I50.20 be the correct ICD 10? (Unspecified systolic heart failure). I...
  6. S

    Wiki Covid

    I am new at coding (just started classes... I'm a M.A.) Please forgive my ignorance. We are a family practice in a very small rural town. We see scheduled patients daily. Currently we are overwhelmed with phone calls for covid testing. A nurse takes the call and then triages ... an...
  7. M

    Wiki Therapy Billing

    I recently started billing and coding for a Therapist/Counselor for substance abuse. I am billing all insurance as out of network. My claims are continuously getting denied. How should I be billing out of network for a substance abuse therapist?
  8. M

    Wiki 87426 question

    previously we were billing out 99000 for covid testing. Now between with the 87426 coming out my office is saying that the 87426 is saying its the antigen and not testing someone. I honestly am unsure how to treat it, as there are people saying different things. I thought this 87426 was the...
  9. K

    Wiki Antibody testing

    I need help. I have antibody testing that needs to be billed out but not sure exactly what codes to bill out for IgM, IgG, and IgA test. Do I bill out 3 codes for each one of them? Is it one code? I have found that 86769 is the antibody testing code. Just not sure if I need to bill it out 3...
  10. B

    Wiki Traumatic vs. Derangement

    There has been some debate on determining whether a case is traumatic vs. derangement. I would like some outside opinions on this topic in general and the specific case specified below. Case # 1 SUBJECTIVE: **** is here today for evaluation of her left knee. *** has had left knee pain ever...
  11. M

    Wiki Lipid Keratopathy

    Hi everyone! I'm trying to code a diagnosis of Lipid Keratopathy, but I have found three different options that I can use. Has anyone had to code this before, and if so, which did you use? I have listed the codes and definitions down lower, and I would love to know what everyone thinks. Of...
  12. D

    Wiki I've been reading the forums and I have a few questions. -Tampa

    Hello My name is Dylan and I'm new to the medical field. I've been reading on these forums since I singed up for my course at the end of May. I opted to get the whole package since I had no previous experience. I picked up a position in the front office of an urgent care, because it was shown to...
  13. D

    Wiki metastasis to brain

    Hi, Am I on the right track here? Pt. Dx w/ uterine ca s/p successful hysterectomy, cancer free 4 yrs., however recent metastasis to the brain. Presenting for radiation therapy today. I choose: Z51.0, Radiation therapy C79.31 Secondary malignant neoplasm of brain Z90.710 Acquired absence...
  14. K

    Wiki CPC Certification Help

    Hi, I'm about to graduate from college for Medical Coding and Billing, and I need to sit in for the CPC certification exam. I'm totally new to this and have 0 friends in this field so I'm very nervous about the exam because I have no idea what to expect. Can anyone recommend some study...
  15. M

    Wiki Thumb replant with failure

    Have an op note for a patient whose thumb was amputated distal to the MCP joint. (It was a complete amputation) Our surgeons reattached the thumb (over 8 hours in the OR) only to have it become apparent at the end that the reattachment was not going to work and so they re-amputated. My...
  16. J

    Wiki PT/INR and E/M with modifier 25 in Long term care

    It has been my understanding that billing an PT (85610) is only for the PT itself and not for the adjustment of the dosage of the medication. Since I work in long term care I have the question on if a low level E/M visit (99307) can be billed with a 25 modifier with a (85610) if an adjustment...
  17. D

    Wiki new to Path question on Icd10 Z codes

    I haven't coded path since ICD10 was implemented. I don't have a ICD10 Lab book. Question: When coding and billing for any drug test for pain management is there a guideline that you have to have an encounter code or Z code billed? To add to that is there any guideline to any other ICD10 code...
  18. D

    Wiki Question regarding 2016 CPC Certification Exam .

    Based on the following statement on the CMS website, can anyone tell me if the 2016 CPC certification exam include questions regarding external causes of morbidity? "Similar to ICD-9-CM, there is no national requirement for mandatory ICD-10-CM external cause code reporting. Unless you are...
  19. R

    Wiki Practicode - ICD-9 coding

    Hi, its me again, can't seem to make a commitment to the Practicode program, have heard mixed reviews about it. Anyway new question here, is practicode all in ICD-10 now? I don't want to do any ICD-9 coding at all.
  20. D

    Wiki Nerve conduction tests. 95885

    I have a question 95885 when dr. performs this on both sides would I bill 95885 with 2 units, or Lt and RT I am not sure I am new to this kind of testing thank you
  21. D

    Wiki 99232 question help

    one of our doctors came into our practice in January and he seen a patient in the hospital for three different days. we are getting a denial that its global pt is in the post op period, we found out that the doctor did surgery on the patient when he was in another practice- not sure how to do...
  22. M

    Wiki 92226 & Wasitng of J0585 (Botox)

    Atena is the only one not paying this code. Any suggestion how can I billed this code so I can start getting paid? Most of the time they pay only on the New Pt. Otherwise they deny it saying "Experimental". My Second Question is if a patient do not show up for Migraine treatment and the meds...
  23. K

    Wiki ICD-10 Certification Question

    I apologize if someone has already asked this question but I have noticed that anyone who had their coding certification prior to the implementation of ICD-10 was also required to get a separate ICD-10 certification. Is that still the case with those taking their coding ceritification exam in...
  24. T

    Wiki Prolia & Lupron Injections- Questions

    I have a Medicare Advantage HMO patient coming for 6 month Lupron injection-( 24 weeks from 08-07-2015) and will also need Prolia injections ( 24 weeks from 09-11-2015) Question #1. Can both injections be done on same day? Question #2. Is it OK to give Prolia on exact 24 weeks date?
  25. G

    Wiki G6024 and PT modifier.

    Okay, we know that Medicare is denying G6024 with a PT modifier. So my question is, how do I bill this so that they pay it?
  26. B

    Wiki HELP - Pro Fee Coding

    Hi everyone. I've been doing outpatient coding but am now assigned to do Pro Fee at a VA. My problem is that we do not have standard operating procedure guidelines to go by. I think I'm missing A LOT of clinics that I should be coding for. My question is this: Does anyone know where I can find...
  27. T

    Wiki A9555

    Question is anyone having to put an NDC# on claim in order for Medicare to make a pymt?
  28. L

    Wiki OP coding question

    Hi, I had a test question that I was shocked that I did not get right. Scenario: Patient had lesion removed from arm, path report states cancerous. The answer they stated is correct is to code the cancer code and 709.9 ? Ok I have coded for a few hospitals and was always told never to do...

    Wiki 93975 vs 93976

    Ok the question of the day here...What is the difference between 93975(complete) and 93976(limited)? Someone please help, I am having a major coding problem here. Thanks so much! :)