1. P

    Wiki IV Guidelines for Charging CPT 96366 following CPT 96367 - How should I charge?

    Hello, My question is, if a patient in the ED received multiple IV drug infusions and one of the drugs only ran for 63 minutes, would I charge 96367 alone or do I add 96366 because it ran over 60 minutes? Here are the drugs that were given: Patient was in the ER from 03/01/18 to 03/02/18...
  2. J

    Wiki Denials for Subsequent Hospital Care (99231 - 99233)

    Hello, Our billing team has been receiving denials from several payers on our Subsequent Hospital Encounter claims (99231-99233). The denials we receive state something along the lines of the code being incident to the primary procedure code or being bundled. Per the CPT book these codes are to...
  3. M

    Wiki Inpatient planned procedure

    Question: A patient is consulted with ENT on 6/20/16 due to hx of SMA type 1 and evaluation for tracheostomy. They state that they will plan for tracheostomy on 6/22/16. I can bill for the consult on 6/20/16, but could I also bill for the subsequent visit on 6/22/16 with a 25 modifier? Please...
  4. P

    Wiki ECMO Management codes with subsequent care

    I have a question regarding ECMO: Can Dr. Smith bill ECMO management 33949 in addition to subsequent hospital care 99231-25 for the same date of service (as long as documentation supports both codes)? Thanks in advance!
  5. J

    Wiki Coding an infusion when there is a "pause" in the infusion

    We are having a difficult time trying to find any information on how to treat this particular instance. The scenario: A patient comes in for infusion, it starts at 8:00 but at 8:45 they pause it because of a reaction, it is resumed again at 9:00 and continues for another hour. Is that 15...
  6. S

    Wiki Initial or subsequent MI?

    Hi, I would like to ask for your input regarding coding initial or subsequent MI. I have a patient who was admitted due to SOB. Patient had an NSTEMI 2 weeks ago. Later during the admission, patient became bradycardic and reported chest tightness. A code was called . Monitor showed...
  7. S

    Wiki Ob drop in visit?

    When a OB patient comes in as a drop in and the dx is elevated bp, do we still code it as a subsequent prenatal visit?
  8. S

    Wiki Z98.89 or Z47.1

    Which is the correct Dx code for an x-ray done the same day after a knee or hip replacement? I'm interpreting code Z47.1 to be used at subsequent visits after the initial surgery. Thanks.
  9. T

    Wiki Subsequent injury codes versus aftercare codes

    If there is subsequent care for injuries, monthly PT treatment, should I continue to code the injury code with subsequent healing code or switch over to aftercare codes since the injury has been treated and the care is now for rehabilitation. Any help is appreciated!!
  10. M

    Wiki sequela or subsequent

    I am really confused thought I had the initial sequela and subsequent down but not so sure now. This patient came into our facility for follow up on foot injury. Provider documented the patients presents today with right foot pain. Seen at a different facility for the initial treatment has a...
  11. Lynda Wetter

    Wiki Subsequent hospital care

    Does the below statement fulfill the requirement for a subsequent care code 99231? Seen and examined. Left leg lesion is raised around hair follicle. There is some fluctuation. I believe he would benefit from I & D. I called Dr. X, acute care surgery service who would evaluate him for possible...