units

  1. M

    Question When billing on one line bilaterally, is the price supposed to be doubled since we are billing bilateral?

    When billing bilaterally on one line, are we supposed to double the billed fee? Metaphorical example, if we are billing a line at $400.00 and the service reimburses/allows from insurance at $350.00 for one unit, and then the bilateral portion of the CPT would be paid/allowed half at $175.00...
  2. S

    Multiple Units of One Code??

    I'm trying to code for gouty tophi excisions done on multiple fingers and can't figure out how to do this... The code I found to use is 26160 (if you have a better one for gouty tophi then by all means correct me). The doctor performed the excisions on the left index, middle, and ring fingers...
  3. H

    Heparin in bladder instillations - HELP!

    Our urogynecology office does bladder instillations frequently, & always bills Heparin. I just want to make sure we are billing them correctly. I discovered recently that we are incorrectly billing the units of HEPARIN. Chart states 40,000 units, we've been billing 1. Yikes! Here is how we...
  4. C

    J3301 billing

    When administering less than 10mg, can we still bill J3301 with a quantity of 1? The code description states "10mg" and not "up to 10mg" as is the case for other drugs. I understand on the facility side when the dosage is less than the amount indicated for the HCPCS code that it is...
  5. N

    Getting paid for units for 26356 25260

    I submitted a claim to MN Medical Assistance for tendon repair. He repaired multiple tendons in the forearm and hand. I submitted 26356 with 3 units (MUE is 4) and 25260 with 3 units (MUE is 9). MN MA only paid for one unit for each. When I called them they said they only allow one unit for...
  6. M

    Medical Nutrition Therapy code 97804

    Hi all, I have been searching online to no avail. We have some patients who saw one of our dietitians as a group. We are billing 97804 and this code is billed in units for every 30 minutes. These group MNT patients were seen for 1 hour and 45 minutes (105 minutes total). Would this be billed as...
  7. L

    Denial of multiple units of lesion excision (same CPT)

    We've recently started to see denials for excisions (same CPT) on the same claim. For example, 11403 x 3 units. Sometimes 1 unit will pay and other times none will pay with a message that the modifier used is incorrect or missing. We were able to get these paid until now with -76-59 on the...
  8. S

    Stelara 45 mg/0.5 ml injection

    How do I code for this? I already know the administration code. When I look in the HCPCS book under Stelara, it gives me the generic name and then 1 mg. The provider is billing this as 45 mg/5 ml, 45 units. This Stelara is a pre-filled syringe so there is confusion at our office. Some think...
  9. C

    BCBS denials for duplication on Diabetic shoes

    I am new to the Podiatry billing and have been having difficulties getting our claims paid for Diabetic shoes, CPT A5512 with Modifiers KX, LT, RT & CPT A5500 with Modifiers KX, LT, RT. We usually bill for 2 pairs of shoes and 3 pairs of inserts; therefore, 2 units and 6 units. We have the...
  10. M

    IHC staining confusion (88342, 88344) - please help!

    Could someone please help me with this? The pathology report supports ONE specimen. The report states "IHC stains are performed with appropriate controls & reveal strong & diffuse positivity for CK5/6, CALRETININ, & WT-1 (Nuclear). Focal positive staining is seen for CK 7, MOC31, & BEREP4. The...
  11. C

    Billing units for HyQvia J1575 I need help!!

    Last year I billed for HyQvia using an unlisted J code. When I billed for this my units were "1" and I put the details of what was administered in box 19. Beginning Jan 1 2016, HyQvia has a new billing code, J1575 Injection, immune globulin/hyaluronidase, (Hyqvia) 100mg, immunoglobulin So...
  12. P

    Helpful Anesthesia Billing Guidelines Resources

    Hello, Does anyone have any reputable [online] anesthesia coding resources with clear instructions on calculating time units? I've been directed to the 'Anesthesia' website, but did not locate information there. I understand there are many variables to reaching units (i.e. payer specific...
  13. D

    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
  14. D

    26720 fracture coding help

    patient has two broken fingers on the same hand would I bill 26720 by itself or 26720 with 2 units
  15. C

    Confused Units for 35476 for lower extremity (VENOUS)

    Hi.. I have a case where venous balloon angioplasty was performed on Rt.Common iliac vein, Rt.External Iliac vein and Rt. Common femoral vein. Please advice if this has to coded as 3 units or should be coded as per the iliac, Femoro-popliteal, and Tibio-Peroneal territory guidelines. Thanks...
  16. S

    J codes for interthecal pump refills

    Hi I am new to pain managment billing/coding. The dr I work for has a patient with pain pump (interthecal) and my question is how do you figure out the proper units to bill Example J3010 .1mg how do u convert from micrograms to milligrams? I know that just 1 unit is only paid .70 by Medicare...
  17. M

    Minutes vs units

    What is the correct way to bill insurance companies for 99144, 99145, 99150? Are you suppose to bill in minutes or units? Thanks.
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