1. M

    Two visits in one day

    I’ve been a coder for eight years. Recently there is come up some things at work and we had two separate providers in our facility see the same patient in one day. It is not ethical to not bill the second visit? From my understanding and knowledge of previous experience both visits have to be...
  2. D

    Wiki 2 inpatient visits on same day

    Can 2 providers in the same specialty, same practice, bill for inpatient visits on the same date of service? If so, is there a modifier required on one or both visits?
  3. A

    PT Billing

    If a patient reaches their cap for physical therapy can we charge a flat rate or do we have to charge them the regular full price for any additional visits?
  4. L

    Mutiple Visits - same Tax ID

    Does anyone have any experience or knowledge regarding billing multiple visits on the same date of service under the same tax ID number? I code for a rural family practice clinic and they are wanting patient's to be able to schedule multiple appointments in one day (if needed), like a "one-stop...
  5. C

    Wiki Out patient visit vs observation

    I have a coder who is billing out patient e/m visits for patients who come in as ob triage / and h *& p is completed on patient. Is this the correct way for coding out patient/ in bed ob traige visits?
  6. C

    Post op visits after global periods are eliminated

    Supposedly, CMS is eliminating 10 day post op periods in 2017 and the 90 day post op periods in 2018. Does anyone know how we'll bill for post op visits after the global periods are eliminated? I assume we'd use the appropriate 99xxx code but will there be special modifiers to indicate that...
  7. B

    N.C. Mediciad Denial for preventive visits on children

    We just recently went to ECW and we cannot get reimbursed for preventive care visits on children. We are using the EP modifier with the CPt codes. our denial reason states attending provider not eligible on service dates. and B7=This provider was not certified/eligible to be paid for this...
  8. S

    Split/Shared Visits based on Counseling Time

    I am looking for any documentation from CMS regarding split/shared visits that states the service can be billed based on time when over 50% of the time spent by both the NPP and MD/DO was for counseling/coordination of care. Does anyone know of any references directly from Medicare? Thanks, Sue
  9. D

    e/m and xray

    the new office I work in are putting modifier 25 on all office visits with xrays, is that necessary? please help :(
  10. K

    Transfer OB with 14 visits

    An OB patient transferred into our practice at 24 weeks. She was seen for a total of 14 visits with us, delivering at 37 weeks. Can we bill 59426 with modifier 22 to account for the large number of visits or should some of the visits be billed separately? She was GDM on insulin and had mild...
  11. J

    Wiki Wellness exams

    Does anyone have any good resources and examples to describe wellness vs sick visits. Thank you.
  12. K

    Wiki new vs established patient-organization aquires

    If an organization aquires a practice and all providers remain at the practice but the tax ID # changes. Should all the first visits for their exisisting patients be billed as a new patient visits?
  13. A

    Pre op appt

    If a surgeon sees a patient and makes the decision for surgery and schedules the surgery a month out and the pre op appt for 2 weeks out, can you bill for that visit? I have always understood that once the decision for surgery has been made, you can't bill for that office visit regardless of if...
  14. S

    Wiki MSW visits in E/D

    Does anyone have any information about MSW billing for patients seen in the E/D?
  15. C

    Ob Post-op/global Days

    Question on OB patient post-op visits. How many visits do you give to an OB patient after they have had the baby? There is no global days on deliveries. My ACOG book states that the normal is 1 free visit for a vaginal delivery and 2 free visits for a cesarean section. We have adopted a policy...
  16. B

    OB Global Billing Question

    Jane Doe had Blue Cross until 12/31/06. She switched to Kaiser on 1/1/07. She had 6 visits in 2006 while covered by Blue Cross and 8 visits plus delivery in 2007 while covered by Kaiser. My thought process is to bill a partial prenatal global to Blue Cross for the 6 visits in 2006. Then bill a...