fredcpc
Guru
The established visit by a physician came out a 99213, but a nurse did a ventipuncture to test for digoxin poisoning. Is this just a 99213, or can it be 99213-25 with 36415.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Coding for 99213 with Ventipuncture 36415
- Thread starter fredcpc
- Start date
btadlock1
Guest
No 25 modifier s required - Just 99213, 36415. Many payers deny the 36415 as inclusive, but usually only when labs requiring blood work are billed. Just as many pay it every time, too.
fredcpc
Guru
coding for 99213 with Venipuncture
So it is ok that a nurse performs the 36415, but I guess that is usually the case. But just to make sure here...the Venipuncture was to test the digoxin toxicity, or quantity. Is that still a 36415?
So it is ok that a nurse performs the 36415, but I guess that is usually the case. But just to make sure here...the Venipuncture was to test the digoxin toxicity, or quantity. Is that still a 36415?
btadlock1
Guest
80162 for the lab, and 36415 for the venipuncture. They're both separately reportable with the office visit.
fredcpc
Guru
coding for 99213 with Venipuncture
Thanx Brandi,
just one more question...my notes are scant here. But here the last part of the note concerning the V-punc, "Patient has been taking medication correctly. Venipuncture is is done by the nurse to assess the quantity of Digoxin in the blood. Results showed elevated digoxin. Final Dx: Digoxin Toxicity."
Is it still 99213, 36415, 80162. Dx: 972.1, E942.1. Any help??
Thanx Brandi,
just one more question...my notes are scant here. But here the last part of the note concerning the V-punc, "Patient has been taking medication correctly. Venipuncture is is done by the nurse to assess the quantity of Digoxin in the blood. Results showed elevated digoxin. Final Dx: Digoxin Toxicity."
Is it still 99213, 36415, 80162. Dx: 972.1, E942.1. Any help??
btadlock1
Guest
I can't be sure of the Dx codes without my book (the internet's not always 100% accurate...still kicking myself for leaving it at work!) Buuuttt....With the notes that you've got, I'd say that you're probably correct. You want the poisoning code frst, and the therapeutic E-code second.
) Buuuttt....With the notes that you've got, I'd say that you're probably correct. You want the poisoning code frst, and the therapeutic E-code second.fredcpc
Guru
Digoxin Toxicity
I know that in some Clinics, if the lab does the test, the lab bills the 80162. My notes don't really make clear whether the lab or the backoffice did the testing. any thoughts??
mahalo...
I know that in some Clinics, if the lab does the test, the lab bills the 80162. My notes don't really make clear whether the lab or the backoffice did the testing. any thoughts??
mahalo...
Anitha Lingala
Networker
Hi,
Usually most of the physician offices have some facility to do the lab tests in their premises and for some, they outsource to other place. We need to ask the physician office to provide the list of in-house labs and the outsourced ones.
Anita L, CPC,CCS,CPMA
Usually most of the physician offices have some facility to do the lab tests in their premises and for some, they outsource to other place. We need to ask the physician office to provide the list of in-house labs and the outsourced ones.
Anita L, CPC,CCS,CPMA
btadlock1
Guest
If it was sent out, you probably can't report it. Most insurers are doing away with pass-through billing, so the lab would have to bill directly for it. If you took the venipuncture, you still report that. You can also report labs that are CLIA-waived, in most cases. Check CMS's website for more information on CLIA-waived labs.
fredcpc
Guru
coding for 99213 with Venipuncture
Thank you Brandi and Anita. I feel better about not coding the lab. I believe my final codes will be 99213, 36415; Dx: 972.1, E942.1.
Thank you Brandi and Anita. I feel better about not coding the lab. I believe my final codes will be 99213, 36415; Dx: 972.1, E942.1.