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Latest activity
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Nntmenendez@hotmail.com posted the thread Wiki Same day 90853 (Group) and 90837 (Individual) with 59 modifier claims being denied in Medical Coding General Discussion.Hello, my commercial claims are denying when same practitioner provides both 90853 and 90837 w/59 modifier same day. Behavioral Health. Any advice please and thank you.
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MProvider removed an endometrial polyp during a c-section. I am at a lost on how to code this any help is appreciated. A large endometrial polyp (2 cm in diameter, 4 cm long) noted arising from posterior uterine segment and prolapsing through...
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jkyles reacted to LisaAlonso23's post in the thread Wiki CPT for Ganglion Impar Nerve Block with
Like.
It's still coded using the unlisted code. 64999. -
TMedical coding had been on my radar for several years, as I had been dealing with CPT and ICD-10-CM for most of my career in clerical medical office roles. When I found out my employer was willing to pay for me to take a course for it, I was...
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Nnatashalage replied to the thread Wiki Hospital Services.Hello I am not an expert but I am recalling the rule that if the Same specialty provided the service in ER and then Admitted the pt on the Same day= bill Inpt e/m only.
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CCynthia Hughes replied to the thread Delayed Vaccine Counseling.If there is not significant and separately identifiable E/M service beyond vaccine counseling with same date administration, there is no separately billable E/M service. For services provided in 2026, the opportunity to bill for immunization...
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In case you missed it, the NCCI PTP, MUE and AOC edits that will go into effect Jan. 1, 2026 are available. www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
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jkyles replied to the thread Wiki Using Modifier 25 for Toradol Injection.Hi there, you're on the right track but this question doesn't contain enough detail. Please search for "Modifier 25" in the forum and on the website. You will find tons of discussion and articles about when it is and is not appropriate to use...
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jkyles replied to the thread Wiki Establish new patient care for 99202.This doesn't sound like a billable visit. What does this mean?
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jkyles replied to the thread Question Can 99395 be billed if it was done via telehealth?.Hi there, no it can't unless you have a payer that allows it. Make sure your providers have the code lists of audio/video and audio-only codes in the CPT manual and the CMS list if you're performing telehealth for Medicare patients.
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DI need help verifying that I haven't missed anything. I have read this op note several times. I am thinking the code should be 28086, straight synovectomy. Originally, I had 27658, 28086, & 28261. After reading the description of the codes and...
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AAGSCodify9 replied to the thread Wiki multiple units for 92507??.The individual frequency of 4 time(s) per 99 Day(s) for procedure code 92507 has been exceeded by 16. The following claim(s) and associated claim line(s) contributed to frequency:
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SHello, I work for an Oral Surgery department. My provider frequently performs 21243 (Arthroplasty, temporomandibular joint, with prosthetic joint replacement), however for this case he also performed a bilateral coronoidectomy (21070). The AAPC...
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AI keep getting denials from Medicare for 93298 and 93297 when the patient also sees provider same DOS. On a separate claim 99214-25 and 93010 are billed. My claim is showing denial for 93298 or 93297 with this as the reason: This procedure or...
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EWith the current political climate and social media disinformation, we have had an increase in vaccine hesitancy within our patient population which has created more alternate/delayed vaccine schedules. Patients on a delayed schedule are asked...