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Latest activity
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CCBLENNIE replied to the thread Wiki O99.344 OTHER MENTAL DISORDERS COMPLICATING CHILDBIRTH coding.Is the patient's anxiety complicating the childbirth in some way, or does she merely have anxiety that she received medication for to maintain her treatment regimen? I wouldn't code O99.344 if it isn't complicating her giving birth since the...
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BDoes anybody have any insight on how we bill S3620 we are pediatricians?
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DHi all, I am currently discussing with the spine coders the appropriate reporting of CPTs 63047 and 63048. As I understand CPT definition states that these codes are reported per vertebral segment with CPT stating that a vertebral segment...
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KKPanzer posted the thread Wiki O99.344 OTHER MENTAL DISORDERS COMPLICATING CHILDBIRTH coding in OB/GYN.Is it typical to code O99.344 as a secondary diagnosis when a patient has a history of a mental disorder (ex: anxiety) is admitted for a vaginal delivery? Home anxiety medication continued during hospital stay but no other reference to the...
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CCBLENNIE replied to the thread Wiki New or Established?.The patient would be considered an established patient according to the E&M guidelines in the CPT manual, assuming the provider the patient is seeing is of the same specialty and subspecialty as the provider who did the PFT reading. The...
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NCan prolonged time be used for multiple providers on the same day, same specialty? So, if Dr. A billed a 99233, 75 minutes and Dr. B saw the patient later in the day and saw the patient for 40 minutes, can I combine both provider's time and add...
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VHello. I have a question if the patient would be considered new or established. The patient had a PFT done let's just say, Sept, 2025. The provider read the PFT (did not see the patient). Then, the patient was seen in Feb, 2026 by a provider...
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nielynco replied to the thread Would this be considered a billable post partum follow up in the hospital?.Probably not in my opinion. -
TIf the patient has individual visit with Provider A 90834 at 1:00, then has group therapy 90853 with Provider A at 3:00. Additionally has a group therapy 90853 with Provider B at 4:00 all on the same day. Billing 90834-XE,HO, 90853, 90853-XP,HO...
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MMaureenDL123 replied to the thread Would this be considered a billable post partum follow up in the hospital?.Quick question Patient had a few mild range BP yesterday Had mild range BPs during labor, normal labs, normotensive since, normotensive since.. Does this warrant billing for post partum?
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Pam Warren replied to the thread Question MUE for Lanreotide-J1930.When providers report medications administered beyond CMS' MUE, they will have to submit documentation to support the necessity of the mega-dose. CMS sets this standard based on what is recommended and approved by the FDA, so if a provider... -
Pam Warren replied to the thread Wiki Phone encounters.There is no one answer to this. It depends on the circumstance, medical necessity, payer rules, intent of the call, and related services. There are codes for phone encounters only, but there are some rules about when you can bill them. Your...
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Kkkindle1807 reacted to marissaclemmer's post in the thread Wiki Major Joint Injection Billing with
Like.
If you do an injection you need to bill for it, you can't just lump it all into an EM code. It's also highly unlikely you would be reimbursed for the J code without the injection code also. If your documentation supports a separately... -
KAgree with Marissa above, to be sure. This is a loaded issue, as many payors, starting with CMS, have tried for years to argue that there is enough overlap in work between the E&M associated with the visit and the work of the injection that they...
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CI am struggling with this procedure. The surgeon states 28730 x 3. But i think it would be 28740 to cover all three rays that were fused. or possibly 28740 with 28297? A dorsal incision was made over the 1st and second incision over third...
