-
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 the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Latest activity
-
While there is not an NCCI bundle for these codes, several payors do have various policies. I'm not familiar with BCN. You would need to see what this particular's policy is. It might be a bundle that can be overridden with modifiers/diagnosis... -
nielynco replied to the thread Wiki Surrogacy Insurance.According to Tricare rules (and as she is a Tricare beneficiary she has already checked and this is why she is telling you not to bill them as primar)y: TRICARE coverage for surrogacy health care is a limited benefit. TRICARE pays second for...
-
nielynco replied to the thread Wiki Fibroid ablation.There is no CCI edit precluding billing 58558, but be sure you have a medical indication for doing so. A diagnosis of uterine fibroids would not in my opinion support the D&C.
-
nielynco reacted to ealvarez113@hotmail.com's post in the thread Wiki Patient admitted with PPROM with
Like.
There are rules for insurance on billing the discharge. If this is not your patient and you just did the delivery, admit and discharge. then you may capture them. But if this is your patient, then you can not capture the admit or discharge. The... -
O34.4_ & Z98.890
-
NNRaizman replied to the thread Wiki CPT 29826 denials.The reason 29826 is being denied is for lack of medical necessity. It has nothing to do with the coding. Subacromial decompression has not been shown, either alone or when it is done in conjunction with cuff repair, to have any benefit. This is...
-
nielynco replied to the thread Wiki Pessary Cleaning.If the prolapse is not being addressed at this visit, and the only purpose is for a scheduled cleaning, you would only report Z46.89.
-
nielynco reacted to rthomas@impcna.com's post in the thread Wiki OB‑GYN Routine Pelvic Exam and Pap After PCP Preventive Visit with Like.
You may want to reach out to some of your payers to see if they have a policy as to how this situation should be handled. For example, our local BCBS released a policy in 2022 indicating that OB/GYN offices should bill for a Women's Health visit...
-
Kkimberlymontesrojas@gmail.com reacted to cedwards's post in the thread Wiki Home Wound Care Coding Help with Like.
Anyone out there willing to give me a crash course on wound care coding & billing? I feel like I am completely lost as it's not in my wheelhouse. I picked up an independent contractor role, and part of the role is wound care coding. I'm also...
-
Ggcmc11528 posted the thread Wiki 92229 - What HEDIS/MIPS codes can be reported w/ 92229? in Medical Coding General Discussion.We just started billing 92229 for DM retinopathy eye exams done in the pcp office. We want to report the HEDIS/MIPS codes as well. We can not agree on what codes should be used. Any recomondations? Currently we are being told to use 2022f for...
-
KI'm inquiring to see if anyone else is having an issue with CPT 29826 not getting paid even though the operative report is stating both subacromial decompression and acromioplasty in a separate paragraph. We are noticing an increase in denials...
-
LHello, I'm struggling to find the CMS-HCC V28 weight for each HCC. I tried looking on the CMS website but could only find the ICD-10 code mapping. Any Ideas where I can find this information at? Thank you!
-
Ccsperoni reacted to jkyles's post in the thread Wiki New vs Established Patient - defining professional services with Like.
Hi there, check your CPT manual's definition of new and established patients: "... professional services are those face-to-face services rendered by physicians and other qualified health care professionals who may report evaluation and management...
-
Ccsperoni replied to the thread Wiki 76830 and 76856.While there is not an NCCI bundle for these codes, several payors do have various policies. I'm not familiar with BCN. You would need to see what this particular's policy is. It might be a bundle that can be overridden with modifiers/diagnosis...
-
Happy Friday eve. Just a heads up that the Medicare administrative contractors are issuing revisions to the LCDs for epidural steroid injections and facet joint interventions. The changes clarify coverage guidelines for FJI RFA and repeat ESIs...