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If that is the case, they can bill a consult. It is not the same rules as new vs. established E/M. Provided Medica covers consults, they can do it. It's a different pregnancy/reason/episode of care. MFM are one of the specialties where you would... -
CCmama12 replied to the thread Failed IUD insertion.Bill the insertion with mod 53, not 52. It's due to the patient's condition, not physician's discretion.
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KAAOS, along with multiple other specialty societies, has been aggressively lobbying against this, has written letters protesting the policy as leading to an undue administrative burden which will have no positive effect on outcomes. There are...
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BWe are seeing this as well. Our lab equipment doesn't perform a panel for these three tests. We use individual swabs, and run all labs individually. In the past, I've been able to fight these denials with the CMS LCD Article #A58741 showing...
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Eemilymechebilling@gmail.com replied to the thread 87789 denials from Medicare.have you tried billing 10 units? if so were you successful? I have some appeals in but in the mean time i am trying to figure out if I should put in some corrected claims
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Eemilymechebilling@gmail.com replied to the thread 87789 denials from Medicare.Have you had any luck with 10 units?
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Eemilymechebilling@gmail.com replied to the thread 87150 & 87798 denials.I am having issues with 13 units of the 87798 being denied as well on our panels we bill 87481x5,87500,87640-xu,87641,87651,87653, and 87798x13 and now all of the 87798 are being denied. I am curious if you have had any luck billing them...
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JJSanti2015 replied to the thread CPT 74420 vs 52005.Just wanna clarify if this report supports both CPT 52005 and 74420 in addition to 52235? "A 26 Fr resectoscope was inserted into the meatus and passed into the bladder, noting a normal urethra. Cystoscopy was performed which reveals a...
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Kkoster.kris@yahoo.com replied to the thread Data - Tests of the Same "Type" Only Counted ONCE?.Thank you so much for this reply. To answer your question of "why does it matter?" I'm completing AAPC's Practicode program, and this is coming from the coaches/instructors. If I follow their advice, it would change the way I calculate the MDM in...
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Vvvazquez8649 replied to the thread 76937 & 75710 with New LE Revascularization Codes.I have received denials due to Procedure code incidental to primary procedure. I thought we are still able to bill the 37252 separately.
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Kkoster.kris@yahoo.com reacted to jkyles's post in the thread Data - Tests of the Same "Type" Only Counted ONCE? with
Like.
Agreed that the concept of test "types" is not accurate. That would contradict AMA/CPT guidance and intent. It is not a CMS rule and I haven't heard of it for any commercial plans. Also, coding that way won't minimize audit risk, if that's... -
Kkoster.kris@yahoo.com reacted to NRaizman's post in the thread Data - Tests of the Same "Type" Only Counted ONCE? with Like.
In this case, why does it matter? Extensive for data still would not get you to a higher code level. But, in any case, YOU are correct and whoever gave you that guidance made it up. It is not present in either CPT, CPT-A, or CPT Knowledge Base...
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TOur provider performed an EGD and Colonoscopy on a patient - During the Colonoscopy he removed a polyp from the cecum with a hot snare and then took random biopsies from the rectum for evaluation of microscopic colitis. This was a screening due...
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Ddesireewhite185@yahoo.com replied to the thread Failed IUD insertion.I would bill the removal and the attempted insertion with modifier 52.
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Ddesireewhite185@yahoo.com reacted to Cmama12's post in the thread Vaginal hysterectomy, Anterior/posterior repair with vaginal colpopexy- advice with Like.
Routine fixation after a vaginal hysterectomy would not be separately billable - however, I would say that would be the case when the patient does not have a pre-exisiting prolapse dx. 10. A vaginal hysterectomy normally includes fixation of the...