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Latest activity
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CHow often should providers see a swing bed patients?
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LLMule replied to the thread KNEE SURGERY QUESTION FOR RECURRENT PATELLA INSTABILITY.As of 2026 the following information is incorrect: "Edited to add: If you look at the AAOS Global Data Guide 27422 is inclusive to 27427. There is also a NCCI edit with 27422 & 27427. 27422 has a higher RVU and more accurately describes what was...
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CThat's saying it would be an error to use a Modifier 59 if the only other service on the claim was an E/M charge. That's why it was given as an example of incorrect reporting. Say a patient had an office visit and a skin biopsy the same...
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Another way of saying it: you can't just blanket append or slap a 59 on every code just to try and get it through edits. Especially if you are appending it to a code when it is the single and only code reported on that DOS. Same idea as when... -
jkyles replied to the thread MDM - Data.Hi, you count each unique test ordered. In your CPT manual the top of data analyzed column in the MDM chart states: In your example that's three tests. CPT Assistant 5/2021 has a Q&A that addresses this.
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Rrstevenson posted the thread Cigna Medicare aka Healthsprings Issues//Contact Person for Nashville, TN? in Billing/Reimbursement.Healthsprings/Cigna Medicare has started some sort of auditing over the past few months, where they are taking small amounts back but their information doesn't match and seems to be random. When we call there is a significantly long wait time to...
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1Question: if we have CPT codes that maybe considered inclusive of the primary procedure 50590 ESWL, Do we still list all CPT codes on the claim regardless or do we exclude the codes considered inclusive based on the NCCI edits? Example of codes...
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CI am considering obtaining my CDEO certification but am wondering if this is best paired with an MA, LPN or RN. I feel like in order to really understand the nuances of a note, this is really needed. I'd like to hear other people's opinions who...
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New and established have the same MDM criteria under the new E/M guidelines. The AMA MDM table shows them in the same line as well: https://www.ama-assn.org/system/files/2019-06/cpt-revised-mdm-grid.pdf If you're leveling based on time, you...
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BBevBash replied to the thread Childbirth at home.There is a new code to replace V24.0 Z39.0 Encounter for care and examination of mother immediately after delivery Care and examination after delivery Care and observation in uncomplicated cases when the delivery occurs outside...
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KUnder the 2021 E/M guidelines for Category 1 (Data) at the moderate level, each bullet represents a distinct type of clinical action. The wording “ordering of each unique test” is plural, but counts as only one category element, regardless of how...
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Wwindurstiansmn posted the thread 📢 We’re Hiring Experienced Coders – Join Optum SIU! in Job Postings.Hello AAPC Community, Optum’s Special Investigations Unit (SIU) is growing, and we’re looking for experienced medical coders who are passionate about accuracy, compliance, and making a meaningful impact in healthcare. This is a great...
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CCapital Health NJ is hiring Remote (residing in PA/NJ) Physician Professional Coders
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Ccorihampton15@gmail.com posted the thread Is 87633, 0563U and 0564U reimbursed in POS 11 in Billing/Reimbursement.I work for a pediatric clinic and they are looking in to PCR testing. Is 87633, 0563U and 0564U payable in POS 11? If anyone has any info on Spotfire testing please let me know. Thank you!
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Is unbundling justified when done through the same incision with separate dx's? I advised the surgeon only CTR was billable, but she wants to add a 59 due to separate diagnoses (ganglion and CTS.) Next, a 2cm longitudinal incision was made...
