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Latest activity
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pookergirl replied to the thread G0296 Humana Primary Dx Z87.891.We used to get them paid with Z87.891 in 2016-2018. Must be a Humana MA thing. Patient had a 99214 and a Z00.00 - Z00.00 is always first listed. A LDCT is a screening study in a patient without signs or symptoms of lung-related issues. The fact... -
Humana Medicare should follow the same benefits that traditional Medicare would cover. I've provided some links below where you can research how traditional Medicare would cover LDCT. CMS MLN for Medicare Preventive Services: see section on...
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WHELP help My provider has a client who has a patient with Aetna and BCBs. Provider bills 155.00 for a session Aetna pays 45.00, Client has a 20.00 copay. How much does BCBS pay. Is BCBS responsible for the 90.00. I need an answer I can give the...
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Aalwilkinson@herzing.edu posted the thread Administration Codes for Infusions and Injections in Outpatient Facilities.I've found a wonderful resource for infusion and injection I would like to share. Find the resources here.
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DHello, I wanted to confirm how to bill a patient coming in for the depo shot for bleeding control, N92.1. The patient brings her own depo. The doctor is going in to see the patient after nurse gives the shot. Can we bill 99212, 25 with 96372...
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RHi can anybody help me with this question. Does use of Modifier SH in Ambulance billing affect reimbursement? Thank you
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Right from your own linked policy, the patient doesn't qualify for an E/M. Your note says that the patient "declined the one on one consultation." From the link you gave: Note that I'm not agreeing that the policy on your link is... -
Kkkidd@mvphealthcare.com posted the thread is this unbundling: CPT 81479 for extraction, purification, quantification and storage prep billed on separate day from codes 81229 and 81265 in Billing/Reimbursement.Received billing for unlisted CPT 81479 for extraction, purification, quantification and storage prep billed on a separate day from codes 81229 and 81265. Patient had amnio done one day, extraction, purification, quantification and storage prep...
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Ccatchisonwork@gmail.com posted the thread Deep brain stimulation in Medical Coding General Discussion.Can you bill an office visit (99213 or 99214) with a deep brain stimulation code 95983?
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I would lean toward billing 76818 with modifier 26 in this scenario. The biophysical profile (76818) includes both the ultrasound assessment and the NST component, but modifier 26 is based on who owns the technical component and who is providing... -
You will any prenatal visits in 2026 using the current method
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It depends on what actually occurred during the encounter. If the patient had a routine well-woman/gynecological exam and a Pap smear was obtained as part of that exam, I would typically use: * Z01.419 = Routine gynecological exam without...
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This is old information, from ICD-9 days, but it might help as there is sequencing advice (I haven't found anything more recent, and this info is from this website): When the delivery occurs outside the hospital admission, it is deemed as...
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KHey guys! patient had a 56405 I&d of vulva for abscess, we are in 10 global period currently, she was brough back to OR for wound packing change under MAC not general anesthesia because she couldn't tolerate it otherwise just to painful , NO...
