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Latest activity
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KI work for a large group family medicine practice and we bill a lot of TCMs for our patients. We get quite a few denials for no qualifying service. We are discussing implementing a 10 day hold on our claims in order to give the inpatient claims...
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KI work for a large group family medicine practice and we bill a lot of TCMs for our patients. We get quite a few denials for no qualifying service. We are discussing implementing a 10 day hold on our claims in order to give the inpatient claims...
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Eemess replied to the thread How to total wound measurements.How do I measure a wound repair that is 0.6 x 0.3. I came up with .18 but I was told that is wrong. It should be 1.8, are they correct?
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DDStrait replied to the thread Penile injection 54235.Is it permissible for the provider to bill an E/M code for the service and code by time? Being that the patient performed the procedure/injection.
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EThis is EXACTLY the type of thing that I've been talking about. Inconsistencies in the simplest of fundamentals that make us all question what is going on and whether we are not understanding something or not. I notice that it says "history" of...
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jkyles replied to the thread KX modifier related questions.Hi, your second bullet is straight from the uniform Medicare administrative contractor billing and coding article for facet joint interventions, but is missing the first sentence which states: If you report a block without the modifier it will... -
Ttkermode reacted to thomas7331's post in the thread Office Visit before Screening Colonoscopy with
Like.
The only specific code for an office visit prior to a screening colonoscopy when there is no patient problem to be managed is HCPCS code S0285, which some commercial payers cover. You can't really use a problem-oriented E/M code 99201-99215 for... -
jkyles replied to the thread Examples of threat of bodily function or severe exacerbation in Ortho.Just adding a reminder that even if the problem addressed is high, at the documentation must also show that at least one other element (data or risk) is high to justify a 5.
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jkyles reacted to NRaizman's post in the thread Examples of threat of bodily function or severe exacerbation in Ortho with Like.
An immediate threat to any limb gets you there. Septic joint, acute infection, compartment syndrome (acute, not exertional), lupus/RA exacerbation, acute open fracture that walks in your door instead of ER, herniated disc with inability to walk...
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jkyles replied to the thread SA modifier for BCBSM.Hi there, I don't have the links handy but that payer is phasing in new incident to rules that include requiring SA whenever the billing provider reports incident-to services. If the NPs are enrolled and bill directly you won't need it for their...
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JDoes anyone have any clarification when coding this new code for facility? EX: is a stent insertin included or coded separately? TY
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LHello all, BCBS Michigan (not sure about other states) is supposedly phasing in major changes to incident-to-billing starting September 1st. I believe we must start using SA modifier for nurse practitioners. Has anyone else heard of this? We are...
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Ssnekavijay22@gmail.com replied to the thread Searching for a job CPC-A.Did anyone finish Practiced from AAPC and waiting for a job?
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RI'm starting to see modifier 33 appended to 96127 for screening. Is this a new ruling that tells commercial carriers to waive copay/deductibles according to the ACA?
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AIn the context of healthcare payers, ASO typically means Administrative Services Only.