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    arichards@mhsystem.org replied to the thread Post-Exposure Rabies.
    Yes. BCBS is paying the allowable for the 90675 w/the S open wound code "A" not paying for the "D" dx.
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    wjbruton posted the thread NC Medicaid Telehealth Codes in Payer/Health Plan.
    Hello - I am not sure if this would be the right forum, but this code is specifically for folks who have dealt with NC Medicaid in the telehealth setting. We have had a few denials over the correct combination of POS, telehealth vs outpatient...
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    natashalage replied to the thread Is it wrong to bill medical when patient seen for routine eye exam?.
    Hello, I am not an expert but I do code eye services; here are my thoughts. I would change dx. The dx Z03.89 is encounter for obs for other suspected dx and conditions ruled out. But you can use for example Z01.00. and add myopia H52.13 and...
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    deirdre posted the thread 36592 & C8014 PTP Edit? in Medical Coding General Discussion.
    Can CPT 36592 and HCPC's code C8014 (new code as of 7/1/26) be reported together? I cannot find those codes in CMS' PTP. Thanks
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    aj.guillen@hotmail.com reacted to Laucoder2's post in the thread DM with Dermatitis with Like Like.
    That is simply an incorrect statement. Under the ICD-10 'with' and 'in' rules, there is an assumed causal relationship with any condition listed under 'with' and there is no need for provider linkage to code any condition listed after the 'with'...
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    aj.guillen@hotmail.com reacted to bcrunk's post in the thread DM with Dermatitis with Like Like.
    See ICD-10-CM 2025 guidelines for "With", these conditions (diabetes and dermatitis) should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are...
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    natashalage reacted to hmanire@gmail.com's post in the thread OB Coding – Normal Prenatal Visit vs. Pregnancy Complication Codes with Like Like.
    You would report the appropriate codes from Ch15 (O00-O9A) for your examples, unless the provider specifically stated in the documentation that the pregnancy state was incidental. Otherwise, it would be correct coding to use codes from (O00-O9A)...
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    natashalage reacted to kbartrom's post in the thread 2027 OBGYN Changes with Like Like.
    Hi Kayla - pls see the following from June 2026 CPT Assistant: Even though pregnancy is not an illness, it is a condition. For the purposes of E/M reporting, normal pregnancy may be reported with an E/M code as a “problem” addressed...
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    natashalage replied to the thread new 2027 ob guidelines.
    Just FYI, i found very good articles from CPT Assistant from June and July 2026 on new 2027 Maternal Care, Labor Management, Antepartum codes. We have Optum coding software and it's there. They also mentioned a modifier that i cannot remember now.
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    natashalage replied to the thread ER Critical Care FACILITY ONLY.
    Hello, sorry, I am not an expert but I code CC in ED and have coded CC in other settings. Based on all information we were given at work and I had read, CC codes are time-based codes. If there is no time, we query the provider or it's inpt E/M. I...
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    natashalage replied to the thread Independent interpretation.
    Hello, I am not an expert, i started coding ED a few month ago and i was told to accept it as yes, it was independent interpretation. "my review"='my read'='my interp'
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    natashalage replied to the thread H&P Clarification.
    Hello, I am not an expert but here are my thoughts. They are 2 different specialties that will treat Different dx. Both of them can bill for Initial Inp E/M but I would put 1st the dx or s/s that will be treated. For example, psych will treat...
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    nvramz2024 posted the thread BCBS Tx denying Cpt codes 15771 & 15772 in Billing/Reimbursement.
    Hi, I am having denials with these two codes. The denial I receive is "THE PRIMARY SERVICE CODE WAS NOT SUBMITTED THEREFORE THE SECONDARY CODE IS NOT ALLOWED. THE INFORMATION SUBMITTED ON THE CLAIM IS INCONSISTENT WITH CURRENT CODING PROTOCOL." I...
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    natashalage replied to the thread 90839 and 90840.
    Hello, I am not an expert but the code that comes to my mind is 90791 or if with medical services 90792- initial psych evaluation
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    nvramz2024 reacted to Pam Warren's post in the thread Patient in a SNF, who to bill? with Like Like.
    While under a SNF plan of care, the patient is not to leave the SNF....they're considered an inpatient and based on the rules of consolidated billing, is expected to provide all medical care at their expense to the patient. You should bill the...
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