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Latest activity
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VCan anyone confirm what dos goes on the claim for TCM charge? For example, for a 99495 charge, if the patient was discharged from the hospital on 12/30/2025 and a face-to-face encounter occurred on 1/5/2026, would it be on the 14th day after...
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Aabarajas replied to the thread EPB Tenodesis.Hello. I need some guidance on how to go about a case where 25448 was performed and EPB tendon transfer for MCP joint hyperextension was performed. I know 26480 is not to be billed with 25448 and have read in another forum that if the physician...
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Lluckylohith245@gmail.com replied to the thread 27599 vs 27514.27514
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Bburgerjurger posted the thread Looking for an externship programme in the evening. in Employment General Discussion.Hello, My name is Mahmood Qureshi. I am a Certified Professional Coder from AAPC since 2024. At present working in Home Health Care since 4 years. I have been trying to have my foot steps in the physician office and in patient facility since 2...
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Rrachaelwilleford replied to the thread RPM 2026 codes.You have to check the actual payer policy. In addition to specifying reporting requirements, some are restricting coverage by indication as well.
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RWe have been doing RPM for several years. We have always used the last day of the month, except for Jan, Feb & March. Since February is a short month, we adjust dates a little bit so we stay in the 30-day period. January readings = Jan 1-30 with...
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RIt is not a code in the United States ICD-10-CM. I even double checked the CDC National Center for Health Statistics lookup tool by year going back to 2019, which is as far back as the CDC's tool goes. You can check the lookup tool here if...
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Rrachaelwilleford replied to the thread principal illness navigator charge - G0023.Yep, at least 60 minutes. No mid-point billing.
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Rrachaelwilleford reacted to KGibbar's post in the thread principal illness navigator charge - G0023 with
Like.
we have a program set up where we can bill G0023 for an illness navigator in our Cancer Center. The question is - the definition says 60 minutes. Does that mean we have to have 60 minutes to bill it, or can it be up to 60 minutes? -
Rrachaelwilleford reacted to Cynthia Hughes's post in the thread Who needs an initiating visit before starting Chronic Care management? with Like.
When reporting time-based chronic care management, the current Medicare guidance is as follows. (https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/mln-publications-items/icn909188) an initiating visit for new...
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Rrachaelwilleford reacted to Cynthia Hughes's post in the thread BCBS downcoding E/M services with Like.
This is happening a lot. Your physician's medical specialty organizations probably have some advocacy resources and also a state medical society or medical group management organization can help advocate for fair payment consistent with CPT...
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Rrachaelwilleford replied to the thread BCBS downcoding E/M services.FYI multiple states are passing legislation, however state laws typically only apply to fully funded plans. Employer funded plans fall under ERISA, which is a federal law. Also, these payers is notifying providers of changing policies, including...
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RMbanerjee You are not missing anything sometimes payers refuse to pay same day OR the medications are the same but differ names OR these meds could contrast in human body OR certain illness cannot tolerate the medications. That is what makes...
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RWe're working through the logistics of offering an individual forum for each chapter. Ideally, a member would log in, and only be able to view (and access), their specific chapter's forum without seeing a clutter of 400+ others.
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WI am hoping to find help when to code Z93.6 as a. primary? I thought if it was the only reason they were being seen it could be a primary code, but I am not seeing it in the guidelines. I know status codes are usually never primary. thank you