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  • W
    whughes9805 posted the thread Trigger Point Injections in Diagnosis Coding.
    Medicare updated their trigger point policy earlier this month. Article A57751 references M79.12 and M79.18 as the only covered ICD-10 codes. A claim for a UHC Medicare Advantage plan was rejected at the clearinghouse referencing the Medicare...
  • W
    whughes9805 replied to the thread Medial Branch Blocks 64493.
    Any particular insurance you are seeing this with?
  • J
    Jocopoco53 posted the thread Medial Branch Blocks 64493 in Orthopaedics.
    Hello We are getting denials for Medial Branch Blocks CPT code 64493. We only use Lidocaine we never billed for lidocaine . We are now getting denials to bill for lidocaine. Is this a new policy has anyone encountered these issues
  • P
    Pkirsch1 replied to the thread 90839 and 90840.
    Thank you.
  • R
    Ritukap11 posted the thread Modifier 78 in Billing/Reimbursement.
    HI Can anyone advise how is the reimbursement affected by modifier 78 Thank you
  • D
    DCMoody posted the thread Conservative Tx clarification in Medicare Regulations.
    I work in a specialist office in NC. We focus on Varicose Vein treatment and use L39121 - Treatment of Varicose Veins of the Lower Extremities for the Medicare guidelines for treatment. (Palmetto GBA Jurisdiction M) The LCD is vague about...
  • M
    MaryElizebeth posted the thread APRN incident it another APRN. in Behavioral Health.
    Our APRN is qualified to practice on her own without supervision. Does this qualify her to be the "physician" for an "incident to" situation?
  • M
    margaret fahy posted the thread PERCUTANEOUS DRAIN PLACEMENT ANTERIOR TO HEART in Interventional Radiology.
    Targeted sonographic evaluation of the chest demonstrate known collection. An 17-gauge coaxial introducer needle was advanced under ultrasound guidance. Through this an 18-gauge Bard biopsy device was advanced under image guidance and biopsy...
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    LeoTPoti posted the thread Electronic Cell Stimulation Procedure Codes in Medical Coding General Discussion.
    A company that I started working for asked about 97014 and 97032. They would like to use the Alpha-Stim M Model. Before buying this device. Can someone help me understand the billing procedure for when these codes should be used?
  • B
    bvansickle replied to the thread Cerumen Removal under anesthesia.
    id tell the provider they need to start documenting that the wax was impacted and was removed with curette, pick and/or alligator instrumentation (assuming its truly impacted). but for the suction of the polyp, not sure id report the 69540...
  • B
    bvansickle replied to the thread Surgery help for BAHA abutment only removal.
    Usually use the unlisted and i dont report the debridment or closure seperately. i dont have a problem with payment, usually just need to send in the op note if the plan does not pay it the 1st time.
  • B
    bvansickle replied to the thread CPT 31292/31255/31256.
    what modifers are you using? CPT says not to report 31255 and 31292 together when performed on the same side. Id also check NCCI, i think they say both the 31255 and 31256 cannot be used with the 31292 when performed on the same side but im not 100%.
  • B
    bvansickle replied to the thread 69436 - no new incision.
    I think you are fine to report 69436.
  • B
    bvansickle replied to the thread Control of oropharyngeal Bleed Denied.
    first id call the carrier to confirm the denial reason, sometimes they can provide a bit more information as to what exactly is causing the denial. Some carriers want 'add modifers to the -78 like -59 or -XE. Id dble check to make sure your using...
  • A
    april.gut91@gmail.com posted the thread Smoking status in Medical Coding General Discussion.
    Question: Regarding CPT II codes (quality codes). In our clinic, we report quality codes such as 1125F for “pain present” and 1126F for “no pain. When a patient’s smoking status is documented as “smoker” or “current smoker,” we capture that...
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