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need some help with ER case

  1. #1
    Default need some help with ER case
    Medical Coding Books
    I got feed back from billing saying the doppler (highlighted below) can not be entered because the date of servc is not during the er visit....
    please tell me what else is wrong with this?
    ER VISIT 05/10/07-05/11/07
    99284-25
    90772
    J1650-JB X 8
    93965-TC
    93965-26 05/16/2007
    85379
    84450
    84460
    82947
    82565
    84520
    80051
    85025

    THANX IN ADVANCE!!!!!
    Last edited by racheleporter; 06-19-2008 at 04:46 PM. Reason: ha ha ha
    Rachele Porter, AS, CPC, CPC-H, CEDC
    no weapons formed against me shall prosper

  2. Smile
    Why Are You Billing The -26 On A Seperate Dos. Are You Billing For The Radiologist Also? Wouldn't That Be Considered A Seperate Encounter With A Different Provider.

  3. Default Er/radiology?
    Are you coding for the professional services (provider)or Hospital services? Are you coding for Emergency or Radiology?

    93965-26 is for professional services meaning, the provider is just reading the report. Therefore, the provider bills for his/her services.

    93965-TC is for hospital services meaning, the use of the equipment at the hospital. Therefore, the hospital bills for the use of the equipment.

    If you are coding for the professional services just code one time 93965 with a modifier -26.

    If coding for Hospital services then code one time 93965 with a modifier -TC.

    Yes, is the same date of service. I hope this helps.

  4. #4
    Default
    I'm recording on an encounter form all of the services for the visit....
    althoughtI -26 was performed on a separate date I recorded it....that's the way my employer wants it done...the EMR has it set up so that the biller will data entry my codes and the separation happens within the EMR...so of course the referring provider won't get credit for the consulting provider and so forth

    Quote Originally Posted by lisammy View Post
    Why Are You Billing The -26 On A Seperate Dos. Are You Billing For The Radiologist Also? Wouldn't That Be Considered A Seperate Encounter With A Different Provider.
    Rachele Porter, AS, CPC, CPC-H, CEDC
    no weapons formed against me shall prosper

  5. #5
    Default
    I'm a professional services coder
    my employer wants us to capture everything for that visit....we code -tc as well as -26 like my example

    Quote Originally Posted by erickapm1976 View Post
    Are you coding for the professional services (provider)or Hospital services? Are you coding for Emergency or Radiology?

    93965-26 is for professional services meaning, the provider is just reading the report. Therefore, the provider bills for his/her services.

    93965-TC is for hospital services meaning, the use of the equipment at the hospital. Therefore, the hospital bills for the use of the equipment.

    If you are coding for the professional services just code one time 93965 with a modifier -26.

    If coding for Hospital services then code one time 93965 with a modifier -TC.

    Yes, is the same date of service. I hope this helps.
    Rachele Porter, AS, CPC, CPC-H, CEDC
    no weapons formed against me shall prosper

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