Results 1 to 3 of 3

Asap!!!!!!

  1. #1
    Default Asap!!!!!!
    Exam Training Packages
    I have a note that I don't feel comfortable billing for what the Dr. is billing..

    99204 and G0438 (Dr. billing)

    Beginning of note...

    Reason for visit..
    1.hypertension. never been on meds.
    2. neuropathy LE . x3yrs on gabapentin and helps, has poor balance and has fallen in past.
    3. dental implants. is on nystatin S&S.
    4. breast ca. lt side. S/P mastectomy stage 2. had implant. sees dr. ..
    5. memory loss. had a ministroke 2009. not on aspirin cuz side effects.
    6. colon polyps. had several colonoscopies.

    chronic problems.
    neuropathy, benign hypertension, esophageal reflux, memory loss, breast ca.

    PHSF..
    family. copd and premature cad
    social. primary language is english
    marital, tobacco use, allergies.

    ROS.
    resp, derm, neuro, musc.

    physical.
    constitutional, eyes, ears, nose, mouth adn throat, neck and thyroid, lymphatic, breast, resp, cardio, abdomen, rectum, extremities, neurological psych.

    assessment.

    Routine general medical eva.
    neuropathy- on gabapentin
    esophageal reflux -cont nexium
    breast ca-order mammo
    hx of cva- ordered mri
    memory loss- ordered carotid doppler
    hypertension-very high.

    I will just bill a level 3 new patient.. any suggestion please..

  2. Default audit
    I would recommend that you do an actual e/m audit of the note and then "suggest" to the physician that the notes support a level "whatever you come up with"... then support that with your audit.

    However, the fact that he's billing the additional code with it does not seem surprising to me - but you may need a modifier on your E/M.

    Those G codes are paid at "carrier discretion". Is this a Medicare patient? The note needs to also reflect that a "personalized prevention plan of service (PPS) was provided for the patient.

    Whatever you do - DO NOT just change the code before consulting with the physician. It is the physician who is assigning codes - however, the coder should be assisting in making the physician aware of the documentation.

    I hope this makes sense and is helpful. ?????


    Kelly R. Ross, CPC

  3. #3
    Default
    Quote Originally Posted by kellyross View Post
    I would recommend that you do an actual e/m audit of the note and then "suggest" to the physician that the notes support a level "whatever you come up with"... then support that with your audit.

    However, the fact that he's billing the additional code with it does not seem surprising to me - but you may need a modifier on your E/M.

    Those G codes are paid at "carrier discretion". Is this a Medicare patient? The note needs to also reflect that a "personalized prevention plan of service (PPS) was provided for the patient.

    Whatever you do - DO NOT just change the code before consulting with the physician. It is the physician who is assigning codes - however, the coder should be assisting in making the physician aware of the documentation.

    I hope this makes sense and is helpful. ?????
    but based on the info do you think it supports both charges?

    Thank you,

Similar Threads

  1. help ASAP please
    By eadun2000 in forum Medical Coding General Discussion
    Replies: 13
    Last Post: 02-21-2014, 12:21 AM
  2. Help ASAP
    By NESmith in forum E/M
    Replies: 1
    Last Post: 02-08-2012, 03:15 PM
  3. Please help ASAP!
    By JAB86 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 10-14-2011, 09:47 AM
  4. Need Help ASAP-Please!
    By dballard2004 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 09-20-2011, 08:27 AM
  5. Please help asap if at all possible
    By broundy in forum Cardiology
    Replies: 2
    Last Post: 08-20-2010, 10:19 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.