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2016 ICD-10-CM Missing Pages
jeudi 31 décembre 2015
Need Some From My Fellow Coders!!!
What is the level of HISTORY represented by 4 HPI items, 8 systems on ROS, and 0 PFSH?
I have never been strong in E&M coding.... will some please provide with me with the answer? and explain the answer? By the way I guessed and selected Extended problem focus.
Thanks in advance!!
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Need Some From My Fellow Coders!!!
58572/58660
When coding 58572, is lysis of adhesions bundled in this or can you also report 58660 with modifier 51? Or should 58572 be reported with modifier 22? It does not say that 58572 cannot be reported with 58660.I am just confusing myself with the more I read.....
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58572/58660
Compliance / Physician Coding Auditing Books
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Compliance / Physician Coding Auditing Books
Medical Secretary/Coder
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Medical Secretary/Coder
Chondromalacia
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Chondromalacia
OBGYN - gestational age Z codes
I can't find anything in the guidelines specifying if the gestational code goes last or not...only that it is an additional code.
Thanks in advance for any help!
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OBGYN - gestational age Z codes
Anyone ever used the CR modifier?! (Catastrophe/disaster-related)
Section 1135 of the Social Security Act authorizes the Secretary of the Department of Health and Human Services to waive or modify certain Medicare, Medicaid, CHIP, and HIPAA requirements. Two prerequisites must be met before the Secretary may invoke the § 1135 waiver authority. First, the President must have declared an emergency or disaster under either the Stafford Act or the National Emergencies Act. Second, the Secretary must have declared a Public Health Emergency (PHE) under Section 319 of the Public Health Service Act. Then, with respect to the geographic area(s) and time periods provided for in those declarations, the Secretary may elect to authorize waivers/modifications of one or more of the requirements described in Section 1135(b) and summarized below. The implementation of such waivers or modifications is typically delegated to the Administrator of CMS who, in turn, determines whether and the extent to which sufficient grounds exist for waiving such requirements with respect to a particular provider, or to a group or class of providers, or to a geographic area. Waivers authorized by the statute apply to Medicare in the context of the following requirements: • conditions of participation or other certification requirements applicable to providers; • licensure requirements applicable to physicians and other health professionals; • sanctions for violations of certain emergency medical standards under the Emergency Medical Treatment and Labor Act (EMTALA) • sanctions relating to physician self-referral limitations (Stark) • performance deadlines and timetables (modifiable only; not waivable); and • certain payment limitations under the Medicare Advantage program. Medicare fee-for-service requirements, including most particularly (but not limited to) Medicare payment rules and amounts, are not, and cannot be, waived under § 1135. Nevertheless, some of the foregoing waivers, when invoked, may have the effect of making fee-for-service payments possible when, absent a waiver, such payments would not have been permissible.
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Anyone ever used the CR modifier?! (Catastrophe/disaster-related)
CPT Coding for Anesthesia
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CPT Coding for Anesthesia
NP's and treadmill stress tests
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NP's and treadmill stress tests
54150 Circumcision on adult dorsal slit in office
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54150 Circumcision on adult dorsal slit in office
fracture
[unable to retrieve full-text content]
person who has a fracture was diagnosed with S32.2XXA and fell at home. This was the only code reported. She was seen in the ER and then came to see...fracture
Cpt 20931
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Cpt 20931
mercredi 30 décembre 2015
Anesthesia/Pain Management Coder Wanted (REMOTE): Contract to FTE
Anesthesia and Pain Management Coders Needed (REMOTE)
Aviacode is looking for coders experienced in anesthesia and pain management with at least 2 years experience (required) and that can commit a minimum of 20 hours a week. Please don’t apply if you don’t have at least 2 years experience and can’t commit a minimum of 20 hours a week.
If you are interested and meet the above requirements, please have them email Ryan.Monson@aviacode.com and include BOTH the questions and the answers to the following questions, and your resume.
Pay will be discussed with you on an individual basis. If we are interested then we will contact you for an interview. (on-shore coders only)
1. Name
2. Email
3. Phone Number
4. Have you contracted with Aviacode before?
4a. When?
4b. Who was your coding manager?
5. Years’ experience coding anesthesia?
6. Years’ experience coding pain management E/M?
6a. Years’ experience coding PM procedures (injections, blocks, etc)?
7. Are you ICD-10 certified?
8. What are your coding credentials?
9. How many hours can you commit during the week (Mon thru Fri) as a contractor?
10. How many hours can you commit over the weekend (Sat-Sun) as a contractor?
11. Date you can start as a contractor?
12. Are you interested in a Full-Time employed position (40 hour week)?
12a. Date you can start as a Full-Time employed coder?
13. Do you reside on US soil?
14. Did you include the questions, the answers, and your resume in your email to Ryan?
For additional job openings with Aviacode, please see here: https://goo.gl/9Z2rn2
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Anesthesia/Pain Management Coder Wanted (REMOTE): Contract to FTE
2016 Medicare Tier Pricing/ Other Insurances
After a nightmare in 2015 with identifying payers using CMS or AMA codes, I'm trying to get a head start on this. Has anyone had any luck getting information out of any of the insurances?
Thank you in advance!!
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2016 Medicare Tier Pricing/ Other Insurances
ICD-10 Proficiency Assessment Service Interruption
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ICD-10 Proficiency Assessment Service Interruption
ICD-10 Proficiency Assessment Service Interruption
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ICD-10 Proficiency Assessment Service Interruption
looking for volunteer job as a medical coder, have 5 years of exp in coding
I am looking for volunteer job as a medical coder. I am a CPC certified coder. I am ICD10 proficient. I have 5 years of experience in US healthcare profession as a medical coder, teleradiology, healthclaim adjudication, medical transcription, revenue cycle management etc. I am recently moved to California east bay area. I was previously stayed in Boston, MA. I have experience in Radiology, emergency room and E&M coding. I am eagerly looking for volunteer job in healthcare as I want to learn more in coding especially in ICD10.
If there is any opportunity in office or remote position please let me know.
Regards
Sutapa Roy
978-905-0322
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looking for volunteer job as a medical coder, have 5 years of exp in coding
looking for volunteer job as a medical coder, have 5 years of exp in coding
I am looking for volunteer job as a medical coder. I am a CPC certified coder. I am ICD 10 proficient too. I have 5 years of US healthcare professional experience as a medical coding, teleradiology, healthcare adjudication, medical transcription etc. I am recently moved to California. I was previously stayed in Boston, MA. I have experience in Radiology, emergency room, E&M coding experience. I am eagerly looking for volunteer jobs in healthcare field as I want to learn more in coding specially in ICD10.
If there is any opportunity please let me know.
Regards
Sutapa Roy
978-905-0322
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looking for volunteer job as a medical coder, have 5 years of exp in coding
Diabetes--E11.21 and E11.22
Originally Posted by phamilton 
Codes are physician selected then sent to coding for billing where I work. If E11.21 Diabetes with nephropathy and N18.3 are chosen together, does this mean that E11.22 Diabetes with CKD is also chosen. Chart list CKD as chronic but not mentioned as diab. Tried to speak with physician about linking these conditions with "diabetic/ with or in" but don't think he understood.
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Diabetes--E11.21 and E11.22
Tenex FAST Procedures
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Tenex FAST Procedures
Plantar Plate Repair
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Plantar Plate Repair
Success with Batch Attestation Upload Option for EPs??
I was wondering if anyone has had success with the Batch Attestation Upload option for EPs on the CMS EHR website, and can advise as to how it's done for a group of EPs? The option went live last year, but the only instructions CMS has uses an EH as an example. I've called the EHR helpdesk, but no one I've spoken to has any experience with it.
Thanks in advance!
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Success with Batch Attestation Upload Option for EPs??
2016 rule for Mental Health CPT code 90838
How the new rule applies. Here is the question presented to me.
*can we bill two separate clinicians as long as one is the MD/NP the second being a ph.d./lcsw as long as same day same location and bill 99213/90838 (of course depending on time)?
I know 90838 is an add on code, so I am wondering how that would work. I haven't been able to find anything on this.
Thanks in advance for your help.
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2016 rule for Mental Health CPT code 90838
Can CPT 49446 be billed separately from 43830?
-
Today, 12:52 PM #1
Can CPT 49446 be billed separately from 43830?
CPT 49446 states that for converstion to gastro-jejunostomy tube at the time of initial gastrostomy tube placement we are to use 49446 in conjuction with 49440. CPt 49440 is for a percutaneous approach. Our doctor performed an open approach which was coded as 43830. I have received a bundling denial. My question is, is it appropriate to bill 43830 and 49446-51 separately.
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Can CPT 49446 be billed separately from 43830?
Ankle Fracture with Sprain
Just wanted to see what is the proper way to code the following:
Patient fractures medical malleolus and has an ankle sprain (both occurred at the same time, same ankle).
Would code everything under the fracture care or would you code the fracture under a fracture care code and the
Sprain with a straight E/M Code?
Thank you,
LLR
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Ankle Fracture with Sprain
Urine Toxicology Confirmatory Billing 2016 Questions
Codeine 80361
Hydrocodone 80361
Hydromorphone 80361
Morphine 80361
Oxycodone 80365
Oxymorphone 80361
Noroxycodone 80361
Buprenorphine 80301
Norbuprenorphine 80301
Fentanyl 80354
Norfentanyl 80354
Meperidine 80362
Normeperidine 80362
Methadone 80358
EDDP 80358
Naloxone
Naltrexone
Propoxyphene 80367
Norpropoxyphene 80367
Sufentanil 80354
Tapentadol 80372
Tramadol 80373
Alprazolam 80346
Hydroxyalprazolam 80346
Carisoprodol 80369
Meprobamate 80369
Clonazepam 80346
Diazepam 80346
Nordiazepam 80346
Temazepam 80346
Oxazepam 80346
Flunitrazepam 80301
Flurazepam 80346
Lorazepam 80346
Midazolam 80346
Amphetamine 80324
Pregabalin 80366
6-MAM 80356, 80361
Benzoylecgonine 80353
MDA 80359
MDEA 80324, 80359
MDMA 80359
Methamphetamine 80324
PCP 80301
THC 80349
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Urine Toxicology Confirmatory Billing 2016 Questions
90670 Prevnar
-
Today, 11:49 AM #1
Hi, is there an age restriction on 90670 Prevnar? I am getting denials for patient's age but do not have any information
Thank you!
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90670 Prevnar
Legitimate Remote Positions?
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Legitimate Remote Positions?
I.V. push during a pharmaceutical stress test
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I.V. push during a pharmaceutical stress test
confused
64590-Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver
64595-Revision or removal of peripheral or gastric neurostimulator pulse generator or receiver
To me they are the same?
If someone has a neurostimulator and the battery has died, and needs to be replaced witch code would be used?
I sure would like some clarification for these two codes if anyone can help.
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confused
Find-A-Code
I recently received my CPC certification (have been working with codes for 9 years), and am starting a part-time remote position starting the 1st. I've been reading about Find A Code, and wondering if it would be beneficial for me? I wondered if anyone else uses this site, and if you find it helpful? What are the positives and negatives if any?Thank you!
Krystle Moring, CPC
ICD 10 Proficient
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Find-A-Code
Hardware pain with healed fracture
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Hardware pain with healed fracture
TURP terminated
This patient is here for TURP …. But only cystourethroscopy was done due to failed attempt to bypass bladder neck …..
Operation note:
Under Spinal Anesthesia
Cytsoscope was inserted till bladder neck
Could not pass the scope beyond a fibrotic prostate and high bladder neck
Trial of resectoscope insertion also failed to bypass the bladder neck area
Procedure terminated
18 Fr 2-way Foley's catheter was inserted
My questios is:
Should I code 52601 for TURP with modifier 52 as the operation was not completed? Or I should only code cystourethroscopy (52000) ???
Thank you
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TURP terminated
TURP terminated
This patient is here for TURP …. But only cystourethroscopy was done due to failed attempt to bypass bladder neck …..
Operation note:
Under Spinal Anesthesia
Cytsoscope was inserted till bladder neck
Could not pass the scope beyond a fibrotic prostate and high bladder neck
Trial of resectoscope insertion also failed to bypass the bladder neck area
Procedure terminated
18 Fr 2-way Foley's catheter was inserted
My questios is:
Should I code 52601 for TURP with modifier 52 as the operation was not completed? Or I should only code cystourethroscopy (52000) ???
Thank you
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TURP terminated
mardi 29 décembre 2015
Find-A-Code
I recently received CPC certification (have been working with codes for 9 years), and am starting a part-time remote position starting the 1st. I've been reading about Find A Code, and wondering if it would be beneficial for me? I wondered if anyone else uses this site, and if you find it helpful? What are the positives and negatives if any?Thank you!
Krystle Moring, CPC
ICD 10 Proficient
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Find-A-Code
Start button for proficiency test not visible?
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Start button for proficiency test not visible?
2016 IR CPT Crosswalk
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2016 IR CPT Crosswalk
2 providers 1 patient same day DIFF.SPECIALTIES
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2 providers 1 patient same day DIFF.SPECIALTIES
NDC Codes
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NDC Codes
Legal Question regarding a patient
Note: I know we are not lawyers, and no input will be considered as legal counsel. I just want to know if I have reason to be concerned.
I work for a 1 doctor/1 nurse practitioner family practice. We have a patient who we strongly suspect is mixing her controlled substances with alcohol. She has come in several times appearing to be intoxicated. Today she was slurring her words and appeared to be unsteady on her feet. Every time she has had an appointment for the past 3 months, she has presented similar to this.
My question is if the practice can be held liable for allowing her to drive in this condition. I know bars can be found at fault for allowing intoxicated patrons to drive. Can a doctor's office also be liable (because we prescribe the drugs)? I know that she has sometimes left the appointment to pick up her grandchildren from school.
If we say the practice isn't liable should she have an accident on the road, are we negligent if we continue to prescribe her medication, knowing it may be mixed with alcohol?
It's really been worrying me, but I don't want to go to my office manager without seeing if I'm reading too much into things.
Again, I know nothing presented will constitute legal advice, I'm just asking for opinions. Thanks.
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Legal Question regarding a patient
HBIG Vaccine coding help please
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HBIG Vaccine coding help please
new to spinal coding - arthrodesis question
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new to spinal coding - arthrodesis question
HBIG Vaccine coding help please
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HBIG Vaccine coding help please
new to spinal coding - arthrodesis question
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new to spinal coding - arthrodesis question
Coder needed for our West Hills, CA location
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Coder needed for our West Hills, CA location
Looking for an experienced CPC coder for our West Hills, CA location
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Looking for an experienced CPC coder for our West Hills, CA location
Contrast Nephropathy
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Contrast Nephropathy
What code for E927.0( ICD-9) in ICD -10
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What code for E927.0( ICD-9) in ICD -10
Buccal Swab
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Buccal Swab
fall codes
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fall codes
Heterotopic Ossification
Total Hip Arthroplasty done on 02/17/2015 the patient comes in for a follow up and the diagnosis is: Status post total hip arthroplasty with heterotopic ossification.
Since this is out of the Global Period would I just code the Follow up - Z09, Z96.641 - R Hip with an E/M Code or is heterotopic ossification considered a complication?
Thinking of coding it like this?
Q65.89 - Heterotopic Ossification
Z09 - Follow up
Z96.641 - R Hip
E/M Code
Any help is appreciated!
Thank you,
LLR
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Heterotopic Ossification
Renal and Peripheral angiographies need help coding please
HISTORY OF PRESENT ILLNESS: The patient is a 68-year-old with a history of resistant hypertension, peripheral artery disease and history of diastolic heart failure as well as renal insufficiency who presents with refractory hypertension. He has been on multiple medical therapies without successful control of his blood pressure. He underwent renal ultrasound which implied an area of stenosis, specifically in the left renal artery by velocities, and he is referred for renal angiography for evaluation of renal artery stenosis as the culprit of his secondary hypertension.
DESCRIPTION OF PROCEDURE: Informed consent was obtained. The patient understood the risks, benefits and alternatives of the procedure and agreed to proceed with the procedure. The patient was taken to the cardiac catheterization laboratory and prepped in the usual sterile fashion. One percent lidocaine was infused subcutaneously to the right common femoral area. A 6-French 11-cm sheath was placed without complication. A diagnostic 5-French IMA catheter was used for selective renal angiography bilaterally with interpretation. At the conclusion of the procedure, an Angio-Seal device was deployed for arterial hemostasis.
FINDINGS: The catheter was placed selectively in the right renal artery and injected which revealed an eccentric 70% proximal stenosis. The catheter was then redirected to the left renal artery and was selectively injected to determine a 70% proximal stenosis.
SUMMARY: Bilateral renal artery stenosis potentially contributing to the patient's resistant hypertension.
Based on the angiography results, it was determined to proceed with stenting of the bilateral renal arteries.
INTERVENTION: Angiomax was used for effective anticoagulation and an IMA guide catheter was used for selective renal engagement. A Runthrough wire was placed to the distal right renal artery of which a 6.5 x 18 Herculink bare-metal stent was then deployed to 8 atmospheres and the proximal aspect was postdilated to 10 atmospheres. There was an excellent angiographic result with TIMI 3 flow and 0% residual stenosis. The catheter was then redirected into the left renal artery and a Runthrough wire was placed to the distal vessel of which a 6 x 18 Herculink bare-metal stent was then deployed to 8 atmospheres with an excellent angiographic result, TIMI 3 flow and 0% residual stenosis. There was complete vascular engorgement of all calyces on selective injection and renal size was determined as normal.
CLINICAL PATHWAY: The patient will be loaded on Plavix and maintained on dual antiplatelet therapy for at least 30 days. Hopefully, this will afford improvement of blood pressure control. We thank you for the opportunity to participate in the care of this fine gentleman.
PERIPHERAL ANGIOGRAPHY
INDICATION: Left lower extremity intermittent claudication.
PROCEDURE: Right femoral artery access with catheter placement in the descending aorta with bilateral iliofemoral angiography, selective third order placement of catheter in the left SFA with left lower extremity runoff.
HISTORY OF PRESENT ILLNESS: The patient is a 79-year-old with a history of hypertension, dyslipidemia and peripheral artery disease who presents with symptoms concerning for left lower extremity intermittent claudication. Noninvasive testing implied significant stenosis in the left SFA. In light of ongoing symptoms despite ambulatory therapy, he elects to undergo angiography to better characterize the nature of his disease.
PROCEDURE: Informed consent was obtained. The patient understood the risks, benefits and alternatives of the procedure and agreed to proceed with the procedure. The right groin was prepped in the sterile fashion and 2% lidocaine infused subcutaneously until adequate anesthesia was obtained. Right common femoral artery was accessed using modified Seldinger technique of which a 6 French 11 cm sheath was placed. A 5 French Contra catheter was placed in the descending aorta of which bilateral iliofemoral angiography was performed. Next, a J-wire was then used to cross over and deliver the catheter to the proximal aspect of the left SFA. This was then used for left lower extremity runoff. At the conclusion of the procedure, an Angio-Seal device was used for right arteriotomy hemostasis.
FINDINGS: The abdominal aorta had mild atherosclerosis and was otherwise normal in caliber. The right common iliac had mild atherosclerosis. The right internal and external iliac were normal in caliber with mild atherosclerosis. The left common iliac had mild atherosclerosis, otherwise normal in caliber. The internal and external left iliacs had mild atherosclerosis and otherwise normal in caliber. The left common femoral artery had mild atherosclerosis. The left SFA had 60% sequential stenosis at the takeoff of the profunda. There was mild atherosclerosis within the profunda itself. The distal aspect of the SFA otherwise had only mild disease. The popliteal artery had mild disease. It was normal in caliber. There was 3-vessel runoff. Mild disease was seen distally.
SUMMARY: Moderate left SFA stenosis at the takeoff of the profunda, mild atherosclerosis in the distal abdominal aorta and iliac tree with 3-vessel runoff in left lower extremity with mild to moderate distal disease.
CLINICAL PATHWAY: At this point, the degree of stenosis does not fully explain the degree of symptomatology. Will focus on medical therapy with further ambulation and risk factor modification. We thank you for the opportunity to participate in the care of this fine gentleman.
Any help please code these maybe 2 times a year Thank you Nancy
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Renal and Peripheral angiographies need help coding please
physical therapy
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physical therapy
Code 95018
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Code 95018
Cpt 11750 and 64450
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Cpt 11750 and 64450
Zarxio
-
Today, 09:13 AM #1
Is anyone dispensing the new Neupogen replacement drug Zarxio? Our doctors are looking into it and the drug rep said "everyone" is using it and "no one" is having reimbursement issues (sales pitch or what). So far haven't found any other practices using it.
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Zarxio
Cpc certified ,the philippines
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Cpc certified ,the philippines
lundi 28 décembre 2015
97597 vs 11042/11045 codes
I just started coding wound care charts on the facility side and the APC coordinator keep asking me for missing procedures (debridements) that I think should be coded on the physician side. Should she know this? Those codes are usually already there sometimes. When to use 97597 vs 11042/11045 etc. codes?
Thanks
Tamara
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97597 vs 11042/11045 codes
Loss of Domain
In ICD-9-CM Vol 1, when the surgeon documented loss of domain in an abdominal surgical wound, we were advised to use ICD-9-CM code 879.3 for Open wound of abd wall, anterior, complicated. See "Expose the Layers of Abdominal Wall Reconstruction" In Coding Edge June 25, 2010 By John F. Bishop, PA-C, CPC, CGSC, CPRC
However, in ICD-10-CM, rather than complicated open wounds, we now specify if it was by laceration, puncture or bite and if there was penetration into the peritoneal cavity and with or without a foreign body. I don't feel that any of these descriptions fit for loss of domain in an open abdominal surgical wound.
The patient had a ruptured AAA with a massive retroperitoneal hematoma which resulted in abdominal compartment syndrome. The surgeon left the abdomen open and placed an Ab-Thera wound VAC. My surgeon was called in to manage the open abdomen. When he brought the patient to the OR and removed the wound vac, the patient was "found to have complete and total loss of domain with a massive retroperitoneal hematoma resulting in evisceration of this entire intraperitoneal hollow viscera."
I am seeking advise on how to code the loss of domain and evisceration.Thank you in advance.
Karen
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Loss of Domain
Certification Exams as of Jan 1, 2016
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Certification Exams as of Jan 1, 2016
ICD-10-CM for Open Abdomen
Does anyone have any suggestions?
Thank you, in advance,
Karen
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ICD-10-CM for Open Abdomen
new to carotid angiography coding HELP!
Procedure:
1. Bilateral Carotid Angiography
2. Cerebral Angiography.
3. Aortic arch angiography
4. Angio-seal of the right femoral artery after confirming mid arterial stick with right common femoral angiography
Indication:
Staged procedure for left carotid stenting planning. The patient was consented. Timeout was performed. Risks and benefits were discussed with the patient. The risk of stroke, MI, bleeding were discussed with the patient. The patient was prepped according to protocol. Access was obtained from the right femoral artery using 5-french sheath. A diagnostic Judkins right was used to engage with the left innominate artery and using Glidewire was directed into the right common carotid artery. Selective angiography of the right common carotid artery with cerebral angiography with multiple angiographic images were performed.
Catheter was withdrawn into the origin of the innominate artery and angiography of the right vertebral artery was performed. Then, subsequently, the catheter was directed into the left subclavian and angiography of the left subclavian and the origin of the left vertebral artery was performed.
We attempted to engage with the left carotid artery with some difficulty. We used a heah hunter catheter and a Glidewire was used to advance, it keeps pushing the catheter out. Finally, we were able to have a head hunter engage in the origin of the left common carotid artery that is bovine in oriign and originating from the right innominate artery. Angiography of the common carotid and the internal carotid arteries in addiction to cerebral angiography was performed.
Omniflush catheter was advanced over guidewire and digital subtraction imaging of the aortic arch and origin of the great vessels was performed.
Findings:
1: Aortic arch appears to be within normal range type A
2. Bovine anatomy of the origin of the right innominate artery and the left common carotid artery was noted, no significant disease at the proximal segment of these vessels.
3. Patent right innominate artery and patent origin of the right vertebral artery.
4. Patent right common carotid artery with no significant disease at the level of the bulb of the right internal carotid artery.
5. Cerebral angiography of the right system appears to be normal, both arterial and venous stasis with complete opacification of the sinus and venous phase without any abnormality noted.
6. Patent left subclavian artery.
7. Patent left vertebral artery.
8. Bovine origin of the left common carotid artery.
9. Patent left common carotid artery.
10. Severe stenosis of the left iternal carotid artery, which appears to be at least 90% nascet criteria.
11. Normal cerebral flow and normal cerebral circulation noted on angiography.
Final Conclusion:
1. Severe stenosis of the left common carotid artery, correlating with the CT angiography appears to be 90% by NASCET criteria.
2. Patent right vertebral and left verterbral arteries.
3. Normal Cerebral circulation based on cerebral angiography.
4. Angio-seal of the right femoral artery without any immediate problem.
5. No immediate complication and stable neruologically prior to discharge.
HELP me please
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new to carotid angiography coding HELP!
35476 vs 36595 - Fibrin sheath obstruction removal during IJ dialysis cath exchange
Procedures:
After informed consent was obtained, the patient was taken to the interventional suite, and sterilely prepped and draped in the usual fashion. Local anesthesia was provided with 1% Lidocaine with epi. The cuff was bluntly dissected free from the subcutaneous tissues and the enveloping fibrin sheath, and extracted. Guide wire access was obtained into the IVC. An angiogram of the SVC was then completed, demonstrating an obstructive fibrin sheath in the SVC. The sheath obstruction was greater than 60%. 10mm PTA was performed in the SVC to relieve the obstruction. A new 36cm Ash Split catheter was then placed over guide wire and positioned in the right atrium under direct fluoroscopic guidance. Both ports pull and flush easily. The catheter is fixed to the chest wall with 0-Neurolon suture.
Estimated Blood Loss: 5ml
Amount of Radiocontrast used: 10ml
Fluoro time: 1:33 minutes:seconds
Impressions: Successful removal and replacement of left IJ tunneled cuffed dialysis catheter. Fibrin sheath obstruction post PTA of the SVC.
I appreciate any feedback!
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35476 vs 36595 - Fibrin sheath obstruction removal during IJ dialysis cath exchange
Job opportunity- hannibal mo
Requirements: High School Diploma or GED. 1 year experience in health care organization. CPC OR CPC-A certification required. A non-certified coder will be required to pass the coding certification exam with AAPC. Communication skills and attention to detail are a must.
Send Resume to kwilson@hannibalclinic.com
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Job opportunity- hannibal mo
Ear wash
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I billed 69210. Pt had bilateral procedure. The guidelines state to use modifier 50 for bilateral. It rejected stating "procedure is inconsistent...Ear wash
Radius Fracture
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Radius Fracture
E&M Coding: New vs Established
I have recently been asked for some clarification on how we do E&M coding for an inpatient setting. We are an infectious disease specialty clinic and are called in for consultations. Sometimes it is a patient that we have already seen in our clinic, and the consult is for the same reason we were treating them. Sometimes that patient will need a consult for something completely different.
The debate is how to properly code for the consults. When I started working for the office, I was informed that we treat a patient as a "new" patient if the consultation is for something different that what we were seeing them for in the office. Example: A patient with TKA PJI was seen in clinic and is now in the hospital for infective endocarditis. I was also told to use 9922X for a new patient.
For these types of patients, would we use 9925X for the initial visit, then 9923X for the F/U's? A large portion of our patients are Medicare/Medicaid.
Some help from my "seasoned" friends would be greatly appreciated! Have a wonderful day!
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E&M Coding: New vs Established
Intolerance to drug VS adverse effect
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Intolerance to drug VS adverse effect
HELP.... Coding Question
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HELP.... Coding Question
CIC Exam Prep help!! :)
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CIC Exam Prep help!! :)
Modifier 79
Our common sense would say that the payer should see different diagnosis codes (for the toe fracture encounter & the knee injection encounter) & allow for payment on the 20610 codes but it's never that easy with payers :-)
Side note, follow up with the payer to see if the bilateral ICD10 code being used on the procedure with the RT or LT modifier rejects.
For example,
For payers that prefer we itemize out the CPT 20610 on two lines, our orthopedic office will use the unilateral ICD10 code to match with the unilateral procedure.
For payers that prefer bilateral billing, our orthopedic office will use the bilateral ICD10 code to match with the bilateral procedure (20610-50).
Other coders will probably have different opinions on this (I've seen it in these forums since ICD10 implementation) but this is how we bill these scenarios & we don't see specific reimbursement issues (for this at least!).
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Modifier 79
Part Time Experienced Biller for OB-GYN Practice in Montvale, NJ
OB-GYN practice looking for experienced biller with coding experience. CPC strongly preferred and must be ICD-10 proficient. 10-15 hours per week. Hours are flexible and negotiable. The candidate must have strong knowledge of scrubbing claims and reviewing charges before submission for payment processing. Communicating with insurance companies and patients regarding questions and concerns of coverage and claims processing is also crucial.If interested please reply and I will provide further information.
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Part Time Experienced Biller for OB-GYN Practice in Montvale, NJ
delivery
Has anyone ever had to code for delivery 59409 in the ED?? Our ED delivered baby at 39 wks vaginal delivery and then was transferred to another facility for OB care. No complications etc. Can I bill out 59409?? Do I need to add modifiers??
Thanks for your help!
Vicki, CPC
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delivery
Adjunct Instructor Needed (Spring Hill, Florida)
I am currently looking for an instructor to teach a Medical Insurance and Billing Class for the March term in Spring Hill, FL. The classes run on Monday's from 8:30-1:30 and Monday's from 5:30-10:30. I am either looking for someone who would be interested in teaching both or 2 people (one for days and the other for nights).
I prefer a Certified Professional Biller to teach that class but will also consider a CPC. If you (or someone you know) is interested please send your resume fax (352) 684-3033 or email dprice@ata.edu ASAP.
Thank you!
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Adjunct Instructor Needed (Spring Hill, Florida)
Dx coding for: Mood disorder with anger, aggression, anxiety and depression
I have a Psychiatrist that frequently lists dx like this on his in-patient visits. 'Mood disorder with anger, aggression, anxiety and depression'.
Under disorder, mood, there is 'Depressive' - which leads to the Depression category F32.9, rather than the F39 Mood Disorder category. I also have the anger, aggression, and anxiety, which can be symptoms of the mood disorder, or can be problems all their own.
Can anyone offer insight?
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Dx coding for: Mood disorder with anger, aggression, anxiety and depression
No fault won't pay driver was drinking
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OK I have a patient that was driving drunk when they were injured in a motor vehicle accident. Under NYS no fault, their insurance company is not...No fault won't pay driver was drinking
Abuse Codes
I am mental not able to handle the abuse codes. For some reason they are driving me mad! I can't make heads or tails what I am sure is a very simple explanation. I am hoping someone has a link or a tip that will help me.
Is this correct?
Abuse VICTIM CONFIRMED - T74
Abuse VICTIM SUSPECTED - T76
Abuse PERPETRATOR Confirmed - Y07
Abuse PERPETRATOR SUSPECTED - am I blind? I can't find this.
I have a few perpetrator suspected and confirmed. When I use my 3M, I was using for the perpetrator or physical abuse of a child, T76.12XA. I am getting an age conflict, so I changed it to T76.11XA and the error went away. But the Adult and Peds codes in this section I read as these are the victims, not the perpetrators. I am coding this as the adult abusing the child, which made sense for T76.12XA. If I code T76.11XA, I read that as adult abuse of an adult.
I have read several articles and looked at several things but I am not able for some very odd reason able to get my head around these codes. Anyone have a good article I can read or something simple I am just missing??
Thank you!
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Abuse Codes
dimanche 27 décembre 2015
_seeking employment
I completed and passed the medical administrative assistant (MAA) certification and the billing coding specialist (BCSC) certification in July 2015. I am scheduled to take the CPC certification in February 2016.
I would like to add that I have 5+ years experience working as a medical underwriter so I have a working knowledge ICD-9 and CPT codes.
Any help or suggestions are greatly appreciated. I will be happy to forward my resume upon request.
Sincerely,
LaShelle Hooper
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_seeking employment
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