Remote Device Check Place of Service

Can anyone help me with the POS for coding a remote device check 93296 and 93294 when the patient is sending transmission from home?

* This article was originally published here

Nephrology billing- dialysis

Good afternoon! I wanted to get some clarification on dialysis billing for an outpatient and Inpatient facilities. I have the understanding that billing the training CPT code (90989 & 90993) is to only be billed once. Is this correct? Also, you are not able to bill and office code along with the dialysis code unless there is another concern/issue other than the dialysis. I am trying to ensure we are providing the correct billing for these dialysis patients. Any insight anyone would like to...

Nephrology billing- dialysis

* This article was originally published here

Neurosurgery education

Hi, I'm relatively new to neurosurgery coding. My providers sometimes perform unlisted endoscopic endonasal neurosurgeries and I'd like to get a better understanding of the anatomy to choose comparable codes. Does anyone have any educational resources to recommend that aren't too costly?

Thanks!

* This article was originally published here

G0454

Anyone have experience billing G0454? My practice is going to start using it and I have a few questions. We are a practice that sees patient's in SNF's and do not have an actual office.

1. What place of service would you use with G0454 when patient is in a SNF? I would assume POS 31 (skilled) would be fine but wanted to see if there are any issues anyone has had with this.

2. Can G0454 be billed by the physician on the same day as a D/C (99315/99316) by an NP/PA. Documents for DME are...

G0454

* This article was originally published here

HELP! Ultrasound billing requirements -documentation

Hi guys
I really need some help with finding a resource to show my providers. Here's the scenario:

We are a large Urology group practice. We bill globally for ultrasounds. We own the equipment and the facility and employ a tech and radiologist that perform and do a preliminary interp of the ultrasound. The interp is sent to us and then we bill under the ordering urologist. Our urologist have not been doing any kind of note or documentation of the radiologist report. Can we bill these...

HELP! Ultrasound billing requirements -documentation

* This article was originally published here

Calcified Stenosis of RCA

Hello,
Can anyone offer some advice on how you would code the following:

Lesion #2: 70% calcific stenosis of the mid right coronary artery

I keep debating on I25.10 or I25.84 or both! I think the I25.84 would best represent the CAD and following the "due to" in the alpha index would presume causal relationship. I don't think both unless CAD is present in another artery that is not calcified.

Thoughts??

Thanks in advance!!

* This article was originally published here

Incision, drainage & Revison

OB/GYN: NY

Need help!

What CPT code(s) would be used for Incision, Drainage and Revision of Clitoral Carbuncle?

Physician will be doing procedure in ambulatory surgi-center

Appreciate the help

* This article was originally published here

How did you get started with your coding career?

I have my CPC-A and currently work as a biller/front desk for a dental office. I have been looking to advance my career and am having little luck even landing interviews. I've been looking for coding and billing positions but am wondering if I should be looking for other positions. What position did you start in to begin your coding career?

* This article was originally published here

SUD OP billing

Please help...

We have started doing family therapy and education groups at our facility but the insurance companies don't want to pay for both H0026 & 90846 in the same day. Does anyone have any suggestions for how else we can bill these?

Also for billing 90853 does anyone know what type of license a provider has to have? I have been billing under a MA LCDC for the past 3 years and had no problems up toil now 2020 they are stating her license doesn't fit the description for a billing...

SUD OP billing

* This article was originally published here

Outpatient Physical Therapy Billing

Hello Everyone, Hope all are good at health and safe.

I came across the hurdle which I can best clear with your expert help.

I have to create clean claim with Physical Therapist's 1st visit for PT evaluation (97162) and the procedures (97110) (97112) and (97140) on the same day by the same therapist.
How do I create the claim and which particular modifiers should go with the particular CPT codes in order to submit the clean claim?

Appreciated your help!!

* This article was originally published here

76805 once per pregnancy or once per trimester

Hi,

The CPT code 76805 more than 14 weeks trimester is only once per pregnancy or once per trimester?

Thanks in advance

* This article was originally published here

Billing Secondary Insurance

When billing to secondary insurance, if the CPT code originally billed to primary is not recognized by the secondary can you change the CPT code?

* This article was originally published here

Subsequent visits in the ER room (no IP bed is available)

Does anyone have guidance on how to code subsequent visits in the ER room? Preferably PSY visits. The POS conflicts with E/M codes and subsequent IP codes?

* This article was originally published here

Two BCBS insurances, which one is Primary?

We had patient who is 61 years old that came into our office today. He stated his primary insurance was a BCBS retiree plan, his secondary was BCBS through his employer. He stated the reason the BCBS retiree plan is his primary is because it pays better, I ran his insurance and his secondary does have his BCBS retiree plan listed as the primary payor. But I could not find anything online to confirm if this was accurate, that the patient could choose which insurance he wanted as primary based...

Two BCBS insurances, which one is Primary?

* This article was originally published here

CIRCC instructor

I am planning to sit for the CIRCC exam this year. I am looking for a tutor. Does anyone teach this one on one?

* This article was originally published here

Billing prenatal claims

Hi all, I have a pretty extensive question and could really use some help! Our docs just started billing for prenatal services, prior to that the hospital was doing it so we were not able to do the deliveries. Now that we've taken over the prenatal patients aren't we supposed to look for the deliveries and bill them? My manager is telling me this is incorrect that I should just bill the initial, subsequent and pp claims. Also I'm having a difficult time trying to get the dr's to stop billing...

Billing prenatal claims

* This article was originally published here

When will the CPC exam return to facilities?

I would like to schedule my exam in either August or Oct this year. July and Sept are not available in my area. There is no way I would be able to take the exam in my home when I have small children regardless my husband is watching them. There has to be a way to safely take the exam in a facility and still follow social distancing depending on the size of the facility and the amount of people scheduled that same day. Does anyone know when the exams will be held in facilities again? My goal...

When will the CPC exam return to facilities?

* This article was originally published here

Shunt reprogramming

Question re: shunt reprogramming for Neurosurgery.
When the neurosurgeons do a shunt reprogramming in the hospital, we bill 62252, but it always gets denied. The doctor owns his own shunt reprogrammer, so I do not append a 26 modifier. Any suggestions on how to get this paid?

* This article was originally published here

Professional and Facility for RFA of intraosseous basivertebral nerve?

Not sure if this is the right section to ask this question, but I am stump.

I work at a pain management group that does RF lesionings and other spinal surgeries at our ASC facility. The provider would like to do a rfa of the intraosseous basivertebral nerve on the L4-L5. Based on the AAPC Coder, the HCPCS code C9752 would best fit for this procedure, but since it's a C code, it can only be billed on the facility side.

I'm trying to figure out what the professional side would be for this...

Professional and Facility for RFA of intraosseous basivertebral nerve?

* This article was originally published here

IUD insertion w/paracervival block

I work with a provider who uses paracervical blocks for difficult IUD insertions and she wants to bill for the block. The description in my OBGYN coding companion for CPT 58300 states local anesthesia is included in the IUD insertion, but CCI edits state there are no bundling issues for 58300 and 64435. Is anyone billing the block with the insertion?

* This article was originally published here

New Patient

We gave flu injection to a patient and subsequently two days later saw the patient for a new well visit. Insurance has denied stating does not meet criteria for a new patient. We often have patients come in for labs and flu shots prior to the initial visit. Where can I find information to fight this?

* This article was originally published here

E/M Codes for audio only visit in lieu of in person visit for IL Medicaid?

Did anyone get reimbursement from IL Medicaid for Audio only E/M visit ? if yes, what code. modifier and POS used in the claim.Thank you!

* This article was originally published here

Behavioral Health diagnosis/documentation

I'm hoping I could get some suggestions for knowledge references. I'm looking for Mental Health guidance for coding. I've coded for many years, but not in the mental health field. I'm learning from my providers that they feel the general medical documentation is different than psychiatric documentation. Any help would be greatly appreciated. thank you in advance.

* This article was originally published here

Interventional radiology

I have the opportunity to further myself by learning International Radiology. I have no idea where to begin. Any direction would be greatly appreciated.

* This article was originally published here

BlueCross & BlueShield O80 and O82 not specific enough

Hello,
My doctors are from New York for global deliveries I use diagnosis O80 and outcome of delivery and gestational weeks, and for c-sections O82 and outcome of delivery and gestational deliveries the EOB is coming back as diagnosis is not specific. When I call they say the same thing even if the c-section was performed because arrest of descent and I bill that ICD 10 code O64.0xx1 still comes back as nonspecific. I have searched the policy and procedures and no policy change except for...

BlueCross & BlueShield O80 and O82 not specific enough

* This article was originally published here

Anesthesia ASC Facility Charge

Hi, can someone help me with billing Anesthesia Facility Charge for an ASC?
Do you have these charge amounts billed into the fee for the surgery? Or do you bill separately for the Anesthesia?
If you bill separately for the Anesthesia Facility Charge, do you balance bill the patient for the co-insurance amount from the insurance?

Thank you in advance for any help someone can give me on this.

* This article was originally published here

Cigna ultrasounds in office 76830

OB/GYN-New York.

Cigna recently started to deny cpt code 76830 stating it's considered experimental/investigational/unproven

has anyone else received similar denial?

* This article was originally published here

Trying to starting a billing company

My boss is wanting to start up a Billing Company in addition to the medical practice they already have going.

I am trying to get some tips on helping her get software and recommendations on what most companies are doing as far as services they provide.

Any help or recommendations would be greatly appreciated!

* This article was originally published here

MODIFIER 59 with 96372

I need a written rationale to explain to my charge entry person on why a 59 modifier is not to be used with 96372.

I have looked at the NCCI and see no listing of a 59 modifier needed. The only thing is I draw a blank on how to word they "WHY".

Can someone please help me with composing the answer to "WHY" or provide the information. I do not have AAPC Coding software available to me.

I do not want audits for over-use of the 59 modifier.

* This article was originally published here

Dr. Order for Post Op Pain Block

This has been a problem for a long time
The Dr's admin orders sometimes does not have the nerve block checked. But at some time before the surgery it is ordered and my anesthetist
does the procedure pre-op.

Now I do not have a written order in the chart

How do others handle this?
How do you handle if it is a verbal order?

Thanks for any help

* This article was originally published here