Archive for 'Coding Challenge'
Posted on 08. Jul, 2015 by rpandit.
Question: One of our physicians was called and asked to do a consult on an inpatient. This patient was being treated in a rehab facility but was mobile enough to come to our office to be seen. The physician billed a new patient visit of 99203 along with 69210 for removal of impacted cerumen. This was denied by Medicare for “Not being paid separately when patient is an inpatient.” Should I have still submitted a consult code even though she was seen in the office? How should this be billed in the future?
Posted on 24. Jun, 2015 by rpandit.
Question: Our physician injected multiple branches of the genicular nerve (superior lateral, superior medial, and inferior medial). Do we report 64450 once, or bill it three times with modifier 51? Also, what would be the correct code for thermal radiofrequency ablation of this nerve?
Posted on 12. Jun, 2015 by rpandit.
Question: We have patients who have instructions from their employers to get a 90-day drug supply to save the employer and the patient money. My pediatricians want to help our patients in this regard, but we aren’t sure if there are restrictions against giving out more than a 30-day supply of ADHD medications. Can you advise?
Posted on 27. May, 2015 by rpandit.
Question:My records indicate that spirometry is a coverable CMS expense, but we cannot get Medicare to reimburse for it. The denials state that COPD/pulmonary dysfunction and chronic bronchitis are not coverable. My CMS sheet states that is exactly what the test is covered for. What should we do?
Posted on 14. May, 2015 by rpandit.
Question: I have three questions about using 99051:
1. Should we use 99051 in addition to the E/M code for that service (scheduled hours)?
2. What is the definition of “basic service?”
3. Would you provide references for using this code?
Posted on 23. Apr, 2015 by rpandit.
Question: We have been facing challenges for reporting bilateral procedures like injection codes 64483 (Injection[s], anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single level) and 27096 (Injection procedure for sacroiliac joint www.collegeessay-help.com, anesthetic/steroid, with image guidance [fluoroscopy or CT] including arthrography when performed). Is it better to report modifiers LT and RT to each injection or append modifier 50 to one injection code?
Posted on 08. Apr, 2015 by rpandit.
Question: I’ve heard that the mass of a uterus is important for choosing the proper code, so how do I use that information in my code selection for the pathologist’s uterus exam?
Posted on 30. Mar, 2015 by rpandit.
Question: A patient visited our office for therapeutic injections of Toradol and Kenalog. Do I report the injection codes or HCPCS medication codes? Would they be billable with an epidural injection?
Posted on 18. Mar, 2015 by rpandit.
Question: When the otolaryngologist performs a scope in the office and also gives a shot (using 96372 for administration and a separate code for the medication), is there any reason to put a modifier on the administration 96372 code?
Posted on 25. Feb, 2015 by rpandit.
Question: Our podiatrist visited an established patient at a nursing home but noted an infection and tinea pedis not previously seen. His notes describe an I&D on the left hallux, and he also wrote orders for the tinea pedis. Additionally, he performed nail care 11721 with Q8. How should I code this encounter? Please share some info on the I&D procedure.