Archive for 'Coding Challenge'

Reader Questions: Heed the POS for Rehab Inpatients

Posted on 08. Jul, 2015 by .

0

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?

Answer:  (more…)

Continue Reading

Reader Question: Choose 64450 for Genicular Nerve Injection

Posted on 24. Jun, 2015 by .

0

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? 

Delaware Subscriber

Answer: (more…)

Continue Reading

Reader Question: Look to State Guidelines for 90-Day Supplies

Posted on 12. Jun, 2015 by .

0

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?

Supercoder.com Subscriber

Answer: (more…)

Continue Reading

Reader Question: Appeal for Payment if LCD Support Spirometry Diagnosis

Posted on 27. May, 2015 by .

0

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? 

Colorado Subscriber

Answer: (more…)

Continue Reading

Reader Question: Don’t Bill 99051 as Stand-Alone Code

Posted on 14. May, 2015 by .

0

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?

Oklahoma Subscriber

Answer:  (more…)

Continue Reading

Reader Question: Meet All the Criteria Before Reporting Bilateral Injections

Posted on 23. Apr, 2015 by .

0

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?

Alabama Subscriber

Answer: (more…)

Continue Reading

Reader Question: Don’t Prioritize Mass of Uterus

Posted on 08. Apr, 2015 by .

0

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?

Kentucky Subscriber

Answer: (more…)

Continue Reading

Reader Question: Procedure Specifics Dictate Whether 96372 Can Be Billed With 62310 or 62311

Posted on 30. Mar, 2015 by .

0

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?

Oklahoma Subscriber

Answer: (more…)

Continue Reading

Reader Question: CCI Edits Direct Whether 96372 Is Allowed With Scope

Posted on 18. Mar, 2015 by .

0

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? 

Nebraska Subscriber

Answer: (more…)

Continue Reading

Reader Question: Demonstrate Distinct Multiple Procedures to Unbundle CCI Edits

Posted on 25. Feb, 2015 by .

0

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.

Missouri Subscriber

Answer:  (more…)

Continue Reading