Archive for 'Coding Challenge'
Posted on 08. Apr, 2014 by rpandit.
Question: Does discussion time with family members count toward critical care? (more…)
Posted on 25. Mar, 2014 by rpandit.
Question: We have a patient pregnant with twins whose BP readings at her second prenatal visit were very high. The physician wanted the patient to come in every two weeks for a simple nurse BP check to have her pressure monitored. Half of the readings were high and the others normal. Should I bill the insurance for the nurse’s visits done outside of her antepartum schedule? (more…)
Posted on 12. Mar, 2014 by rpandit.
Question: Our surgeon stabilized a pilon fracture using an external fixator and operated to fix the fibular fracture. After two weeks, an internal fixation was done. Can we report both the external and internal fixation procedures for this patient? (more…)
Posted on 26. Feb, 2014 by rpandit.
Question: If you are billing home visits, 99341-99350, the place of service is 12. My question is what will appear in block 32 of the CMS-1500? Do I have to enter the patient’s address into my computer software database as a location, or can I make up a generic location in my database that just states: Patient Home, see block 5 on CMS-1500 for physical address? (more…)
Posted on 11. Feb, 2014 by rpandit.
Question: I’m always concerned about protecting our patients’ health information, especially if they receive care that they don’t want to become common knowledge. What’s your advice for these situations, especially when the patient receives care from multiple departments in the hospital?
Posted on 22. Jan, 2014 by rpandit.
Question: We recently finished our first internal audit and found a potential issue: One of the doctors told me that they only choose level 99212 when it is a follow-up from a previous visit. He chooses levels 99213 and above for everything else. I do not believe it is that simple because I thought even if it was not a follow-up visit, something like a minor cold might warrant 99212. Can you advise?
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Posted on 08. Jan, 2014 by rpandit.
Question: I sometimes e-mail patient records to consultants for help on how to bill. How can I make sure I’m not committing a HIPAA violation? (more…)
Posted on 19. Dec, 2013 by rpandit.
Question: I am billing 99407 with 99213 and getting denials. I have used the modifier 25 with 99213, but it seems to be asking for a modifier for the 99407. Can anyone help me with this modifier? Also I am using TOS 9 for consultation, would this be correct or should I be using TOS of 1?
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Posted on 11. Dec, 2013 by rpandit.
Question: Does the 2 percent sequestration cut apply to claims with dates of service on/after April 1, 2013, or does it apply to claims submitted on/after April 1, 2013? (more…)
Posted on 27. Nov, 2013 by rpandit.
Question: Which diagnosis code should we report for a patient who comes in for a routine hip replacement follow-up that includes an x-ray?