telephone visit or face to face

When a provider takes a phone call from a patient and the patient is in the parking lot of the facility would the visit be billed as a face to face or a telephone encounter? We are a FQHC facility.

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Vaccine admin code 90473

Is cpt code 90473 (immunization administered by intranasal or oral route for patients >18 years?

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coding

Hello
Can US guidance 76930 be billed with LHC brachial access or is this bundled into cath.
Thank You
Robin

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Coding Lisfranc Dislocations by Primary Arthrodesis

Good afternoon,
Our practice has recently had several Lisfranc surgeries and I wanted to seek out advice to ensure we were billing them correctly. Any responses to either of my questions for these types of surgeries would be greatly appreciated!

One of the recent surgeries involved a Lisfranc dislocation of all five of the tarsometatarsal joints as well as one of the midtarsal joints. The surgeon treated these injuries by fusing the first TMT joint, fusing the second TMT joint, fusing the...

Coding Lisfranc Dislocations by Primary Arthrodesis

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Neurosurgery Exam

Does anyone have tips on preparing for a Neurosurgery exam?

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Brachial plexus injuries coding help!!!

Hello! Are there any experienced Plastic Surgery coders on here or anyone who is very familiar with coding for brachial plexus injury codes? I am trying to understand not only how to bill these cases, but how to bill the number of units. I get so many denials for exceeding number of units. Any help is appreciated. Some CPT codes that we use often are:
64861
64856
64901
64902

and usually with multiple units on each.

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Second surgery denied even with mod 79

HI. I received a issue from a fellow coworker. She has a patient who had a foot amputation done which has a 90 day global period. Paitent had a sig flex done during the global period. That claim was denied by Medicare Part B as part of the global period. A mod 79 was attached. When she call Medicare to state the mod should be valid, they said it is not and we should be billing with another modifier.

Has anyone else seen this? The sig was not part of staged procedure. Any advise or...

Second surgery denied even with mod 79

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Cardiac cath help

93458 by MD
93454 by coworker
I am unsure.


Indication:
1. Angina pectoris functional class 3-4
2. Baseline abnormal EKG suggestive of anterolateral wall ischemia
3. Elevated coronary artery calcium score
4. Hypercholesterolemia and hypertension
5. Dyspnea upon exertion
6. Angina pectoris functional class 4 during recovery time after Lexiscan nuclear test today at this institution, terminating the test to proceed with cardiac catheterization
7. I explained to the patient the...

Cardiac cath help

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Billing Company Software

Hello - I have a few questions about how third-party billing companies operate.

1. Do most third-party billing companies use a billing software or do they use their client's EHR to submit claims?
2. If they use a software, is billing software usually compatible with most EHRs?
3. I assume all billing software is ran through a clearinghouse, but what about EHRs?

I'm new to all this and trying to figure out how a third-party billing company would operate. Thank you.

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Rules for coding ear procedures

Can anyone tell me what the rules are for coding excision of cholesteatoma/polyp with an ear procedure such as a myringoplasty? There are no ncci edits with cpt code 69610 and 69540. But since it is happening in the same ear, I wasn't sure if an excision of a polyp would be included in the myringoplasty procedure. And same for when it is a removal for a cholesteatoma (cpt code 69145). Since there are no ncci edits, it is ok to use either 69540 or 69145 with cpt code 69610? or are codes 69540...

Rules for coding ear procedures

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VCMJR5 Resume0.0001

Vino C. Mody Jr.
Dependable and a strong team player. Extensive Experience and Expertise in Health Administration and Teaching. I always finish my assignments on or before completion schedule.
6154 Black Mallard Place, El Paso, TX 79932

678-427-6511 cell; 915-642-4269 home; vinomodyjr13@gmail.com

Objective
A career in teaching and medical administration - coding, billing, audit, compliance, data management, analysis, and internal training.

Work...​

VCMJR5 Resume0.0001

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Multiple procedures during Bronch

Provider biopsies and brushes the same lesion during bronch. Are both 31625 and 31623 billable since they are the same lesion?

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Coding per insurance- HELP!

I have a new SR. Management team that wants to change the way we bill out therapy codes based on what the insurance would cover so for instance- Medicare would be billed how we always have been in the past but commercial plans would get a different billing structure due to their high volume of denials on certain codes. I am inclined to think that the coding needs to be consistent across the board. Am I right or is it OK to change how things are coded (the codes still absolutely are supported...

Coding per insurance- HELP!

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Loss of credentials???

Curious.....

If you don't renew your membership, you lose your credentials?? I thought you would lose credentials if you did not keep your CEU's up to date!!! I received an email from the AAPC stating otherwise....

WHAT'S THE DEAL???

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Laparoscopic Ovarian cystectomy

I am a little unsure about this.
A D&C of cervix was done first. After that, a physician used a laparoscope and excised an ovarian cyst at its base then the cyst was also removed and the base was cauterized. Cyst was sent to pathology.
Do I code 57800 and 58661? I am not sure if 58661 is removal of the ovarian cyst, it seems that this code is for the removal of the ovary?
Please help.
thank you
Nina

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split thickness graft with closure/repair

Is split thickness considered intermediate or complex closure? Graft with 5 cm 10cm came from patient's own leg to his turbinates or intranasal cavity.
Do I multiply 5 x 10 for total cm?
Is repair for split thickness intermediate or complex?
thank you

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E/M training

I am a fairly new coder. I am really struggling reading reports and determining the E/m codes. Is there anything or coarse you might recommend. I just started my first coding job and am struggling. Thank you.

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Are there any Proctors that can answer this question?

Hello,
I am taking the CPC Exam online in 3 weeks. I am very nervous for the obvious reasons, but I am also concerned about the notes I have made in my CPT book. I hand wrote my own E/M chart to make it easier and faster to look them up instead of going through the entire E/M code pages or using the E/M chart in the book. I have seen and heard other CPC exam takers say their proctor did not view the handwritten charts as a problem since another version of the same chart technically already...

Are there any Proctors that can answer this question?

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Ophthalmology/Optometry

Are the ophthalmologist and optometrist considered the same speciality if both are memebers of the same group for defining the 3 year rule of new and established pt.?

Thanks you,
Caroline

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CRC Exam Prep Course Advice

I recently purchased the CRC prep course. This is my first time taking a distance learning course for a certification. My CPC and CPMA were both in person training courses. For those who have taken the CRC Online Prep and sat for the exam, what would be your best suggestion/advice for reviewing the content provided? I am trying to see the best way to tackle the chapters. I see that each chapter has reading material, quizzes, lectures and a chapter review exam. Is it best to read the content...

CRC Exam Prep Course Advice

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Adolescent Residential billing for MH and SUD

I need help. I have been billing for adults my whole career, but now have some questions regrading adolescents. This would be for residential care at a residential facility. Primary dx will usually be MH, and I cannot find any specific information on if billing will even change from what I am used to with Adults. I did find a couple modifiers, but that is it... Does anyone have any experience with the adolescent MH/SUD residential billing world that could help???? Should I be using a...

Adolescent Residential billing for MH and SUD

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Billing for Personal Protective Equipment (PPE)

Is there a CPT code that could be used for giving a patient (PPE)?

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Type 1 Osteotomy/Type 1 Schwab Osteotomy

I have a surgeon that performed a L4-L5 type 1 osteotomy. It looks like it's a total facetectomy. Has anyone coded a type 1 osteotomy? I have also seen it called a type 1 Schwab Osteotomy. Not sure of what CPT code to use.

Thanks!

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Op note cloning

Hi does anyone know where I can get some guidelines or information on cloning of the body of the OP note? I have a provider copying surgeries from other notes (that are the same kind of surgery) and just changing the level of the spine that is being operated on. I need to provide him with some kind of guideline or clear information that clearly states this is not allowed. Thank you!!

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OR billing

Can someone please enlighten me about how OR services should be billed for inpatient services.
I am currently conducting inpatient facility audit and I see surgery time listed on the surgical notes as the exact start and end time for anesthesia. ie
if anesthesia bills 3 units the surgery time bills 45 minutes. Is this correct?

Thanks

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Neonatal Jaundice vs Hydration

Hello,

My Question is Can Hydration support medical necessity if patient is suffering from neonatal jaundice.

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Contract Negotiation for a laboratory

Hello all, I was wondering if anyone had a recent opportunity to negotiate a contract with insurances like Aetna & Cigna for a laboratory. I am particularly interested in getting a sense of how much percentage of Medicare rates they are offering. Any insight would be greatly appreciated!

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Molecular Lab Coding Experience

Hello!

I am curious to see if there is anyone out there with molecular lab coding experience. The company I work for is bringing on a new lab. I am curious to see if there is anyone out there with any experience in this area!

Thanks!
Heather

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Sequencing

I just want to clarify something because I'm not sure if this is the correct thing to do.
I work for a specialty (cardiology) and I was told by someone higher up to only code that specialty dx's. However, sometimes a pt has renal failure or resp failure which does attribute to why the pt is being seen in the hospital. I was also told that only cardiology should be listed first but sometimes we see them only because of elevated trop.. which is an unspecified abnormal serum testing code...so...

Sequencing

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Billing E&M for a LVN

Can you bill an E&M visit for a LVN utilizing incident-to guidelines?

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