Use of 56501

We had a patient come in for a visit on 01/21/2021 - treatment #1 and 01/28/2021 - treatment #2, both for 99213 - MOD. 25 (OFFICE/OUTPATIENT VISIT EST) and 56501 (DESTROY VULVA LESIONS SIM). My billing system is not letting me submit and showing me the following errors..

"Pattern 20920 Procedure Code 99213 is within the global period of 10 days of History Procedure Code 56501 performed on 01/21/2021 on Claim ID 144376-0012477617, Line ID 12875300 by the same provider. Please review...

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Career question

Hi my name is Manisha. I did my bachelors in India. I am a certified CPC-A for quite a long time. I am not getting job in either billing or coding since I don't have any experience. I am thinking to do an associate degree in Medical coding. Do you think that getting an associate degree helps to open door for me to get any entry level position in medical industry? And can any degree can be substitute from experience in medical field? Also if I pursue associate degree, should I do it in...

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CPT 93241

Has anyone been using the new codes for the extended holter monitor (greater the 48 hours up to 7 days) CPT 93241?

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cpt for 5.5 impella insertion?

please help.

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Medical BILLING position in Suffolk County, NY

Are you a CPC-A (or studying for your CPC) and complaining no one will hire you without experience??
I have an opportunity to work as a medical biller, alongside 2 certified coders to gain valuable experience in billing and get your foot in the door at Northwell Health. Position is located in Bay Shore, NY.
PM your resume for additional information.

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Question about saturation biopsy....

I have a question regarding saturation biopsy of the prostate. Our doctor did a prostate biopsy and took 24 cores. He did not use a template to do this. He coded this as a saturation biopsy. Is this correct? Does a template need to be used to use 55706? What exactly is the difference between 55700 and 55706? Is it just how many cores are taken? Any help would be appreciated!

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Incident To for Physical Therapy

I am currently taking a physical therapy course to learn more in the field I am currently working in. One thing has me confused. Incident to rules state that "Auxiliary staff may perform services ordered where such delegation is permitted under the doctor’s license, provided that the physician is in the office suite providing supervision. The physician does not need to be in the room, but they must be in the office and immediately available to intervene if needed." For physical therapy...

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Remote Patient Monitoring Billing

Anybody that has been billing 99453, 99454, 99457 for RPM that can email me so I can get some clarification on billing out these codes. Please shoot me an email to herbie@up2parmc.com.

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NEW or ESTABLISHED PATIENTS IN A GROUP PRACTICE

This is a group practice with Obgyn and Maternal Fetal Medicine subspeciality.
Patients are scheduled among the 4 office locations depending on their medical needs.
The doctors circulate among the 4 locations
There is one central EMR with patients database.
Each facility has its own identifying tax id.

Questions:

1. Patient goes to Ultrasound A has a face to face with a MFM specialist for a consult. The following week the patient goes to OB office for an...

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ER Wound Re-Check/MDM

Hi All,

I have two questions relating to ER's. The first is- If a patient comes in for a uncomplicated wound re-check and is seen by Dr. B but the simple suture repair (12001) was performed by Dr. A, could a ER visit be charged since a different ER provider saw the patient? This leads me to my second question.

On my E/M Audit tool, on Table A, it states New Problem to Examiner. However, I've seen different information regarding this especially for same specialty providers. Since...

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50, QW, RT LT modifers for BCBS

So all my procedures and pregnancy tests are being rejected by my clearing house :
Using 50 modifier: 64494 Acknowledgement/Rejected for Invalid Information-The claim/encounter has invalid information as specified in the Status details and has been rejected - Procedure Code Modifier(s) for Service(s) Rendered (64494)
Using QW: 84703 Acknowledgement/Rejected for Invalid Information-The claim/encounter has invalid information as specified in the Status details and has been rejected -...

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CRC Credential

I am very pleased to join the ranks of those who have gone before me and obtained the Certified Risk Adjustment Coder credential. I will happily affix "CRC" to my signature block.

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central venogram w balloon angioplasty of SVC

I am only asking for opinion for procedure 1.
I think 36010,75827, 37248 ?

EXAM:
1. Central venogram with balloon angioplasty of the SVC
2. Removal of left-sided portacatheter
3. Implant of new right-sided portacatheter

HISTORY: SVC syndrome
Intravenous conscious sedation was administered by a dedicated
independent observer with continuous hemodynamic and respiratory
monitoring performed, including the use of pulse oximetry...

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2021 E/M Office visit if patient is not present

Hello,

I need some assistance, Can we code/bill E/M office visit if patient is not present?

Thank you,
M

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Retrograde Pyelogram

Good Morning I'm looking for some help with coding denials for Retrograde Pyelogram-CPT 74420(26) and Cystourethroscopy-52332. As I have reviewed there are no active CCI edits between the two codes, however Aetna and BCBS are continuously denying to reimburse for the retrogrades...Can anyone help explain if their practices run into this issue and or what is the warranted supporting information in billing both? Thank you.

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Device Interrogation Documentation

Hello,

I am needing to find information about the requirements for billing device interrogations in the hospital setting. I have always been told that we can't bill any interrogations out without documentation that is separate from the note. Such as having the printed information from the interrogation in the patient's file that supports the actual interrogation being completed. I was recently told that I can bill out device interrogations in the hospital setting without this...

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Sigmoid sinus resurfacing; mastoidectomy, cpt code(s)?

Can you tell me the correct code for Sigmoid sinus resurfacing; Mastoidectomy? I found 61591 and for primary closure 1573_ codes.
We need to call insurance for authorization before surgery can be done and I've never had to code this surgery before. I also noticed that 61591 is on the inpt only list. Has anyone else coded for this surgery? Is 61591 the correct code?

Thank you in advance for your help.
Carol

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Remote E/M auditor and physician educator.

Hi ,

Company in Maryland is looking for Remote E/M auditor and physician educator. For more details please reach out to Catherine M. Zito - czito@lighthouseha.com

Thank you!

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Other Hemodialysis

How do you code and bill Continuous renal replacement therapy?

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billing before initial ob visit

Hello,

Our ob/gyn providers often see patients that do their own home pregnancy tests. When they have problems, like spotting and come in for a check before the initial visit is scheduled to establish ob care, the doctors often choose ICD 10 code O36.80X0 inconclusive fetal viability and bill a 99213/99214 and the payer always denies as inclusive to ob care. How can we get paid for this type of visit before initial care is established?

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Prolonged services

Hi,

We have the prolonged services reporting guidelines as



Where we have instruction as
For New Patient Visits:
If total time is less than 15 minutes No Code will apply
If time is greater than 74 minutes add Prolonged EM Service
For Established Patient Visits:
If total time is less than 10 minutes No Code will apply
If times greater than 55 minutes add Prolonged EM Service
from...

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Cancelled ASC injection

The procedure is 64483 for L4/L5. Patient was given local Aesthesia. Somehow the PT became scared and decided to cancelled the injection. I plan to bill 64483 with modifier 74. The insurance is Blue Cross, not sure if they will pay for it. Also PT has a co-pay for ASC service, MD is worried the PT might be angary when he receives the bill because the injection was actually not done.

What do you think we should do?

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Tesio Removal/Replacement

I don't know why Tesio catheter removal/replacements are always confusing to me. I'm thinking 36581 but for a Tesio would this be billed 2 x along with 77001 for the fluoroscopy guidance? See the operative course below. Any feedback is greatly appreciated.

OPERATIVE COURSE: Patient was taken to the operating room, timeout called, everyone agreed. Right neck was prepped and draped. The old catheter would not flush adequately. This was prepped and draped and local placed. We then cut...

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2021 E/M Guidelines Chronic Pain

If a patient has chronic lumbar pain and chronic knee pain does that count as 2 chronic conditions? Or would they lump it together as 1 under chronic pain? They would have to be evaluated as two seperate regions with seperate pain scales and seperate assessment/management so I would say two seperate conditions. Thoughts?

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Medicaid Billing Groups?

I was hoping that someone would know online billing groups or forums I can join for Medicaid to get help and tips for billing and coding.

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Modifier for repeat vulvectomy

Pt had right partial vulvectomy done 2 months ago ( 56620), and returned for left side this time with same diagnosis ( recurrent vulvar dysplasia/condyloma). The surgeon did not mention it was planned. Since it is still in 90 days global period, do I need to use modifier to indicate the left vulvectomy? ( I code for hospital)


Thank you for advice.

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Tonsil Injection

Patient present's with Eagle's Syndrome and we performed an injection of lidocaine with epinephrine into left tonsil. I cannot find an appropriate cpt code if there is one to appropriately fit, or would this just be included in the E/M code? Thank you for any help!!!

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Hypertension with Heart Disease guidelines

I need clarification on the Hypertension with Heart Disease combination code I11._. The way I read the Hypertension w Heart Disease ICD10, it relates only to Heart Disease as in codes I50._ or I51.4-I51.9. Is there a combo code for Hypertension with ASHD? I11._ Hypertension w Heart Disease does not appear to include ASHD. I am assuming then, that I would code I10 and I25.10 for example when reporting Hypertension and ASHD. Thanks

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Has anyone that has taken the cpc test have any advice for the diagnosis part?

Has anyone that has taken the test have any advice for the diagnosis part? I got a 20% on it all 3 times any advice thanks

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