Starting a new EHR system, documentation

Hi, there has been a question regarding if the employer is starting a new EHR system, If the physicians need to start all new history forms for the system for each patient. Who should have to do these, Dr vs nurses...time involved. etc. Its been stated that the established records will pull forward into the visits documentation for that day. I believe the Progress note needs to be able to stand on its own. If its ever pulled for an audit, court etc.
Is it acceptable if the information...

Starting a new EHR system, documentation

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Pre-surgical Covid Testing

Hello. I am in Nebraska and I thought I read somewhere that the commercial plans and Medicare are not going to be covering pre-surgical testing for Covid. Has anyone else heard or read this anywhere?

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RN Billable Services Question

I have searched everywhere online and still couldn't find the answer I was looking for. I work for a mental health organization and we have our NP and two RNs that provide the medical visits to our clients. We have just started using medical billing and none of us really have any good experience or knowledge on how to bill them correctly. We have reguarly use behavorial health codes for years. Now with NP and RNs providing the medical services, that makes it complicate for us.

Our RN...

RN Billable Services Question

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External Fixator Distraction

For certain tibia pilon or tibia plateau fracture presentations, my providers will utilize a uniplane external fixator to distract the knee or ankle joint so that the fracture can be visualized and repaired. The fixator is removed at the end of the same surgery. Some of my providers will attach a 20690 [application of external fixator, uniplane] on the charges for the operation in addition to the open fracture treatment. Has anyone found any documentation as to whether an ex fix can be...

External Fixator Distraction

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bx w/ ed&c

I need help settling a dispute in my office. Our providers sometimes do a bx followed by ed&c if they are clinically suspicious of it being malignant. Typically this is only done on older patients, patients who live far from the clinic, or more recently, due to covid and limiting trips/people in the office. I know that you cannot bill for the both the bx AND the ed&c on the same lesion on the same DOS and that these do need to be help for path. If the lesion comes back showing that it was...

bx w/ ed&c

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cpt codes to use for in home/telehealth palliative care

Does anyone know what is the best cpt codes to use for palliative care delivered in the home and via telehealth? Also is there certain documenation required to be used for Dx code Z51.5 encounter for palliative care?

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cdi-specialist

Hi,
does anyone have or know where I can review and practice with CDI worksheets? Any advice is appreciated. Thanks!

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Blackboard Not Working

I tried taking my ICD-10 test this morning and Blackboard was having issues. It took 2 minutes to go to the next question and after 3 minutes of it not working my internet closed out of the page and reopened. When that happened, Blackboard submitted my test with only 5 questions answered.

Has any one else been having issues with Blackboard today? I emailed aapc as they're not open on the weekends, but I want to know if anyone else had this issue.

*My internet is working perfectly normal...

Blackboard Not Working

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Coding help Please

Hi all!
Needed some help in coding this? Would I code 27310? What about the repair would that be inclusive since it is due to the excision? Thank you .
Procedure Performed: Excisional Biopsy left gouty tophus, left quad tendon with quad repair

...

Coding help Please

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ENT Coding Education

Anyone looking for reasonably priced ENT Coding Education, please note that I and my colleague Jennifer McNamara will be delivering a VIRTUAL course over two days mid-November offering 12 CEUs, covering just about just about everything an Otolaryngology coder would want addressed. We will be covering anatomy, diagnoses and CPT coding education in all areas where an Otolaryngology practice sees, including new technologies, endoscopic sinus surgery, the larynx, mouth and neck, skull base and...

ENT Coding Education

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Coding problom ! How do you codes for AWV, Sick Visit and Risk reduction therapy same day?

I am working at Internal and pulmonary disease and allergy immunology office. Can I bill AWV, Sick visit and risk reduction therapy as same day? Thanks !

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CPC-A Practicum (Practicode)

Has anyone purchased this program and do you recommend it? I am graduating from a Health Records Coding Program next Friday. I interviewed for a position this week and I was given an offer for employment. There was an oversight on HR's part, in the job description it says they require CPC. I am a CPC-A (I passed my CPC exam in early April). I was called yesterday and told that they were very sorry, but they couldn't offer me the position I had accepted, but they could offer...

CPC-A Practicum (Practicode)

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DMERC Denials

I have ran across a patient's claim where DMERC is denying: Benefit maximum for this time period or occurrence has been reached. We billed out 1 unit of L3670-LT-KX this year. Anybody have any suggestions on how to deal with the denial?

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Sub-acute Inpatient Detox and Substance Abuse Treatment Center Billing

Hi All!

I have recently move from Internal Medicine/ Family Practice FQHC Billing to Behavioral Health/ Substance Abuse In-Patient Treatment Facility. I am new to this field and would like to any feed back on where this billing is professional or institutional.
Please advise.

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Temporary Doctor Billing

The specialist office I work at is losing a doctor in less than two months. We have two doctors that see patients at our main office and the one provider who is staying also sees patients at our satellite office. Management is strongly considering hiring a part time, temporary doctor for one or two days a week at the satellite office just so the other provider can be available at the main office more. How long they plan on having the temporary doctor on payroll depends on how soon they hire...

Temporary Doctor Billing

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COVID-19 ON 2020 Exam

Are there questions regarding COVID if you take certification exam this year?

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Referring in same group

Can my doctor ,who is a Cardiologist, refer a patient to an Electrophysiologist within the same group and the Electrophysiologist bill for consult/new patient visit?

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Exam under Anesthesia

Physician performed Exam under Anesthesia (EUA) and a vaginoscopy
Vaginoscopy performed to r/o vaginal septum
CPT codes EUA-57410
vaginoscopy-57130

Per AAPC 57410= An exam under anesthesia is bundled into all procedures as the “look–see” during other procedures that involve the female genital system. This code can only be billed when it is the only service provided. When the exam is performed in the office setting, even if the physician must use moderate sedation or a local anesthetic to...

Exam under Anesthesia

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Encounter for a high risk pulmonary embolism

Hello,

I am trying to find the right encounter code for a patient who is at high risk of a pulmonary embolism/DVT as there is a family history. The patient themselves do not have any active PE or DVT. I have tried billing out Z76.89 but, was denied. Should I just be billing out the code for the family history? Or is there encounter code that I should be billing out as primary? Any help would be greatly appreciated.

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CS MODIFIER

When a patient presents with COVID-19, as a hospitalist, can we use the CS modifier? Also when the patient is COVID-19 recovered but we are using diagnosis codes Z09 and Z86.19 can you use the CS mod with that as well?

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PRICING 99072

Hello!

For those charging for new category 1 CPT 99072, how are you determining your price to report?

Thank you

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CANPC LECTURE EL PASO, TEXAS AAPC LOCAL CHAPTER, 072020

CANPC Anesthesia and Pain Management
Vino C. Mody Jr., COC, CPC, CCS-P, CANPC, CCVTC, CEDC, COPC, 4Med CICP, RMC, REMS, CMAA, CBCS, Medical coding certification (Expert Level), CNPR, CRMC
Local Chapter AAPC Event
El Paso, TX
Anesthesia
General endotracheal anesthesia: Patient is unconscious and has no control of airway; airway is controlled through intubation
MAC (Monitored anesthesia care): Patient cannot be easily aroused but will respond to painful stimuli. Patient is able to control...

CANPC LECTURE EL PASO, TEXAS AAPC LOCAL CHAPTER, 072020

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Medication dose exceeds max. allowable

I am running into a problem with one payer denying claims that have dexamethasone attached. Our providers generally administer 10mg so we charge 40 units of J8540 (.25mg per unit). The payer I'm having trouble with will only pay for 4 units (1mg).
Is there anything I can do to at least get paid for the 4 units instead of having all 40 denied? My 1st idea is to split the charges into separate line items (one with 4 units the other with the remaining 36) so that less are denied but something...

Medication dose exceeds max. allowable

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Injection given in patient's home

The office I work for (outpatient behavioral health) is planning to start having nurses go to patient's homes to administer psychiatric medication injections. Is this billable as "incident to" since the provider is not in the building where the patient is having the injection done? If not, is this billable at all? I have no clue about how home health visits work.

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Any Waystar clearinghouse users?

I'm curious to know what PM system you use and if you have a bi-directional interface? What do you see as pros/cons of your system?

(We use next gen now but not in love at all. I do, however, like waystar.)

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VA requiring SSN to submit claims?

Has anyone else recently experienced VA claims bouncing back from their clearing house when the patient's SSN is not used as the member ID number (HCFA box 1a)? We were originally advised to put the VA authorization number in this box for claims going to Optum. However, when we submit them this way they kick back & will only go through if we put the SSN in box 1a, & move the VA auth number to the Prior Authorization Number box (HCFA box 23). Just wanted to reach out to see if this is...

VA requiring SSN to submit claims?

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24515 vs 24430

DX: left humerus shaft fracture nonunion ( injury was in 2019)

Procedure: open reduction, internal fixation of left humeral shaft nonunion. Debridement left humeral fracture.

A longitudinal incision was made, just lateral to the biceps muscle. The bovie was used to cauterize any bleeders. The brachialis muscle was then split to visualize the humeral bone. this incision was carried down to the bone to allow better visualization of the fractures and to excise any necrotic soft tissue and...

24515 vs 24430

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CPT code for excision of bony fragment, subcutaneous tissue, anterior knee

what would be the best code to use for excision of bony fragment, subcutaneous tissue, anterior knee.

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Modifier -59, XE in cardiology

We received a claims analysis letter from Amerigroup, stating that our provider fell outside of average utilization of the ff modifier. -59, XE

I queried our system and found the root cause.

Frequently our provider consults on cases, reads EKGs and echoes, stress test for the same patient, all same day service - so we bill as ff

99223-25
93010-59
93306-26-59
78452-26-XE

Are we overutilizing modifier -59?

What should be the correct way of using modifier -59?

Thanks!

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Difference between modifier 59 and modifier XS

Hello, Can you please differentiate between modifier 59 and modifier XS with reference to gastrointestinal endoscopy. Please illustrate with some examples related to EGD, ERCP, Colonoscopy.

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Hospital Consults for return Patient in Post Op

My Ortho doctor has had a couple patients that he did surgery on for fractures. The patients have had a fall and were admitted back into the Hospital and our ortho was called to to consult the patients who now are needing a second surgery. Is still possible to bill In Patient visit? It is a new fall but still might be considered related to the initial surgery.

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