http://www.supercoder.com/forum/ Supercoder - Ask an Expert? Forum: - Recent Topics en Sun, 12 Feb 2012 12:50:43 +0000 http://www.supercoder.com/forum/topic/office-visit-with-procedure#post-11354 Sat, 11 Feb 2012 21:15:54 +0000 Jami Deerfield 11354@http://www.supercoder.com/forum/ <p>A patient comes into the office for a procedure, 97597 Debridement, would I code 99213 for the office visit with modifier 25 and 97597, or would I just code 99213 and 97597?</p> <p>Also, how would I code the same procedure a week later, when the patient comes in again? </p> http://www.supercoder.com/forum/topic/high-bladder-and-omental-adhesions#post-11315 Fri, 10 Feb 2012 04:56:01 +0000 Try Super 11315@http://www.supercoder.com/forum/ <p>ICD-9-CM codes for a cesarean section with high bladder and severe omental adhesions that were cut during the procedure to get through the uterus to deliver the baby. </p> http://www.supercoder.com/forum/topic/what-dx-for-this-colonoscopy#post-11345 Fri, 10 Feb 2012 21:33:43 +0000 maarit 11345@http://www.supercoder.com/forum/ <p>PT is followed for possible liver transplant by another hospital and they requested a screening colonoscopy. She had a screening colonoscopy by us about 2 months ago. This is a Medicare PT. the chief complaint is listed as constipation by our doctor. The result of the endo was normal: 'Surveillance colon exam in 5 yrs if lever transplant takes place." What Dx and CPT should I use? There is no mention of personal history of polyps or high risk.<br /> Thank you for advice. </p> http://www.supercoder.com/forum/topic/cpt-code-7#post-11341 Fri, 10 Feb 2012 20:57:13 +0000 Balkrishna B Sundar 11341@http://www.supercoder.com/forum/ <p>Please provide me with a proper CPT code I can bill on a psychiatric patient that keeps on inserting a rubber tubing into his urinary bladder? </p> http://www.supercoder.com/forum/topic/allergy-provider-documents-nad-for-psych-system-bc-says-no-must-be-constituti#post-11350 Fri, 10 Feb 2012 22:42:03 +0000 Alinda Johnson 11350@http://www.supercoder.com/forum/ <p>CAN OUR ALLERGY PROVIDER USE THE NAD FOR HIS PSYCH EVALUATION IN A COMPREHENSIVE EXAM. THIS IS HIS TEMPLATE HE HAS USED FOR YEARS ON PAPER.<br /> STEDMANS DICTIONARY SAYS IT STANDS FOR (NADISTRESS) MENTAL OR PHYSICAL APPERANCE.<br /> I WOULD APPRECIATE ANY WRITTEN ARTICLES ON THE SUBJECT .<br /> I NEED TO APPEAL BY 2/16/12. THANK YOU<br /> ALINDA D. JOHNSON<br /> AJOHNSON @DEDHAMMEDICAL.COM </p> http://www.supercoder.com/forum/topic/10060-100601-vs-26010-26011#post-11349 Fri, 10 Feb 2012 22:23:49 +0000 Maiu Reismann 11349@http://www.supercoder.com/forum/ <p>Should drainage of finger abscess be billed using 10060-10061 or 26010-26011? </p> http://www.supercoder.com/forum/topic/inpatient-drug-and-alcohol-treatment#post-11197 Mon, 06 Feb 2012 14:55:29 +0000 Vanessa Vergnetti 11197@http://www.supercoder.com/forum/ <p>What are the correct codes to use for this service? </p> http://www.supercoder.com/forum/topic/office-visit-after-lumpectomy#post-11100 Wed, 01 Feb 2012 23:53:27 +0000 maarit 11100@http://www.supercoder.com/forum/ <p>The surgeon wants to bill 99215 for an office visit where he explains the path results of a recent lumpectomy (CPT 19301 which carries a 90 day global). The path shows carcinoma too close to the margin, which is why he needed to meet with the pt and explain the next step: mastectomy. Would you code this visit with mod. 24?<br /> thanks </p> http://www.supercoder.com/forum/topic/endoclips-on-mucosal-rectal-tear-during-colonoscopy#post-11346 Fri, 10 Feb 2012 21:38:32 +0000 maarit 11346@http://www.supercoder.com/forum/ <p>Uneventful, screening colonoscopy 45378, but a 0.5 mm long mucosal tear in distal rectum was noted and 2 endoclips were placed to that short and apparently superficial tear as it is in distal rectum in close proximity to rectal outlet and rectal veins.<br /> How would you code the clips and what would be the Dx: 863.45?<br /> thanks </p> http://www.supercoder.com/forum/topic/two-specialties-same-inpatient-stay#post-11344 Fri, 10 Feb 2012 21:26:00 +0000 Tori Dobbs 11344@http://www.supercoder.com/forum/ <p>Can a specialist (admitting doc)and the patients Primary Doc both bill for visits during the same inpatient stay? </p> http://www.supercoder.com/forum/topic/endoclip-placement-on-a-tear-during-ercp#post-11343 Fri, 10 Feb 2012 21:24:13 +0000 maarit 11343@http://www.supercoder.com/forum/ <p>I have coded the below OP report as follows:<br /> Dx 574.51, 574.21 CPT 43264, 43262, 43271, 43235 -59, 43273, 74360<br /> I'm unsure if the documentation supports EGD and the fluoro. Also, how would you code the placement of an endoclip on a tear...or would this be bundled?</p> <p>The side-viewing duodenoscope was passed through the mouth and advanced with ease to the 2nd portion of the duodenum. The visualized esophageal and gastric mucosa are normal. The ampulla appears a bit prominent but has no evidence of recent stone passage. Cannulation of bile duct was achieved on first attempt with wire guide. Common bile duct was filled with contrast.numerous filling defects. Because of the numerous stones, a sphincterotomy was followed by 8 mm CRE balloon dilatation of the cut and then a 12 and 18 mm stone extraction balloons were used to extract the stones. There was a 4 mm long mucosal tear above the roof of the sphincterotomy and there an endoclip was placed to close it down. After clip was placed the bile duct was cannulated again and non-occlusion by the clip was verified. Fluoroscopy interpretation during procedure by myself. </p> http://www.supercoder.com/forum/topic/arthroscopic-shoulder-surgery-coding#post-11295 Thu, 09 Feb 2012 17:36:57 +0000 Sue Bolton 11295@http://www.supercoder.com/forum/ <p><code>29819,29827,29824,29828,29826,29807,29823</code><br /> I am beginner at coding shoulders &amp; not sure if I have coded correctly? Massive rotator cuff tear. Rotator cuff was extesivley scarred down, esp anteriorly involving 3 tendons. Multiple releases anterior &amp; mobilize of posterior cuff tear.Biceps tenodesis. Multiple margin convergence to reconnect anterior part of tear to posterior part of tear. Multiple anchors implanted. SLAP trephination repair superior glenoid after biceps release. Multiple piece of loose body debrided and removed from the joint. Decompression anterior &amp; lateral aspects of acromion out to the AC joint &amp; across the AC joint with modified Mumford with removal of distal inferior clavicle where it was impinging on the cuff. </p> http://www.supercoder.com/forum/topic/drug-screen-80101-vs-g0431-for-medicare-patient#post-11306 Thu, 09 Feb 2012 21:29:00 +0000 agnes hajdys 11306@http://www.supercoder.com/forum/ <p>DR PERFORMED A URINE TEST IN OUR OFFICE FOR DRUG SCREEN , MEDICARE PT BILLED WITH CODE 80101 QW MOD. CLAIM DENIED. PLEASE ADVICE IF WE REBILL WITH CODE G0431 WITH ICD CODE C58.69,724.4,719.41 WOULD NOT DENY MY CLAIM?<br /> THANKS<br /> AGGI </p> http://www.supercoder.com/forum/topic/dx-code-6#post-11339 Fri, 10 Feb 2012 20:22:25 +0000 Carol Reinke 11339@http://www.supercoder.com/forum/ <p>what dx code would you use for screening lymphedema?</p> <p>thanks<br /> carol reinke </p> http://www.supercoder.com/forum/topic/a9505#post-11330 Fri, 10 Feb 2012 18:07:06 +0000 lawrence kanter 11330@http://www.supercoder.com/forum/ <p>Medicare, here in florida have been denying cpy code A9505 with adjustment code N362, which means exceeds maximum units per day. we have always used 1 unit at 100.00 and we use 5 units(500.00) now, as of 01/01/12 it is being denied, I called the local medicare and the woman answering the phone told me that is was an unpublished edit that was activated 01/01/12, but she could not tell me how many units i can use or where i can find the answers to this questions, oh yeah, she said i could appeal it or make corrections and re-file but she could not tell me how many units are exceptable now, anyone have any answers,please help!!! Desperate!! </p> http://www.supercoder.com/forum/topic/billing-em-code-with-95180-rapid-desensitization#post-11304 Thu, 09 Feb 2012 21:00:15 +0000 Tina Holland 11304@http://www.supercoder.com/forum/ <p>I have been advised I should not bill an office visit with the rapid (95180) code. The insurance company is trying to argue the ov is included in the rapid?? Is this true Tina </p> http://www.supercoder.com/forum/topic/pulmonary#post-11331 Fri, 10 Feb 2012 18:31:45 +0000 Sue Baker 11331@http://www.supercoder.com/forum/ <p>Our doctor bills for a 99214-25, 94640 and 94060. Medicare says that 94640 bundles with 94060 but a modifier may be used to unbundle the code for reimbursement. Do you know what modifier I would attach to 94640? </p> http://www.supercoder.com/forum/topic/peroneus-brevis-transfer-with-posterior-tibial-tendon-repair#post-11329 Fri, 10 Feb 2012 18:06:03 +0000 Jessica Weathers 11329@http://www.supercoder.com/forum/ <p>What would be the appropriate way to code this scenario<br /> Peroneus brevis debride and transfer to the posterior tibial tendon<br /> with additional repair of the posterior tibial tendon.<br /> 27691 + 27659?<br /> if we are transferring the PB to the PT and then PT requires additional suturing and anchoring to repair it after the PB is transferred would you separately bill them out?</p> <p>Thanks in advance!!! </p> http://www.supercoder.com/forum/topic/veinwave-radiofrequency-skin-procedure-cpt#post-11328 Fri, 10 Feb 2012 18:05:37 +0000 Donna Christian 11328@http://www.supercoder.com/forum/ <p>Our general surgeon is using the Veinwave radiofrequency for nasal spider varicosities. Would this be an unlisted CPT 37799? Thank you. </p> http://www.supercoder.com/forum/topic/billing-28308-twice#post-11327 Fri, 10 Feb 2012 16:54:31 +0000 sandy lukert 11327@http://www.supercoder.com/forum/ <p>1. Left foot Weil osteotomy of the second metatarsal.<br /> 2. Left foot Weil osteotomy of the third metatarsal.<br /> 3. Gastrocnemius lengthening.</p> <p>We billed 27685, 28308, 23808/51</p> <p>Insurance is denying 28308 as included in 23808. This CPT is per digit. Can anybody help? Is there something that we need to do that we did not? Any help is appriciated.<br /> Operative report below to help..</p> <p>We identified and separated<br /> out the gastroc from the from the soleus underneath it and then I placed<br /> retractors around and isolated the gastroc and then performed a Strayer<br /> gastrocnemius lengthening, when we completed this, we are able to gain<br /> additional dorsiflexion of about 5 to 7 degrees. Once we completed this, we<br /> irrigated with copious bacitracin laden irrigation. We sutured in a lengthen<br /> position, the lengthened out gastroc with interrupted sutures. We close the<br /> subcutaneous tissue then with 3-0 Vicryl sutures and close the skin with<br /> interrupted 3-0 nylon sutures. We then placed sterile dressings around this.<br /> We then turned our attention to performing the Weil osteotomy to the left<br /> forefoot. We made approximately 5 cm incision over the dorsum of the left foot<br /> in second web space. The incision was carried down by blunt and sharp<br /> dissection, care protecting surrounding neurovascular structures. Using this<br /> incision, we gained access both medially and laterally to the second MTP joint<br /> and the third MTP joint. We made arthrotomies on the dorsum of both of these<br /> joints and elevated the capsule medially and laterally to expose the MTP<br /> joints. After gaining exposure, we then prepared for Weil osteotomies by<br /> protecting the soft tissues. We used a thickened blade on the second and third<br /> metatarsals and we performed a oblique Weil osteotomy of the second and third<br /> metatarsals, when we completed these osteotomies, we had appropriate shortening<br /> back these metatarsals and we temporarily pin the shortened Weil osteotomies<br /> into the desire position. We verified the degree of shortening and positioning<br /> on multiple planes of fluoroscopy. We were satisfied with the with the amount<br /> of shortening. We then placed many fragment screws from dorsal to plantar in a<br /> standard fashion. We gained good purchase and good stabilization of the Weil<br /> osteotomy, placing too many fragment screws in the second metatarsal and one in<br /> the third. When we completed this, there was overhanging bone left from the<br /> Weil osteotomy, we used a combination of rongeur and a rasp to smooth and<br /> remove the overhanging bone. We then took the second, third MTP joints through<br /> a range of motion and found good stable range of motion. There was no<br /> mechanical block to motion. At this point we irrigated with copious bacitracin<br /> laden irrigation. We then placed two 0.045 K-wires to the tip of the second<br /> through the second and third toes across this second third MTP joints under<br /> direct visualization. We placed these K-wires with the second, third MTP joint<br /> in plantar flexion. We checked the position of these pins on a multiple planes<br /> of fluoroscopy. We were satisfied with the position. We bent the K-wire, cut<br /> them short, and placed protective caps over these. We then irrigated with<br /> copious bacitracin laden irrigation. </p> http://www.supercoder.com/forum/topic/laparoscopy-cholecystectomy#post-11294 Thu, 09 Feb 2012 17:15:49 +0000 Jami Deerfield 11294@http://www.supercoder.com/forum/ <p>If the doctor started laparoscopy cholecystectomy then after about 15 mins. decided this was not the best way to go and changed it to an open cholecystectomy. Would I just code 47600, or is there another code I need to have? </p> http://www.supercoder.com/forum/topic/sleep-study-plus-oxygen#post-11286 Thu, 09 Feb 2012 15:11:44 +0000 yides fuchs 11286@http://www.supercoder.com/forum/ <p>I wonder if you can help me with this Question- -A Patient had to have Oxygen during a Sleep Study can the provider bill for the Oxygen? and if yes which code? </p> http://www.supercoder.com/forum/topic/new-emg-question#post-11324 Fri, 10 Feb 2012 16:10:43 +0000 Try Super 11324@http://www.supercoder.com/forum/ <p>i have been denied claims for emgs we used 95860 or 95861 then 95900*units and 95903*unites and 95904*unites they only pd for 95860 and 95861 how do i resubumit with the new codes95885 and 95886 and 95887 </p> http://www.supercoder.com/forum/topic/endoscopic-hip-bursectomy-with-it-band-release#post-11323 Fri, 10 Feb 2012 15:52:17 +0000 Shawn Coyle 11323@http://www.supercoder.com/forum/ <p>I need help coding this one... Endoscopic Hip Bursectomy with IT Band Release </p> http://www.supercoder.com/forum/topic/administration-code-for-j0897#post-11322 Fri, 10 Feb 2012 15:48:53 +0000 T Birdwell 11322@http://www.supercoder.com/forum/ <p>Just wondering if anyone has had the 96401 denied by Medicare? By Amgen website you can use 96401 or 96372. We have been having it denied and was wondering if medicare is requiring us to use 96372? I have browsed the Medicare website and can't find any information. </p> http://www.supercoder.com/forum/topic/cpt-95930#post-11321 Fri, 10 Feb 2012 15:45:15 +0000 Moni Johnson 11321@http://www.supercoder.com/forum/ <p>is this code considered unilateral or bilateral? Can this code be billed with an office visit and or other cpts codes such as 92250,92225 and get reimbursed? </p> http://www.supercoder.com/forum/topic/axilla-mass-excision#post-11320 Fri, 10 Feb 2012 15:36:34 +0000 Christine Burgan 11320@http://www.supercoder.com/forum/ <p>for an axilla abscess would you code "00400" or "00300"? </p> http://www.supercoder.com/forum/topic/modifier-62-and-radiology#post-11312 Fri, 10 Feb 2012 00:45:07 +0000 Try Super 11312@http://www.supercoder.com/forum/ <p>if vascular surgeon performs evar 34804 and interventional radiologist does angio and s &amp; i can the radiologist also bill 34804 with 62 modifier on the vascular surgeons work? </p> http://www.supercoder.com/forum/topic/cpt-for-exc-infect-ptfe-graftbypassligate-av-fist-repair#post-11318 Fri, 10 Feb 2012 14:33:03 +0000 Anne Niesen 11318@http://www.supercoder.com/forum/ <p>Excised infected PTFE bypass graft(placed for steal )(?CPT 35903) and ligation of brachiocephalic AV fistula w/ vein patch repair of brachial artery. essentially we removed PTFE graft and "undid" previous Brachiocaphalic AV fistula placed for hemodialysis due to infection. </p> http://www.supercoder.com/forum/topic/hidradenitis-of-infra-mammary-fold#post-11283 Thu, 09 Feb 2012 13:04:39 +0000 Lynn Pascoe 11283@http://www.supercoder.com/forum/ <p>Is it appropriate to use a benign lesion excision for the excision of hidradenitis in the area of the inframammary fold ? This is not really a "lesion" per se, but all the information I see resorts to this coding because there is no cpt code for this anatomical area.</p> <p>Please advise,<br /> Lynn </p>