http://www.supercoder.com/forum/ Supercoder - Ask an Expert? Forum: Family Practice Coding - Recent Topics en Sun, 12 Feb 2012 13:10:00 +0000 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/newborn-visits-in-physician-office#post-11246 Tue, 07 Feb 2012 21:35:48 +0000 Cyndi Bartkowiak 11246@http://www.supercoder.com/forum/ <p>In our doctor's office, a newborn is seen as a quick assessment within a few days of birth at no charge. The mother returns with the baby at 2 weeks for an exam. Should this be an E&amp;M and should it be established or new? </p> http://www.supercoder.com/forum/topic/patient-receiving-oxygen-in-the-physician-clinic#post-11255 Wed, 08 Feb 2012 15:31:34 +0000 Marlene Rolf 11255@http://www.supercoder.com/forum/ <p>We have a patient that received oxygen in the physicians office. 10 liters in 25 minutes. I found that the administration of the oxygen is part ot the E&amp;M visit. But what about the actual oxygen? Is this billable? Any help would be appreciated. Thanks. </p> http://www.supercoder.com/forum/topic/can-a-patient-sent-to-np-from-dr-in-same-practice-be-considered-new#post-11143 Thu, 02 Feb 2012 21:56:28 +0000 Tanya Ocampo 11143@http://www.supercoder.com/forum/ <p>We have 4 Nps in our clinic, 3 are family pratice and 1 is Cardio.<br /> Can a patient be referred by physician in our clinic to one of our NPs for primary care be considered a new patient? Or would they be considered established since they have seen a physician? </p> http://www.supercoder.com/forum/topic/hospital-discharge-and-stress-echo#post-11015 Mon, 30 Jan 2012 20:34:03 +0000 Stephanie Beadle 11015@http://www.supercoder.com/forum/ <p>We have a patient who was discharged from the hospital and we billed for a 99239. He immediately presented to the clinic for some additional stress/echo testing-93351/TC, 93320/TC, 93325/TC. We are receiving denials on the stress/echo services indicating they were incidental to 99239. Is this truly the case and the adjustment is ours or is there an appropriate modifier I can use to support these services? I guess I’m wondering if a 59 modifier would be appropriate to use in this case? I should also mention that we have attempted with a 25 modifier on 99239 without success. </p> http://www.supercoder.com/forum/topic/non-medicare-patient-presents-for-a-general-visit-and-gets-a-pap-smear#post-11085 Wed, 01 Feb 2012 17:20:40 +0000 Cyndi Bartkowiak 11085@http://www.supercoder.com/forum/ <p>Non medicare patient presents for a general visit and wants a pap smear as well. How do you code to include a general visit and the collection of the pap smear? can this be coded with a G0101 even though it is not Medicare? </p> http://www.supercoder.com/forum/topic/group-diabetes-education-in-rhc#post-10899 Thu, 26 Jan 2012 20:19:42 +0000 Christine Mcclure 10899@http://www.supercoder.com/forum/ <p>what code to use to bill medicaid when a certified diabetic educator who is a NP provide group education session </p> http://www.supercoder.com/forum/topic/coding-question-5#post-10833 Wed, 25 Jan 2012 16:54:22 +0000 monica drozd 10833@http://www.supercoder.com/forum/ <p>WHERE DO I FIND EXPLANATION OF THE TERM SEPARATE PROCEDURE IN THE CPT? </p> http://www.supercoder.com/forum/topic/how-to-properly-bill-a-pap-smear-to-non-medicare-payers#post-10794 Tue, 24 Jan 2012 18:04:27 +0000 Cyndi Bartkowiak 10794@http://www.supercoder.com/forum/ <p>There appears to be too many options when billing a pap smear. Please clarify, based on 2012, the proper coding structure for a pap smear for medicare versus non medicare. During a sick visit versus a general physical. Which codes will obtain the best reimbursement and which codes are not acceptable today? This specific client uses a Q0091 (does this represent the optaining of the specimen?)or an 87210 (wet mount) when performing test inhouse. very confused. </p> http://www.supercoder.com/forum/topic/medicare-g-code-for-power-vehicle-consult#post-10791 Tue, 24 Jan 2012 17:03:17 +0000 Cheryl Style 10791@http://www.supercoder.com/forum/ <p>What is correct G code to submit with Medicare claims when<br /> doing evaluation for power-operated vehicle? </p> http://www.supercoder.com/forum/topic/groin-sprain#post-10768 Mon, 23 Jan 2012 22:42:43 +0000 Victoria Collins 10768@http://www.supercoder.com/forum/ <p>What ICD9 is used for groin sprain? Pain in groin goes to abdominal code 789.0x and pain in testicle testis goes to 608.9 unspecified disorder or male genital organs. Twisting pain from lifting. </p> http://www.supercoder.com/forum/topic/how-to-code-for-medical-insurance-exam#post-10730 Mon, 23 Jan 2012 14:36:14 +0000 Matthew Woodward 10730@http://www.supercoder.com/forum/ <p>If a patient presents to the office for an insurance exam how do I code this? I have looked at the Preventive Medicine Services codes and I don't feel that it is a preventative exam since it is being requested by a third party it is more an administrative exam... I have also looked a the Basic Life/ and or Disability Evaluation Servies 99450. However, this code does not say for medical inurance evaluation is is only for Life or Disability Insurance... Any ideas? </p> http://www.supercoder.com/forum/topic/coding-iv-infusions#post-10698 Fri, 20 Jan 2012 14:37:17 +0000 Marlene Rolf 10698@http://www.supercoder.com/forum/ <p>A patient in the physician clinic receives IV infusion of Demerol, Protonix, and Reglan, along with Normal Saline. The NS started at 10:00 am, Protonix at 10:20 over 3 min, Reglan at 10:23 over 3 min, and Demerol at 10:27 over 5 min, and the NS was DC'd at 11:30 am with a dx of gastritis with nausea &amp; vomiting. How would you code the infusion? Thinking 96374, 96375 x 2, but not sure about CPT for infusing the NS. Would it be 96361 or is it incidental and not billable since we do not have dx of dehydration. Must you have a Dx of dehydration to use the 96360 as initial infusion. Infusion coding is so confusing. Any help would be appreciated. Thanks </p> http://www.supercoder.com/forum/topic/need-help-with-ultrasound-coding#post-10569 Tue, 17 Jan 2012 17:06:33 +0000 Cyndi Bartkowiak 10569@http://www.supercoder.com/forum/ <p>When ultrasounds of the liver, gall bladder, pancreas are performed, is it best to code with a singe organ ultrasound for each rather than an abdominal limited and a retroperitoneal limited? </p> http://www.supercoder.com/forum/topic/evaluation-and-management#post-10443 Thu, 12 Jan 2012 22:45:54 +0000 Sharmila Govindsami 10443@http://www.supercoder.com/forum/ <p>Hi,<br /> I have an established patient who comes in for a sick visit.<br /> BC has a new policy(eff:08/2010) that states that one of the two components for established visits will be MDM and the other will be either History or Exam. I hope this applies to all insurances including MEDICARE. Please update.<br /> Secondly, if a physician says- HTN continue meds as prescribed, is this prescription management. Would this be moderate risk in MDM?</p> <p>Waiting for your response.</p> <p>Thanks,<br /> Sharmilla. </p> http://www.supercoder.com/forum/topic/multiple-visits-in-one-day#post-10573 Tue, 17 Jan 2012 18:27:40 +0000 Brenda Taylor 10573@http://www.supercoder.com/forum/ <p>Am I correct in thinking that I can only bill one office visit a day. If my phys. sees a patient for his work comp injury and during the visit the patient brings up non work related issues such as sinus infection, can I bill the private insurance for the sinus and the work injury to workers comp?</p> <p>If I can only bill for one visit are there any suggestions on how to be compensated for the time spent on the illness/injury that is unrelated, say to the workers comp visit? </p> http://www.supercoder.com/forum/topic/have-question-on-billing-of-94620#post-10484 Fri, 13 Jan 2012 18:38:14 +0000 brenda hernandez 10484@http://www.supercoder.com/forum/ <p>I do billing for a provider that see's patient's in facility's he has been doing the 6 min walk stress test on some of the patients and im billing the <code>94620</code> which medicare keeps dening. ok so I get it now you can't use that code for if patient is in a facility so does anyone have any input on what code I should be billing I am at a loss.<br /> thanks for any imput<br /> brenda </p> http://www.supercoder.com/forum/topic/med-induced-b12-deficiency#post-10494 Fri, 13 Jan 2012 22:09:46 +0000 Margaret Hines 10494@http://www.supercoder.com/forum/ <p>What is ICD-9 code for Metformin induced Vit B12 deficiency? </p> http://www.supercoder.com/forum/topic/excise-callous-foot#post-10440 Thu, 12 Jan 2012 22:09:36 +0000 Michele Hancock 10440@http://www.supercoder.com/forum/ <p>Dr excised a callous on a patients foot. Would CPT 97597 be appropriate? No anesthia was used. Tool was a scalpel. There was no open wound and did not involve a burn. </p> http://www.supercoder.com/forum/topic/repair-vs-em#post-10249 Mon, 09 Jan 2012 17:50:39 +0000 Matthew Woodward 10249@http://www.supercoder.com/forum/ <p>Patient presents to office for a laceration repair. The physician determined after exploration that it could not be sutured, but did use silver nitrate to stop the bleeding. No suture were used just steri strips. Can I still use a 12001 or should I use a 12001 with modifier 52. </p> <p>I don't see there is a code for just cauterization of a wound. </p> http://www.supercoder.com/forum/topic/em-question-2#post-10347 Wed, 11 Jan 2012 17:26:22 +0000 Eileen Mullen 10347@http://www.supercoder.com/forum/ <p>Established pt was seen by Internal Medicine in a satellite clinic in August 2011. Patient self referred to another Internal Med provider at the main clinic in September 2011 (patient wished to change to a female provider). The first visit (at the satellite clinic) was billed 99214. The second visit (at the main clinic) was billed 99202. Both clinics bill under the same tax ID number. Both visits were face-to-face encounters with MDs.</p> <p>Should the second visit have been billed established patient since it was same specialty and patient self referred? </p> http://www.supercoder.com/forum/topic/icd-9-10#post-10332 Wed, 11 Jan 2012 13:31:28 +0000 MARTHA EPPLEY 10332@http://www.supercoder.com/forum/ <p>What would you put for "herpes gladitorum." The only thing I could come up with was 054.9. </p> http://www.supercoder.com/forum/topic/normal-saline#post-10291 Tue, 10 Jan 2012 19:03:55 +0000 Brenda Taylor 10291@http://www.supercoder.com/forum/ <p>What is the correct code for Normal Saline 100ml? I know J7050 is to report 250 ml but I only want to bill for 100 mls.</p> <p>Thank you </p> http://www.supercoder.com/forum/topic/hcpcs-questiondoctors-office-help#post-10269 Tue, 10 Jan 2012 05:27:45 +0000 hazel joseph 10269@http://www.supercoder.com/forum/ <p>Where can I find the payment rate (dollar amount) (for my particular region) for several HCPCS codes? Can you please provide the link? </p> <p>Thanks very much! </p> http://www.supercoder.com/forum/topic/billing-for-normal-saline#post-10268 Tue, 10 Jan 2012 00:28:49 +0000 Brenda Taylor 10268@http://www.supercoder.com/forum/ <p>What is the correct code for Normal Saline 100ml? I know J7040 is to report 500ml but I only want to bill for 100 mls.</p> <p>Thank you </p> http://www.supercoder.com/forum/topic/egd#post-10285 Tue, 10 Jan 2012 17:23:59 +0000 Don Hodson 10285@http://www.supercoder.com/forum/ <p>Our physician performed an EGD with biopsy 43239 and also a balloon dilatation 43249 at the same time. Neither codes are in the CCI edits for each. How do we bill this? </p> http://www.supercoder.com/forum/topic/profees-and-modifiers#post-10216 Fri, 06 Jan 2012 22:20:56 +0000 Cyndi Bartkowiak 10216@http://www.supercoder.com/forum/ <p>When a physician selects an E&amp;M code as well as a Physical Code, e.g. '99395', then selects and medication injection, Kenolog, is placing a 25 modifier on the E&amp;M code enough? </p> http://www.supercoder.com/forum/topic/zofran-and-demerol#post-10025 Tue, 03 Jan 2012 14:31:49 +0000 Roger Henson 10025@http://www.supercoder.com/forum/ <p>A patient came in and received an injection of Zofran 4mg and Demerol 50mg. I am using the following codes...are they correct and do I need to use a modifier? Thanks</p> <p>J2405<br /> 96372<br /> J2175 </p> http://www.supercoder.com/forum/topic/can-i-bill-for-body-composition-analysis-printout#post-10048 Tue, 03 Jan 2012 20:28:35 +0000 Julie Landry 10048@http://www.supercoder.com/forum/ <p><code>99091</code> <code>99420</code> </p> http://www.supercoder.com/forum/topic/does-anyone-have-a-problem-filing-a-t-dap-to-medicare-when-it-is-injury-related#post-10044 Tue, 03 Jan 2012 20:03:15 +0000 Teresa Crawley 10044@http://www.supercoder.com/forum/ <p>(90471) </p>