http://www.supercoder.com/forum/ Supercoder - Ask an Expert? Forum: Internal Medicine Coding - Recent Posts en Sun, 12 Feb 2012 12:42:13 +0000 http://www.supercoder.com/forum/topic/new-pft-code-for-2012#post-11291 Thu, 09 Feb 2012 16:12:05 +0000 Deborah Marsh 11291@http://www.supercoder.com/forum/ <p>The CPT manual states "94240 has been deleted. To report thoracic gas volumes, see 94726, 94727." You can also get an idea of how the codes cross from the slides in the AMA presentation: <a href="http://www.ama-assn.org/resources/doc/cpt/08-2011-pulmonary-manaker.pdf" rel="nofollow">http://www.ama-assn.org/resources/doc/cpt/08-2011-pulmonary-manaker.pdf</a>. For example, see slide 15. (No need to say 2012 coding will depend on what the documentation supports.)</p> <p>Regards,<br /> Deborah Marsh, JD, MA, CPC, CHONC<br /> The Coding Institute </p> http://www.supercoder.com/forum/topic/cpt-code-suture-removal#post-11282 Thu, 09 Feb 2012 08:48:41 +0000 apoorba ganguly 11282@http://www.supercoder.com/forum/ <p>If the suture removal is done under anesthesia (other than local), then any of these 2 codes would be used, based on the factor whether the same or different surgeon is doing the suture removal process: 15850, 15851. If it's done under local or no anesthesia, these codes could not be used. </p> http://www.supercoder.com/forum/topic/new-pft-code-for-2012#post-11275 Wed, 08 Feb 2012 20:45:41 +0000 LINDA HISCOCK 11275@http://www.supercoder.com/forum/ <p>I'M LOOKING FOR THE CORRECT CODE FOR THE PFT FOR 2012 THAT REPLACE CODE 94240.<br /> I'VE BEEN READING IT'S JUST ONE CODE BUT FROM A FEW OF THE ANSWERS ON HERE IT LOOKS LIKE 3-4 CODES COULD BE USED.<br /> THX'S </p> http://www.supercoder.com/forum/topic/can-you-code-same-date-em-critical-care#post-11252 Wed, 08 Feb 2012 14:15:32 +0000 Wendy Clark 11252@http://www.supercoder.com/forum/ <p>99231-99233 same date w/ 99291 </p> http://www.supercoder.com/forum/topic/cpt-code-for-ekg-pft#post-11208 Mon, 06 Feb 2012 18:03:13 +0000 Zakari Tata 11208@http://www.supercoder.com/forum/ <p>thank you </p> http://www.supercoder.com/forum/topic/cpt-code-for-ekg-pft#post-11186 Sun, 05 Feb 2012 17:24:56 +0000 BARBARA PRATER 11186@http://www.supercoder.com/forum/ <p>Office Visit with a 25 modifier<br /> ekg<br /> pft </p> http://www.supercoder.com/forum/topic/cpt-code-for-ekg-pft#post-11162 Fri, 03 Feb 2012 18:42:20 +0000 Sanjit Mishra 11162@http://www.supercoder.com/forum/ <p>What is the reason for visit?<br /> Was it in any way a screening exam?<br /> Medical Necessity/Indication for EKG and PFT. What is the reason for such order of tests written in the order form? </p> http://www.supercoder.com/forum/topic/cpt-code-for-ekg-pft#post-11126 Thu, 02 Feb 2012 18:31:16 +0000 Zakari Tata 11126@http://www.supercoder.com/forum/ <p>How do I bill office visit, EKG and PFT together? Thank you </p> http://www.supercoder.com/forum/topic/v700-and-v7231#post-11123 Thu, 02 Feb 2012 17:50:40 +0000 Suhel Siddiqui 11123@http://www.supercoder.com/forum/ <p>Thanks for the reply, Sanjit. It was a WWE and a complete physical...my doctor did an EKG as part of the patient's physical. I wanted to use V70.0 to link to CPT code 93000(EKG) and V72.31 for the WWE portion and link it to 99396. That's why I wanted to know if i could use both Dx codes, V70.0 and V72.31, on the same claim. Thanks </p> http://www.supercoder.com/forum/topic/v700-and-v7231#post-11106 Thu, 02 Feb 2012 14:12:23 +0000 Sanjit Mishra 11106@http://www.supercoder.com/forum/ <p>For billing 99204, the visit has to be a problem-oriented first visit.<br /> For billing 99396, if it is well-woman exam (based on guidelines of well-woman exam), then bill V72.31, otherwise it should be V70.0<br /> For pap, although there is practice of using Dx like V76.2, but you can use V72.31 also. </p> http://www.supercoder.com/forum/topic/v700-and-v7231#post-11074 Wed, 01 Feb 2012 00:37:24 +0000 Suhel Siddiqui 11074@http://www.supercoder.com/forum/ <p>My doctor did a physical, pap and EKG and addressed specific medical issues, all in the same visit. Can i use both, V70.0 and V72.31, along with other dx codes for the medical issues, to bill for this visit? The cpt codes i want to use are 99204-25, 99396, 93000.<br /> Thanks in advance for any help. </p> http://www.supercoder.com/forum/topic/how-to-bill-em-for-2-8hour-sessions-of-95180-rapid-desensitization#post-10838 Wed, 25 Jan 2012 18:43:07 +0000 Sanjit Mishra 10838@http://www.supercoder.com/forum/ <p>Rapid Desensitization: Rapid desensitization (also called rush immunotherapy or cluster immunotherapy) applies to clinical situations in which multiple injections of antigens are administered over a few hours at 30- to 120-minute intervals to rapidly neutralize available IgE antibodies.<br /> 95180 : Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)<br /> For 95180, rapid desensitization must be billed as one hour equals one unit.<br /> So, it is 95180 x 8 units each DOS.</p> <p>Ref:<br /> <a href="http://www.ncdhhs.gov/dma/mp/1N2.pdf" rel="nofollow">http://www.ncdhhs.gov/dma/mp/1N2.pdf</a> </p> http://www.supercoder.com/forum/topic/how-to-bill-em-for-2-8hour-sessions-of-95180-rapid-desensitization#post-10803 Tue, 24 Jan 2012 20:04:22 +0000 Bonnie Bussell 10803@http://www.supercoder.com/forum/ <p>What is the best way to bill for this? It is rapid desensitization for two days, 8 hours each, one 94010 every hour, with a nurse. The doctor checked in on him every 15-20 minutes all day long each day. Any advice is appreciated. </p> http://www.supercoder.com/forum/topic/medicare-advantage-hmo-ppo-wellness-visits#post-10765 Mon, 23 Jan 2012 21:30:40 +0000 Sanjit Mishra 10765@http://www.supercoder.com/forum/ <p>For claims with dates of service on and after January 1, 2011, CWF shall not allow payment for HCPCS G0438 or G0439 if payment for a previous IPPE, HCPCS G0402, is paid in history within the last 12 months. CWF shall count 11 full months starting with the month a beneficiary’s IPPE is paid in the history file.<br /> When denying claims for AWV HCPCS G0438 or G0439 because an IPPE, HCPCS G0402, is paid in history within the past 12 months. </p> http://www.supercoder.com/forum/topic/trochanteric-bursitis#post-10740 Mon, 23 Jan 2012 17:09:56 +0000 Vangie Becenti 10740@http://www.supercoder.com/forum/ <p>Patient came into Internal Medicine Clinic.</p> <p>Dx: Trochanteric bursitis.</p> <p>Procedure: the right trochanteric bursa was injected with 80 mg kenaolog and 1 mL of 1% Xylocaine. He got prompt relief of his hip discomfort.</p> <p>I coded this as follows:</p> <p>20610/RT<br /> J3301</p> <p>Xylocaine??</p> <p>Please advise.</p> <p>thank you. </p> http://www.supercoder.com/forum/topic/medicare-advantage-hmo-ppo-wellness-visits#post-10733 Mon, 23 Jan 2012 14:52:06 +0000 Caroline DeLaCruz 10733@http://www.supercoder.com/forum/ <p>Hi<br /> Are any of the Medicare advantage plans in the NY area paying for wellness exam<br /> (G0402,G0438 &amp; G0439)?</p> <p>Thank you,<br /> Caroline </p> http://www.supercoder.com/forum/topic/counseling-and-prolonged-services#post-10716 Fri, 20 Jan 2012 22:48:30 +0000 Beth Sant 10716@http://www.supercoder.com/forum/ <p>Can physician bill in addition to hospital vist code for "family conference" time? Is this under prolonged services in addition the the E&amp;M code? </p> http://www.supercoder.com/forum/topic/icd-9-code-needed#post-10693 Thu, 19 Jan 2012 23:30:03 +0000 Donna Sorenson 10693@http://www.supercoder.com/forum/ <p>There is no specific code for either of the scenarios you pose. However, <code>251.1</code> other specified hypoglycemia will work. </p> http://www.supercoder.com/forum/topic/icd-9-code-needed#post-10691 Thu, 19 Jan 2012 22:57:31 +0000 Carolyn Carroll 10691@http://www.supercoder.com/forum/ <p>what is the correct icd-9 code for nocturnal hypoglycemia and nocturnal hypoglycemia awareness </p> http://www.supercoder.com/forum/topic/e-code-icd9#post-10547 Tue, 17 Jan 2012 01:47:21 +0000 Leesa Israel 10547@http://www.supercoder.com/forum/ <p>I woud go with the E919.8 code to specify it was a machinery accident. I found the following guidance that might be helpful:<br /> *<br /> 16. Machinery<br /> a. To code an accident caused by machinery in operation, look in the Index under<br /> ”Accident, caused by . . . “ or “Accident, machine”, then choose a term describing the<br /> specific type of machine involved.<br /> b. To code an accident caused by machinery not in operation, identify the cause of<br /> injury and locate this term in the Index. For example, to code a pinched hand in a<br /> printing machine, look under “Caught in, object.” A machine not in operation is<br /> considered an “object”.<br /> c. Distinguish between injuries due to woodworking machines (E919.4) (band saw,<br /> circular saw, radial saw, bench saw) and injuries due to powered hand tools (hand<br /> saw) or unpowered hand tools (unpowered saw).<br /> d. Nail guns should be considered a powered hand tool (E920.1)<br /> *<br /> Best,<br /> Leesa<br /> *<br /> Leesa A. Israel, BA, CPC, CUC, CMBS<br /> Executive Editor, The Coding Institute<br /> Manager, TCI Consulting &amp; Revenue Cycle Solutions<br /> Home office: (866) 458-2973<br /> Email: <a href="mailto:leesai@codinginstitute.com">leesai@codinginstitute.com</a><br /> <a href="http://www.codinginstitute.com" rel="nofollow">http://www.codinginstitute.com</a> </p> http://www.supercoder.com/forum/topic/icd9-code-for-septic-prepatellar-bursitis#post-10532 Mon, 16 Jan 2012 18:05:31 +0000 Sanjit Mishra 10532@http://www.supercoder.com/forum/ <p>726.65: Prepatellar bursitis<br /> The question is we can go for a "septic" prepatellar bursitis, when if the the doctor had excised the bursa for a culture and sensitivity study, and the findings confirm of the type of infection, for if the findings suggest bacterial infection, you can additionally code 041.89 </p> http://www.supercoder.com/forum/topic/e-code-icd9#post-10528 Mon, 16 Jan 2012 17:26:47 +0000 sherry lyons 10528@http://www.supercoder.com/forum/ <p>PT HAD AN INDUSTIRAL ACCIDENT AND HIS HAND WAS CRUSHED WHEN IT WAS CAUGHT IN A CONVEYER BET. I FOUND THE CRUSH INJURY TO THE HAND BUT AM TORN ON THE E CODE I WAS GOING TO GO WITH E919.8. E918 DOES SAY CRUSHED BUT THE DOCTOR DID SPEICIFY IT WAS INDUSTRIAL AND E919 DOES SAY MACHINERY .<br /> THANK YOU </p> http://www.supercoder.com/forum/topic/2012-aridol-mannitol-bronchial-challenge-j7665#post-10519 Sun, 15 Jan 2012 18:08:09 +0000 Sanjit Mishra 10519@http://www.supercoder.com/forum/ <p>J7665 is a new code for the year 2012. You need to check really the usage is how many units of J7665 so as to decide the discarded number of units. In this context, I would suggest the use of JW modifier with the HCPCS codes with the number of units discarded to be billed in the 2nd line along with first line billing of used units.<br /> Centers for Medicare &amp; Medicaid Services (CMS) clarifies the appropriate use of modifier JW Discarded drug not administered when reporting unused units of drugs and biologicals for reimbursement. Failure to follow this guidance could result in excessive units billing.<br /> Medicare reimburses physicians, hospitals, and other providers or suppliers for the unused units of a single-use vial or other single-use package as well as the dose administered up to the amount indicated on the vial or package label. </p> http://www.supercoder.com/forum/topic/2012-aridol-mannitol-bronchial-challenge-j7665#post-10487 Fri, 13 Jan 2012 19:35:54 +0000 Try Super 10487@http://www.supercoder.com/forum/ <p>Does anyone know what the Medicare B LCD is for this new code? And since the J7665 = 5mg, and the kit contains (for use) up to 635mg (which cannot be saved for another patient), how do I bill for this? Maybe J7655 x 127 units? </p> http://www.supercoder.com/forum/topic/np-ekg#post-10457 Fri, 13 Jan 2012 03:00:35 +0000 Sanjit Mishra 10457@http://www.supercoder.com/forum/ <p>But, I think you this will happpen in a when the Claim has to be billed on the basis of "Incident-To" billing, as if all part of the services are being performed by the physician. As per first clause of this guideline, since the services are an integral, although incidental, part of the physician's professional service, you can bill both EKG as well as Interpretation and report(93000).<br /> Guidelines:<br /> If an NP and a physician work together to provide physician services, the services can be billed under the physician's provider number, to get the full physician fee, under the Medicare provision for "incident-to billing." However, certain rules must be followed when billing services under the incident-to provision. The rules are:</p> <p>-The services are an integral, although incidental, part of the physician's professional service.<br /> -The services are commonly rendered without charge or included in the physician's bill.<br /> -The services are of a type commonly furnished in physician's offices or clinics.<br /> -The services are furnished under the physician's direct personal supervision and are furnished by the physician or by an individual who is an employee or independent contractor of the physician. Direct supervision does not require the physician's presence in the same room but the physician must be present in the same office suite and immediately available.<br /> -The physician must perform "the initial service and subsequent services of a frequency which reflect his or her active participation in the management of the course of treatment."<br /> -The physician or other provider under whose name and number the bill is submitted must be the individual present in the office suite when the service is provided.<br /> *<br /> The incident-to rules are stated in the Medicare Carriers Manual (Part 3, Chapter II, section 2050), available online at:<br /> <a href="http://www.hcfa.gov/pubforms/14_car/3b2000.htm" rel="nofollow">http://www.hcfa.gov/pubforms/14_car/3b2000.htm</a> </p> http://www.supercoder.com/forum/topic/np-ekg#post-10431 Thu, 12 Jan 2012 20:52:16 +0000 Melanie Larrison 10431@http://www.supercoder.com/forum/ <p>When the NP does an EKG in the office but the Doctor is the one who will be billing for the service because the NP can't, what CPT code should the Doctor be billing, 93000 or 93010?</p> <p>Thank you. </p> http://www.supercoder.com/forum/topic/icd9-code-for-septic-prepatellar-bursitis#post-10392 Thu, 12 Jan 2012 14:10:31 +0000 sherry lyons 10392@http://www.supercoder.com/forum/ <p>septic prepatellar bursitis I looked at 727.2 but it does not idicate that it is septic? </p> http://www.supercoder.com/forum/topic/can-4719-be-used-to-support-aspirin-desensitization-95180#post-10331 Wed, 11 Jan 2012 08:09:57 +0000 Sanjit Mishra 10331@http://www.supercoder.com/forum/ <p>Reimbursement guidelines often override other coding guidelines. If you have BCBS insurance, and if BCBS has this criteria, then you are left with the option to code Dx 471.9 if the document justifies using 471.9, otherwise you will not be covered by BCBS. </p> http://www.supercoder.com/forum/topic/can-4719-be-used-to-support-aspirin-desensitization-95180#post-10309 Tue, 10 Jan 2012 21:23:38 +0000 Try Super 10309@http://www.supercoder.com/forum/ <p>Per BCBS NC, pt was told he has no benefits for 95180 under his personal policy, but then was told they would allow it if a diagnosis code of 471.9 was used. I have been unable to confirm that this can be used. -Bonnie </p> http://www.supercoder.com/forum/topic/cpt-code-for-joint-injection-and-aspiration#post-10286 Tue, 10 Jan 2012 17:40:23 +0000 Zakari Tata 10286@http://www.supercoder.com/forum/ <p>how about the depo medrol administration, don't we need the 96372 together with J1030? Thank you </p>