http://www.supercoder.com/forum/ Supercoder - Ask an Expert? Forum: Neurology Coding - Recent Posts en Sun, 12 Feb 2012 11:51:12 +0000 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/cpt-code-for-doppler-laser-imager-flasher#post-11314 Fri, 10 Feb 2012 03:32:06 +0000 Maqbol 11314@http://www.supercoder.com/forum/ <p>what is a CPT code for Doppler Laser Imager Flasher. this procedure is used for evaluation of small fiber neuropathy. I could not find it in the search on this site. </p> http://www.supercoder.com/forum/topic/new-emg-codes-958859588695887#post-11313 Fri, 10 Feb 2012 03:25:08 +0000 Maqbol 11313@http://www.supercoder.com/forum/ <p>very informative link, thnx Sanjit! It solves a lot of issues. </p> http://www.supercoder.com/forum/topic/how-do-you-code-the-reprogrammingmaintance-on-a-baclofen-pump#post-11262 Wed, 08 Feb 2012 17:49:09 +0000 Renita Bowman 11262@http://www.supercoder.com/forum/ <p>How do you code when a patient is seen by a physician and all he does is the reprogramming/maintance of the patients baclofen pump, which code do I use? Also how do you code if the physician does a reprogram and refill of the pump?</p> <p>Thanks for you help. </p> http://www.supercoder.com/forum/topic/j3030#post-11237 Tue, 07 Feb 2012 18:48:36 +0000 BARBARA PRATER 11237@http://www.supercoder.com/forum/ <p>Thanks </p> http://www.supercoder.com/forum/topic/new-codes-95938-95939-primary-for-95920#post-11216 Mon, 06 Feb 2012 21:04:48 +0000 Diane Welsh 11216@http://www.supercoder.com/forum/ <p>I'm not convinced. It is true that 95938 and 95939 do not numerically fall within the 95925-95937 range, but they do fall within the range as sequenced in CPT. 95938 is between 95926 and 95927, 95939 is between 95929 and 95930. </p> http://www.supercoder.com/forum/topic/j3030#post-11211 Mon, 06 Feb 2012 19:29:02 +0000 Sanjit Mishra 11211@http://www.supercoder.com/forum/ <p>HCPCS----Code Description------HCPCS Code Dosage-----Payment Limit<br /> J3030----Sumatriptan succinate--- 6 mg ----------------- $75.197 </p> http://www.supercoder.com/forum/topic/simple-vs-complex-brain-neurostimulator-coding-changes-2012#post-11204 Mon, 06 Feb 2012 16:57:13 +0000 Amy Allen 11204@http://www.supercoder.com/forum/ <p>Any other ideas on this?? </p> http://www.supercoder.com/forum/topic/new-codes-95938-95939-primary-for-95920#post-11198 Mon, 06 Feb 2012 15:23:30 +0000 Sanjit Mishra 11198@http://www.supercoder.com/forum/ <p>As per book published by AMA, 95938 is not a Primary CPT for CPT 95920. </p> http://www.supercoder.com/forum/topic/new-emg-codes-958859588695887#post-11193 Mon, 06 Feb 2012 10:44:34 +0000 Sanjit Mishra 11193@http://www.supercoder.com/forum/ <p>I hope this link will answer your queries:<br /> <a href="http://www.aan.com/globals/axon/assets/9099.pdf" rel="nofollow">http://www.aan.com/globals/axon/assets/9099.pdf</a> </p> http://www.supercoder.com/forum/topic/j3030#post-11188 Sun, 05 Feb 2012 17:28:53 +0000 BARBARA PRATER 11188@http://www.supercoder.com/forum/ <p>Can anyone tell me what the medicare allowable fee is for the J3030? I am in Florida. thanks </p> http://www.supercoder.com/forum/topic/intraoperative-monitoring#post-11172 Fri, 03 Feb 2012 23:05:30 +0000 Sanjit Mishra 11172@http://www.supercoder.com/forum/ <p>CPT 95961 ( Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or depth electrodes, to provoke seizures or identify vital brain structures; initial hour of physician attendance) code should be used for the first hour of attendence.<br /> *<br /> For any subsequent attendence CPT 95962 (each additional hour of physician attendance) should be used.<br /> *<br /> Also CPT codes 95961- 95962 (functional cortical mapping) are not eligible for the 95920 (intraoperative neurophysiology testing per hour) hourly add on code.<br /> *<br /> *<br /> Only one unit of 95925 can be used regardless of the number of nerves or dermatomes (skin sites) that are stimulated in each upper limb (on one or both sides). Similarly, only one unit of 95926 can be used regardless of the number of nerves or dermatomes (skin sites) that are stimulated in each lower limb (on one or both sides). Note that the codes are defined as bilateral codes. Modifier 52 must be used for unilateral studies </p> http://www.supercoder.com/forum/topic/new-codes-95938-95939-primary-for-95920#post-11159 Fri, 03 Feb 2012 18:00:57 +0000 Diane Welsh 11159@http://www.supercoder.com/forum/ <p>It seems logical that <code>95938</code> would be reported as a primary procedure for add-on code <code>95920</code> since <code>95938</code> is a combination of <code>95925</code> and <code>95926</code> which are both primary procedures for <code>95920</code>. Unfortunately CPT doesn't include <code>95938</code> or <code>95939</code> in the note following +<code>95920</code>.<br /> "Use 95920 in conjunction with the study performed, 92585, 95822, 95860, 95861, 95867, 95868, 95870, 95900, 95904, 95925-95937".<br /> Is this an oversight? Does the AMA intend to correct CPT? </p> http://www.supercoder.com/forum/topic/new-emg-codes-958859588695887#post-11148 Fri, 03 Feb 2012 04:05:59 +0000 ELI LEHRMANN 11148@http://www.supercoder.com/forum/ <p>Thanks for the reply. What would the Qualifying Service" be for 95886? </p> http://www.supercoder.com/forum/topic/intraoperative-monitoring#post-11136 Thu, 02 Feb 2012 21:26:58 +0000 Marina Daviti 11136@http://www.supercoder.com/forum/ <p>superbill received:<br /> 95961 X 12<br /> 95925 x 12<br /> 95926 x 12<br /> 95920 x 12<br /> As per my understanding, only 95920 is billed per hour. Baseline intraoperative procedures can be reported only once.<br /> What code should we use for electrodes(37 were used during operation ). </p> http://www.supercoder.com/forum/topic/new-emg-codes-958859588695887#post-11109 Thu, 02 Feb 2012 15:19:22 +0000 Sanjit Mishra 11109@http://www.supercoder.com/forum/ <p>CPT codes 95900 and 95903 may be billed together for the same patient on the same day of service when multiple nerves are tested, some with and some without F waves, because in that case they describe 2 distinct and independent services provided on the same day.<br /> *<br /> However, CPT codes 95900 and 95903 cannot be billed together for the same nerve in a given patient on a given day. It is appropriate to add modifier -59 when billing 95900 and 95903 to indicate separate and distinct procedures on the same patient on the same day. </p> http://www.supercoder.com/forum/topic/new-emg-codes-958859588695887#post-11077 Wed, 01 Feb 2012 04:41:32 +0000 ELI LEHRMANN 11077@http://www.supercoder.com/forum/ <p>Need some guidance please.</p> <p>Billed the following, with the following denials:</p> <p>95903 x2 units Denied for needing a Mod<br /> 95904 x2 units Denied for needing a Mod<br /> 95868 m59 x2 units Denied for max 1 unit/day<br /> 95869 m59 x1 units Allowed and Paid<br /> 95886 x1 units Denied for Global/Qualifying Service Missing/Not Identified</p> <p>Why do the NCS codes (95903/95904) need a Mod?<br /> What service does 95886 need as a qualifying service?<br /> Why can the Doc only do 1xunit of 95868?<br /> What should the correct coding be?</p> <p>Thanks!<br /> Eli </p> http://www.supercoder.com/forum/topic/simple-vs-complex-brain-neurostimulator-coding-changes-2012#post-10996 Mon, 30 Jan 2012 15:17:23 +0000 Amy Allen 10996@http://www.supercoder.com/forum/ <p>But in 95974 it states "complex" cranial nerve neurostimulator, and under the new definition of what "complex" is, if they change less than 3 parameters, wouldn't this now be considered a "simple" programming? </p> <p>Perhaps they normally change more than 3 parameters with cranial nerve neurostimulators..... I just wasn't sure. </p> http://www.supercoder.com/forum/topic/simple-vs-complex-brain-neurostimulator-coding-changes-2012#post-10980 Sun, 29 Jan 2012 21:41:43 +0000 Sanjit Mishra 10980@http://www.supercoder.com/forum/ <p>I think 95974 will work.<br /> 95974: Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour<br /> *<br /> Please let me know if this answer addressed your question or not. </p> http://www.supercoder.com/forum/topic/simple-vs-complex-brain-neurostimulator-coding-changes-2012#post-10941 Fri, 27 Jan 2012 17:20:42 +0000 Amy Allen 10941@http://www.supercoder.com/forum/ <p>In 2012, CPT changed the definition of a simple vs. complex neurostimulator. Instead of being defined based on what parameters the stimulators are CAPABLE of changing, they are instead based on how many are ACTUALLY CHANGED during the programming. (3 or less = simple, more than 3 = complex).</p> <p>There are simple reprogramming code options for spinal cord and peripheral neruostimulators, but not cranial. The only programming option available for cranial is complex. </p> <p>So my question is....how do I code the procedure if 3 or less parameters are changed on a cranial nerve neurostimulator (like VNS)? </p> http://www.supercoder.com/forum/topic/inpatient-consultation-consultation-requested-by-members-of-the-same-group#post-10743 Mon, 23 Jan 2012 18:14:48 +0000 Jennifer Godreau 10743@http://www.supercoder.com/forum/ <p>Laz, CPT 2012 makes the answer, "Yes, you can charge for consultation services in these situations." Prior to the revised EM guidelines in CPT 2012, I would have still hedged toward yes, but the answer is now definite.</p> <p>Here's the article as covered in Part B Insider Nov 2011:</p> <p>It’s an age-old debate–when an established patient presents to your practice to see a new physician, should you report a new patient office visit code? CPT® 2012 attempts to clarify when that’s possible with a revision to the “New and Established Patient” section of the CPT® manual.</p> <p>The rules: Currently, CPT® indicates that a “new patient” refers to a patient who has not received any professional services, such as an E/M or other face-to-face service from the physician or physician group practice – within the same physician specialty – within the past three years.</p> <p>Clarification: CPT® 2012 takes that definition a step further, now stating, “A new patient is one who has not received any professional services from the physician or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.” The portions of the description that are new for 2012 are underlined.<br /> What this means to you: If your practice employs various subspecialists, CPT® now makes it clear that claims for patients who see different doctors with different subspecialties can be billed using a new patient code (such as 99201-99205). Peter A. Hollmann, MD, chair of the CPT® Editorial Panel, offered the following example during the CPT® 2012 Annual Symposium in Chicago on Nov. 16:</p> <p>Example: A cardiology practice employs a general cardiologist and an electrophysiologist (EP), and both physicians are classified as these separate specialties with their payers. The cardiologist refers a patient to the EP for consideration of an implantable cardiodefibrillator. In this situation, the visit with the EP should qualify as a new patient visit, assuming the payer accepts these CPT® rules.</p> <p>Glad to share some good news,<br /> Jen Godreau, CPC, CPMA, CPEDC<br /> Director of Development &amp; Operations<br /> SuperCoder.com from the Coding Institute, LLC </p> http://www.supercoder.com/forum/topic/x-code-for-neuropsych-testing#post-10714 Fri, 20 Jan 2012 20:17:58 +0000 Kim Mchaffie 10714@http://www.supercoder.com/forum/ <p>As mentioned above, we tried to bill X9524 to match with 6 hrs, but the claim was denied due to invalid code. Per CCS website, the X9524 is not authorized in service code-02, only X9514 (one hour) and X9516 (2 hours). Also, my co-worker called to talk with case manager and they said to use X9514! Really a conflicting everything! That's reason I need help how to bill X code for neuropsych testing... </p> http://www.supercoder.com/forum/topic/inpatient-consultation-consultation-requested-by-members-of-the-same-group#post-10584 Tue, 17 Jan 2012 20:53:02 +0000 Luz 10584@http://www.supercoder.com/forum/ <p>We are a group of Neurologist,with 13 diffferent subspecialty (for example Epilepsy vs NeuroOncogist) and they all bill under the same group number as neurologist. My question is if one of the physician admit the patient then ask another physician of the same group but different subspecialty-to see the patient in consultation (same date of service) because of a problem related to his/her subspecialty, would both of the service billable? Or how would you advise to code these services.</p> <p> The same scenario as described above but two consultation services. Each subspecialty medical expertice is beyond the requesting professional knowledge of each other. </p> http://www.supercoder.com/forum/topic/therapeutic-injection-for-cts#post-10551 Tue, 17 Jan 2012 04:30:15 +0000 Deepak Ahuja 10551@http://www.supercoder.com/forum/ <p>CPT 20526 is correct for therapeutic injection. </p> http://www.supercoder.com/forum/topic/therapeutic-injection-for-cts#post-10534 Mon, 16 Jan 2012 18:58:16 +0000 Patti Koski 10534@http://www.supercoder.com/forum/ <p>Dr. wants to know what the best code is for a therapeutic injection for carpal tunnel and cubital tunnel. He says it is not a nerve block. So is '20526' the correct code? </p> http://www.supercoder.com/forum/topic/x-code-for-neuropsych-testing#post-10304 Tue, 10 Jan 2012 20:10:28 +0000 Leigh DeLozier 10304@http://www.supercoder.com/forum/ <p>I found some Medi-Cal info online that lists X9514 as what you report for the test and pre-interview up to a maximum of 6 hours. My understanding from that info is that you'll only report 1 unit of X9514 for your test. If that policy's still in place, that would be why they didn't reimburse you for multiple units on your second claim -- you only get 1 unit of X9514 because it represents the 6 hours you're reporting. </p> http://www.supercoder.com/forum/topic/need-dx-code-1#post-9977 Thu, 29 Dec 2011 22:29:22 +0000 Sanjit Mishra 9977@http://www.supercoder.com/forum/ <p>782.0 </p> http://www.supercoder.com/forum/topic/need-dx-code-1#post-9961 Thu, 29 Dec 2011 18:18:07 +0000 Heather Jackson 9961@http://www.supercoder.com/forum/ <p>NEED DX CODE FOR SOFT TISSUE HYPERSENSITIVITY </p> http://www.supercoder.com/forum/topic/dx-for-spastic-hemiplegia-due-to-an-intrauterine-stroke#post-9815 Wed, 21 Dec 2011 23:23:05 +0000 Sanjit Mishra 9815@http://www.supercoder.com/forum/ <p>342 Category of Codes: Hemiplegia and hemiparesis<br /> ----------------------<br /> Note: This category is to be used when hemiplegia (complete) (incomplete) is reported without further specification, or is stated to be old or long-standing but of unspecified cause. The category is also for use in multiple coding to identify these types of hemiplegia resulting from any cause.<br /> *<br /> hemiplegia due to late effect of cerebrovascular accident (438.20-438.22)---- Most appropriate, if Late Effect.<br /> infantile NOS (343.4)-----You will agree that this will not be applicable in this case.<br /> The following fifth-digits are for use with codes 342.0-342.9<br /> 0 affecting unspecified side<br /> 1 affecting dominant side<br /> 2 affecting nondominant side </p> http://www.supercoder.com/forum/topic/dx-for-spastic-hemiplegia-due-to-an-intrauterine-stroke#post-9802 Wed, 21 Dec 2011 19:29:29 +0000 Lynne Gardner 9802@http://www.supercoder.com/forum/ <p>Patient is 54 years old.<br /> We've had different opinions in the office on how to code this. Use the 'late effects - 438' code? Use 343.4 ? (Even if 'cerebral palsy' is not stated) </p>