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Latest activity
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Rrahul.verma1@optum.com posted the thread Question Billing of 11042 with 37224, 37228 in Billing/Reimbursement.Is this a correct billing if performed on the same limb. Pre-op diagnosis: Peripheral arterial disease with nonhealing foot wounds Procedure: Access taken from right and 37224, 37228 was performed on left. After that, 11042 was also performed on...
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Ssdifuh278652 posted the thread Wiki Doctor Consulting A Doctor Of Different Specialty In Same Hospital - MDM in E/M.Hello, When a doctor consults with another doctor of a different specialty within the same hospital, and the consultation isn't reported separately with a consultation code, does it count towards Category 3, "discussion of management with other...
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NNRaizman replied to the thread Wiki Is 64585 appropriate for removal and replacement?.I think, I may actually be wrong here - see my extended comment below
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NNRaizman replied to the thread Wiki Is 64585 appropriate for removal and replacement?.I am reading more and more on this and I can see that I am wrong and that an argument -could- be made for 64555. The other related family codes lump "insertion or replacement" and "revision or removal" together, though the specific codes 64555...
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JIf a patient has Commercial insurance primary and traditional Medicare secondary how do you bill to receive credit for the AWV with Medicare? If the primary is billed for the G0439 will the primary payer deny as a contractual obligation?
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NHello, In the February edition Proper Use of Modifiers 59, XE, XP, XS & XU booklet , from the CMS website, they are recommending on when it is Appropriate & Inappropriate use the 59 or XU , it is very confusing to me as they write we may or may...
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GGator replied to the thread Wiki Vaginal Swab.99000 but, it really never gets paid. Swabs are included in what ever level of E&M was billed.
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GGator replied to the thread Question Bilateral injections and billing with united healthcare.https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-reimbursement/COMM-Bilateral-Procedures-Policy.pdf The J codes that get the JZ mod should not have a side RT/LT/50 modifier. Those mods would be for the administration...
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NNRaizman replied to the thread Wiki E/M with Joint Injections – Orthopaedics Compliance Issue.The above note documents a fairly clear evaluation, confirms that the patient is not at her treatment goal, suggests that she is indicated for surgery and that a discussion of surgery was performed and the patient elected to defer surgery to a...
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pclaybaugh reacted to jkyles's post in the thread Wiki E/M with Joint Injections – Orthopaedics Compliance Issue with
Like.
I think the "cross-out test" as explained below is helpful here... -
pclaybaugh replied to the thread Wiki E/M with Joint Injections – Orthopaedics Compliance Issue.Thank you so much for your insight—I really appreciate you taking the time to respond. You were absolutely right about the example I originally shared; after a closer look, it does meet criteria for a separate E/M. I've since posted a better...
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jkyles replied to the thread Wiki E/M with Joint Injections – Orthopaedics Compliance Issue.I think the "cross-out test" as explained below is helpful here... -
jkyles reacted to NRaizman's post in the thread Wiki E/M with Joint Injections – Orthopaedics Compliance Issue with Like.
That is not at all what the NCCI Policy Manual says! If you want to quote it, it reads, "The decision to perform a minor surgical procedure is included in the payment for the minor surgical procedure and shall not be reported separately as an...
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Rrachel.ford@uihs.org reacted to maryek28@outlook.com's post in the thread Wiki Can 90791 be billed as an e/m code instead? with Like.
My clinic is wanting us to start billing psych evals as an e/m code instead of 90791. Is this appropriate? My view was that since we are supposed to use the code that most accurately describes the service, and there is a specific code for psych...
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SSDargaj replied to the thread Wiki Help billing Wound care supplies.What is the POS? Facility or profee?