Neurology & Pain Management Coding Alert
Understanding Transitional Facility vs. Nonfacility
Question: What is the difference between a transitional nonfacility and a transitional facility? I-m not sure which one our group belongs to or which total RVU group to reference when determining charges. North Dakota Subscriber Answer: If your physicians provide services in any type of doctor's office, you are a transitional nonfacility provider. Understanding the difference and reporting your location correctly is important for accuracy and for reimbursement, as you know: for 2007 the total RVU for a transitional nonfacility was 2.56 and for a transitional facility was 1.90. Some carriers (such as North Carolina Medicare) simply refer to locations as facility or nonfacility. Check your carrier's terminology to further understand what they mean by each term.
Neurology & Pain Management Coding Alert
- Red Flag:
Urinary or Sepsis Problems Can Lead to Neurological Coding Complications
Code neurological conditions based on diagnosis, not symptoms You might be an ace at coding [...] - You Be the Coder:
Multiple-Level EMGs
Question: Should we bill modifier 59 when our neurologist performs multiple levels of EMGs? For [...] - Procedure Basics:
You Can Report 96118, 96119 Separately -- if Details Fit
Watch these 2 areas to keep your claims legit If correctly reporting CPT 96118 and [...] - Compliance:
PHI Release Authorizations Aren't Always Forever
Make sure your authorization to disclose PHI hasn't expired One year ago, your patient signed [...] - Reader Questions:
Watch Documentation for tPA and Critical Care
Question: What is the appropriate way to bill for tPA? Can we bill for tPA [...] - Reader Question:
Consult Criteria May Differ by Payer
Question: I-ve seen information containing consultation definitions that differ from CPT. How do I know [...] - Reader Question:
95920 Can't Coincide With Office Visit
Question: One of our physicians says he can concurrently monitor intraoperative neurophysiology while conducting office [...] - Reader Question:
Reason for Fall Helps Guide Diagnosis
Question: What diagnosis should I report for a patient who falls frequently? New Jersey Subscriber [...] - Reader Question:
Check That Diagnoses You Submit Are in ICD-9
Question: Our Blue Cross carrier denied our claim with diagnoses 847.0, 307.87 and 346.0; the [...] - Reader Question:
Understanding Transitional Facility vs. Nonfacility
Question: What is the difference between a transitional nonfacility and a transitional facility? I-m not [...] - Reader Question:
Verify Details Before Using 95812
Question: Should we report 95812 or 95816 for an EEG obtained in the awake state [...] - Reader Question:
Observe PHI Rules for Patients and Staff
Question: How should a medical facility handle employees- access to their own medical records or [...]
