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First, Humana DID pay 80%. It's 80% of the allowed amount, not 80% of billed charges. $763.96 x 80% = $611.17.
But here's the thing... unless it is in the deductible period at the beginning of the ... [ Read More ]
Any advice would be appreciated.
I have an example of a patient that has Humana Medicare Replacement as primary and Medicaid as secondary. Billed amount $2,150. Humana allowed $763.96 and paid $611.17... [ Read More ]
[B]Procedures:
INCISION AND DRAINAGE OF ABSCESS WITH REMOVAL OF FOREIGN BODY[/B]: The plantar surface of the right foot was cleansed with Betadine swab sticks ×3. No local anesthesia was used. Th... [ Read More ]
Per NCD 20.15 its not covered for routine other than the initial welcome to medicare visit.
[QUOTE][COLOR=#000000][FONT="]There is no coverage for EKG services when rendered as a screening test o... [ Read More ]
[QUOTE="elizabethcaste, post: 426935, member: 344648"]How do you code a patient that is coming for therapy services and dx is status post rt shoulder arthroplasty?[/QUOTE]
Didn't see any replies, so ... [ Read More ]
[QUOTE="Chelsea1, post: 410292, member: 166144"]I do not know which stent code to use for the following portion of this report;
Using a LIMA guiding catheter, the ostium of the LIMA graft was cannuli... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
[QUOTE="kseverson, post: 402961, member: 40199"]I am a certified coder. In my current job, I'm an office manager and do the coding along with all the other office management tasks. I'm thinking abou... [ Read More ]
Find out if bunionectomies and sesamoidectomies can be coded together. Within your podiatry practice, you no doubt come across patients dealing with the discomfort and prevalence of bunions. Numerous CPT® and ICD-10-CM codes are available for documenting bunions and their [...]
Question: Encounter notes indicate that a patient reports to the surgeon with a bunion on their right great toe. The provider removes bone from the bunion, and also removes the sesamoid bones under the great toe. Can I code the sesamoidectomy [...]
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Understanding when to use surgery codes will increase your practice’s payout. Performing incision and drainage (I&D) procedures is a fundamental aspect of a podiatrist’s role. However, the frequent execution of these procedures does not necessarily guarantee their accurate reporting. Here [...]
Are you as brainy about bunions as you think? Once you’ve answered the quiz questions on page 3, compare your answers with the ones provided below. Answer 1: The primary difference between a bunion and a bunionette is location. A [...]
Question: What’s the difference between G0141 and 88141, and when should we use one code over the other? Texas Subscriber Answer: Both codes describe physician interpretation of an abnormal Pap smear: G0141 (Screening cytopathology smears, cervical or vaginal, performed by automated system, [...]
An estimated 1.5 million people suffer a traumatic brain injury each year. Before Oct. 1, 2021, you were limited to using traumatic brain injury (TBI) codes to report brain compression conditions. Now, with newly added traumatic brain compression codes and [...]
Check out the surgical options your provider might employ. When your provider treats a patient with heel spurs, the devil’s in the details. How? You need to know if your provider removed part of the calcaneus during the surgery. Additionally, [...]
Remember: Heel spurs are also known as calcaneal spurs. If your podiatrist performs surgery to treat heel spurs, you must check the medical documentation for numerous details including if your podiatrist removed part of the calcaneus during the surgery. Additionally, [...]
Increase Diagnoses Coding Compliance with Medicare Transmittal and Manuals directives right at code level.