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Recent content by lindam@caricures.com

  1. L

    Wiki Appendectomy w/ partial cecectomy and ileocecectomy

    I am having a similar issue - Appendectomy w/partial cecectomy - Laparoscopy - "we identified the cecum. There was some atypical attachments of the ileum to the appendix. Using the vessel sealing device we took down the fatty attachments. We were now able to retract the appendix up off the...
  2. L

    Wiki 22 Modifier

    copy of OP report - sorry I took the OP report off - I noticed one place I hadn't blacked out patient info
  3. L

    Wiki 22 Modifier

    I have a patient that had multiple large polyps, that took some time to remove. I would like to add Modifier 22 as it was an extensive procedure. I am trying to figure out the best way to submit. Submitting electronically I have no way of adding records. Would you bill electronically and...
  4. L

    Wiki Meritain Insurance

    Not sure I picked the right discussion - but - does anyone have any contact information for Meritain? I am trying to use the provider portal, but something isn't working correctly. It tells me to contact our Meritain Account Representative - we don't have one - does anyone? The phone # on the...
  5. L

    Wiki Modifier 52 on a screening colonoscopy

    I am in PA. Billed Medicare G0105 with modifier 52 because he had a poor prep. Cecum was reached so I didn't use 53. Medicare is denying the claim. N519 Invalid combination of HCPCS modifiers. Claim/service lacks information which is needed for adjudication. Is there a rule about this, can...
  6. L

    Wiki Sitz Mark Study

    We are considering ordering a patient to have a Sitz Mark study done. If we purchase and provide the capsule they need to swallow - how would I bill her insurance for that?
  7. L

    CPT code 45385 & 45380

    I didn't think you could use both 45385 and 45380 if both polyps were in the same area of the colon.
  8. L

    Wiki Can a physician self refer for a procedure

    We are a colon/rectal practice, one doctor, he is doing Anal Manometry in our office with equipment he purchased. Medicare denied claims without a referring doctor. Patient is a long time patient that dr. felt would benefit from this test, so he referred to himself to do the test in our...
  9. L

    Wiki E/M hospital codes

    I have a patient that was in the hospital. He went home for a few days, then he was readmitted. I billed the readmission as an Initial Hospital visit - 99223, but my claim is being denied. Codes - 16 - Claim/service lacks information which is needed for adjudication". I can't figure out what...
  10. L

    Wiki HIGH RISK SCREENING FLEXIBLE SIGMOIDOSCOPY

    I have a patient that had most of her colon removed. She has a family history of colon cancer and MD is doing a flexible sigmoidoscopy. Is there a High Risk Screening code for flex sig? I now G0104 for screening, but what about high risk?
  11. L

    Wiki coding sequence?

    I work for colon/rectal so no EGD's done here. I use modifier 59 when using 45385 and 45380 for different areas of the colon. I use PT for screening turned diagnostic. 53 for incomplete. I've tried using 52 when patient has a poor prep, but it doesn't seem to help when they have it repeated...
  12. L

    Wiki Pouchoscopy with snare polypectomy

    i don't think that would work. That says unlisted for small intestine, but it is the rectum.
  13. L

    Wiki Pouchoscopy with snare polypectomy

    What CPT code would you use for a pouchoscopy with snare polypectomy. Patient has familial polyposis. Dr. snared 3 polyps in the very short rectum. I don't see an option for snare polypectomy with a pouch, only biopsies. any suggestions?
  14. L

    Wiki Colonoscopy into terminal ileum with biopsies

    What code do you use for this? As far as I can tell there isn't a specific code available. Scope being done to r/o Crohn's
  15. L

    Wiki coding sequence?

    I am not a certified biller - just "promoted" to this job. I have been billing Z12.11 as the primary code for a screening colonoscopy when a patient has a history of colon polyps. Isn't that correct? I follow that with personal history of polyps and then the findings. I've been getting paid...
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