general coding

  1. M

    Wiki Can you pull a diagnosis from a test result?

    We have a bit of a disagreement at my work on interpretation of test results. An example would be: Patient is seen for CKD, congestive heart failure, hypertension and various other issues. The doctor never states the stage of CKD. However he does have an estimated GFR in the test results. Is...
  2. S

    Wiki I need coding help for a surgical procedure

    Hello, I don't generally code inpatient. I have a complaint that a surgical procedure for an overnight patient in the hospital for surgery (surgeon) was coded incorrectly. What would be considered accurate for 31256 CPT with ICD10 H53.9 ? Can you please tell me how this would be coded for...
  3. J

    Wiki 96402 denied for prostate cancer diagnosis

    BCBS of IL is denying 96402 when billed for C61, prostate cancer. The denial states "missing/invalid diagnosis or condition". I have found that they are paying J9217 from the drug, but not 96402 and they have the same diagnosis code. I have been unable to locate any policy to explain this. Does...
    • jball
    • Thread
    • general coding prostate urology coding
    • Replies: 2
    • Forum: Urology
  4. B

    Wiki 69210 vs 69421

    Hi all, I'm new to coding outpatient surgical procedures done in a hospital setting. 1. A patient is having tubes removed under general anesthesia and there is cerumen removed from the same ear. How do I decide which code to use? 69210 OR 69421. I know I can't use both. 2. Does the OP note...
  5. R

    Wiki GC Modifier

    I am having a very hard time finding the guidelines for using the GC modifier with Medicaid patients. I was told Medicaid does not accept the GC modifier. We have a new auditor that disagrees. I need to have proof. Of course, I cannot find proof now that I need it. Can anyone lead me to how to...
  6. R

    Wiki GC Modifier

    Does anyone know if Medicaid accepts the GC modifier? We get denials on these but I cannot find anything on line to support the denial. thanks
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