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Ddemata3 reacted to amyjph's post in the thread Wiki DENIED FOR MISSING/ INCOMPLETE/ INVALID OTHER DIAGNOSIS with
Like.
Agree with all above. This is the bingo! Remove pain codes as advised, do not code signs/symptoms when there is a definitive dx. Change the RT/LT dx to the M17.0 only. Don't listen to reps that tell you to add a 50 modifier to an E/M. (LoL) -
nielynco replied to the thread Wiki G0101/Q0091/S0610/S0612 annual exams!.I created the attached document with regard to billing Medicare which you might find helpful. It includes different scenarios, use of the codes (both CPT and ICD10) and references in case anyone wants to know "where does it say that." I have... -
Sshanamarie replied to the thread Wiki J1010 replacing J1030, J1040 Depomedrol.Sounds like this is something internal you need to figure out. Each manufacturer does have different NDC numbers but I really doubt you are buying multiple different vials from several manufacturers. You can’t determine correct billing without...
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Ttoria11 replied to the thread Wiki High level urology problems?.Thank you for your torsion examples! I'm trying to talk about some examples of high level problems. I'm aware that there's more to determine the overall MDM. Problems addressed is the element that I find is the least often at a high level, so I...
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LHas anyone encountered difficulties enrolling a provider as an out-of-network provider via Availity? Despite submitting the W-9, certifications, and claims via Avality and Mail, the profile still doesn't upload, they are able to pull up the...
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Mmankwan replied to the thread Wiki critical care code 99219 question.thank you JDACPC. any location that including clinic setting?
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CIf the provider is simply reconciling the medication list, that is NOT prescription drug management. Key word "management". Listing prescriptions without evaluation of the problem is not managing the medication. Several MACs gave guidance on...
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TTGETTYS replied to the thread Wiki J1010 replacing J1030, J1040 Depomedrol.I don't remember what website I found it on but I found a crosswalk that shows multiple NDC codes for J1010 (the now new code for J1030 and J1040). If you just google the NDC, they are different for the different manufacturers of the same drug...
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JJim Pawloski replied to the thread Wiki LHC.93459, but why was the leg imaged? Could have done doppler imaging?
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CThank you- Those were my original thoughts(to not work it into my MDM- but I just put the question out there thinking I was missing something because I couldn't figure out why I was asked to work this into my MDM.
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MMrsSpiney replied to the thread Wiki Newbie with breast biopsy question.My question was about the diag. I am sorry if my question was unclear. Is there a different forum for new students for pathology questions? thank you
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CI agree that the issue may be your PA is not fully through the credentialing process. Regarding supervising physician on the claim, you definitely SHOULD include that if you are part of a large multispecialty group. Otherwise you may wind up...
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CDon't look at it from the perspective of what the presenting problem is. Look at it from the documentation. Do some of them code by time instead of MDM? Do you have a more senior coder or manager/supervisor in your practice that has experience...
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Ccarlystur reacted to amyjph's post in the thread Wiki Hospital Consults for Orthopedics Practicess with Like.
Read this: https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c12.pdf It breaks down the scenarios and has examples (if you are billing to MCR or a payer that follows MCR). If talking ED: 30.6.11 - Emergency Department...
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Ttoria11 replied to the thread Wiki Bladder irrigation 51700.51700 is not appropriate when irrigating a catheter, correct? I've seen mixed opinions on this, but I recently found this statement from the NCCI manual from 2022 "Irrigation of a urinary catheter is included in the global surgical package. CPT...