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L
This has bothered me for years!! If 75635 is for a CTA arterial runoff, can we use this for a CTV, like the MRA/MRV, or do we really have to break it down into 73706/74174(5) ??
M
Medicare institutional complex billing specialist here specialized in claims investigator audit, research, improper payment validation, return-to-provider, payment validation, CWF and centralized database proficient looking for CMS Medicare specific roles.
P
ANY LEADS on RISK ADJUSTMENT REMOTE EMPLOYMENT?
I am CERTIFIED CPC; CRC however I have not been able to utilize the CRC certification while in my present coding position.
Interested in transitioning my role to CRC position.
PREFER REMOTE WORK. Thank you for any suggestions.
A
Hi folks...i have a concern over reporting of RPM code 99454. Is it possible to report 99454 on January 30th and then again on February 28th? this falls within 30 days period but not in the same month...please advise!
J
Good morning, we are going to start having a Respiratory Therapist doing the breathing treatments for our patients and I was wondering if anyone knew how we would go about coding and billing when a RT does it vs a Nurse doing it? Thank you!
F
Hi, I may be in the wrong place. I am taking the Certified Billing course self-study I am finding it to be more challenging than I thought it would be. I am looking for tutoring or guidance on this class. Can you please offer advice on where I can go for help and if there are any tutors willing to help with my billing course
L
Finish Practicode !!! last week, waiting for my A to be removed. It was part of my package deal through my class, do I need to call or will it get done automatically? it says 4 to 6 weeks anyone know if that's true?
L
Hello, has anyone had any luck billing the new AMA/CPT telemedicine codes so far? We are receiving denials from Highmark and UHC so far and had no response from other commercial insurances. Any advice would be appreciated. Thanks!
A
Hello, my name is Autumn. I did see your post about hiring in Arkansas for CPC-A 's and you provide training as well. I am interested in a position. Is there contact information on how I can apply?
T
I have a patient that presented to clinic for a Preventive Wellness visit. During which she had an acute problem that the provider addressed in HPI, ROS and PE, and for the plan she done a referral. Is this enough to qualify for a significantly separate E/M?
C
chantal777
Good morning Treman,
Yes. If during an AWV the physician addressed a new or existing problem and well documented in the A/P therefore, the encounter is eligible for an office visit with -25 modifier.
Michele
E
Hello, I have 2 questions.

Q1- Where do I find the updates/changes CPT 2025 Mental Health codes? Such as the E/M codes and therapy.


Q2 - Is Adult Day treatment cpt H2012. What are the requirements that must be met to bill that service? Current practice is billing 3 units per day if requirements are met. (1 unit =60mins). Recently I heard, the 3 units must be met within a 7 day period, not sure how true that is.
D
I am presently seeking some advice from fellow cardiology coders regarding EKG documentation.
Sample: the EKG is performed prior to MD seeing the patient by office nurse, does the MD confirm, sign and date the EKG prior to adding to the patient's electronic chart?
Also, is the EKG findings documented in the patient's progress note. Thank You!
T
TThivierge
Yes the radiologist reads the EKG or doctor then give dx code on outcomes. All this data should be on the EKG final report and provider will mention confirmed results of EKG in treating documenting for the day.
B
Hello members
I am trying to code for 22802:-Arthrodesis posterior for spinal deformity with or without cast 7 to 12 vertebral segments. The Medicare is kicking this code back for LCD/diagnosis reason. Does anyone know an appropriate diagnosis code to use for Medicare payment or which goes with LCD. Also there is no LCD article for the 22802 code. Thank You
Pam Warren
Pam Warren
That LCD was retired in March of 2024. When's your date of service? A draft article is in process. DA59664.
H
clarification: a covid shot was given the same day as a flu shot. the covid administration is 90480. Will the flu shot administration be coded with a 90471 or a 90472 (because it is the 2nd shot given today)?
S
Looking for clarification. I coded 1-M47.26, 2-M48.061, 3- M99.73. Is this correct? If not why? History- Disc degeneration of the lumbar spine. Impression- 1- lumbar spondylosis, including advanced lumber facet arthrosis. 2- L3-L4 mod to severe central canal stenosis. Mild/mod bilat foraminal stenosis. 3- L4-L5 Mod central canal stenosis. Mild/mod rt foraminal stenosis.
C
We recently starting doing Peripheral Nerve Stimulation trials, CPT 64555 billed twice, and now they are wanting to do the permanent placement. This would be CPT 645902, 64555 & 64555 but it is within 365 days of the trial and I am unsure if they will pay the 64555 code more than twice in that 365 day period. Does anyone have any experience with this?
B
How would you code history of tobacco use, currently on nicotine patch? I have had this question come up on an exam, but not sure if I answered correctly. Thank you in advance.
K
I have a question regarding uremic encephalopathy & CKD. if a patient is admitted with drowsiness & he is already a AKI on CKD patient. In this scenario what would be the PDX?
S
I am a CPC in Texas, if there is no provider in the office, can the office open?
A
ajanz54
I have a question, Documentation stated, Obesity with BMI 54.3. How would this be coded, is it E66.8 & Z68.43?
N
Hello. In the world of HCC, can a diagnosis be captured for DM2 without it being addressed anywhere in the note except PMH and meds for Insulin?
R
Pt came with Displaced Hill sachs fracture and provider have done reduction procedure to the fracture site,
which CPT Can we give for this scenario?
P
I'm a new coder. 99441-99443 cannot be billed by same provider within 7 days of E/M service. Would if make a difference if there is completely different dx codes?
S
Hello, I am having a hard time trying to figure out which code is the most appropriate one for this case. Patient had radiation irritation through out the bladder neck, which extended into the prostate. Dr. carefully and superficially resected this area and treated any areas of radiation changes. Chips were sent for pathology. I am going between 52500 and 52601 any help is very much appreciated. TIA
N
Hello i work on a FQHC and I am having issues billing Cervical cancer screening for Medicare , is it G0466 ? Does G0466 covers G0091? Please help me!
Thank you
B
Hi, are you doing self-paced or instructor lead?
K
Kfarrish36
Hi Brandy! Sorry I didn't respond sooner! I am self paced but need to get it done because I actually bought this last July!! I unfortunately haven't been able to get started. I was diagnosed with ADHD this year so thankfully they gave me an extension. So now I have to get both the billing and coding stuff done by October!! I think I can (fingers crossed)! How about you?
L
Can anyone advise if billing for a FQHC if a patient comes in for a anoscopy 46607, would you bill this to the MAC part B in an outpatient office? POS 11
A
good morning. My name is Angela. I am a new student member from Chicago. Are there any meetings in the Chicago area I can attend? I am not certified yet, I take my exam in August this year.

thanks
C
Question - I am new to the RHC. I have reviewed all the site I can. I have a question about the EOB and the whold. Do you know where I can find more information. or a - amount on the eob?
B
Hey-- I saw you posted a few years ago about an opportunity for remote work as a CPC-A. Any chance you know of any current openings?
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j2pricey
j2pricey
Omg I was wondering the exact same thing!!! 🙏 even if I need to take an e/m cert to add yo my credentials this role seemed so ideal
J
Hello I was wandering when is the next chapter meeting for the Bronx .I've ,missed the online one on saturday morning at 9am which usually my laundry day so I was able to log in ontime but still had time to be in the meeeting
N
  1. Can we bill Graft along with other procedure, say for example CPT 17250 or should we send a separate claim for Graft and a separate claim for other procedures.
  2. Can we bill nail debridement CPT 11042 / 11043 along with Graft, if the service is done on wounds/diagnoses unrelated to the wound that received the graft.
  3. Can we use modifier 59 for CPT 11042 / 11043
E
EmilyC
Typically debridement (11042-11046) is included in graft placement when performed on the same wound.

If the patient had multiple wounds and the physician debrided one wound, but placed a graft on a separate wound, you can bill for both the debridement and the graft with a mod 59, but the note must clearly state that wound A was debrided and wound B had a graft placement.
E
EmilyC
There are no CCI edits saying you can't bill 17250 w/graft, but you can't use with debridement. I would also look through Medicare's policy manual. It comes up if you google "Medicare wound care guidelines" just to be sure.
O
We give IV chemotherapy infusions and shots in our office. Occasionally a patient will react to this, and we put put our AED paddles on them just in case, occasionally have to start CPR. How do we bill for this? The AED paddles cost approximately $250 a pair. Usually EMT gets there with in 15 minutes and takes over care and takes them to the hospital within another 15 min. Thoughts?
A
My OT want to charge cpt 96156 from what I am reading that only healthcare professionals who may report E/M services or preventive medicine services can report this. Am I on the right track?
S
the denial code & reason:
97​
:​
The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.​
H
Now that many Anthem plans require prior authorization for 11750, or 11730, how are you handling the appointments in the office? Are the nurses calling or using Availity to approve prior to the procedure? Or are you rescheduling the patient to come back? JJ
C
What diagnosis code is being used, if any, for a non smoking patient? Let me rephrase my question - if a provider wants to indicate that a patient is a non smoker on their insurance claim what is the correct diagnosis code to use?
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