The new CPT® codes are for only nonphysician practitioners who cannot report their own evaluation and management (E/M) services.
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Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers Click here for more sample CPC practice exam questions and answers with full rationaleThe new CPT® codes are for only nonphysician practitioners who cannot report their own evaluation and management (E/M) services.
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I know you probably see this question a lot. My scenario is a patient is possibly schizophrenia. The rheumatologist provider does not establish medical necessity to support patient is schizophrenia. Provider mentions that patient has memory loss in both the HPI and exam. Is is acceptable for me to report memory loss in conjunction to schizophrenia? Can you please put valid sources?
I can’t find a CPT code correlates to this test. CPT 99483 keeps coming up but the billing requirements are much more detailed. I’m wondering if in order to bill for something like this, we would also need to meet all the requirements in that code.
I know it’s pretty specific and a long shot but if anyone can help with me this, I’d be so appreciative.
I am having a hard time figuring out the correct way to bill these codes. Per the definition, they must used to "bill for services provided to patients who are not diagnosed with a psychiatric problem, but whose cognitive, emotional, social, or behavioral functioning affect prevention, treatment, or management of a physical health problem."
An example given to me was a person who has stomach aches due to their anxiety. I found a resource online from Optum360 that gives a list of diagnostic codes to use with these CPT codes, but they do not make sense to me. I was hoping for some insight from my fellow coders. How do these codes fit under a physical health problem? I do understand that they could have physical health problems due to these issues, but as a standalone issue?
Z59.7 Insufficient social insurance and welfare support
Z60.0 Problems of adjustment to life-cycle transition
Z60.2 Problems related to living alone
Z62.29 Other upbringing away from parents
Z62.891 Sibling rivalry
Z63.0 Problems in relationship with in-laws
Z63.8 Other specified problems related to primary support group
Z64.4 Discord with counselors
Plus many more that fall along those lines.
Thank you!
Erin
I’m a new coder and I think I know the answer to my own question, but I would just like a 2nd opinion.
I am coding an urgent care visit. Diagnosis is otitis media, Pharyngitis and Vertigo. He has documented enough for the OM and pharyngitis, but there is really nothing to support the vertigo dx. In the ROS under Neuro, he has circled "dizzy". However, it is not mentioned ANYWHERE else on the encounter form. I know that dizziness can certainly be caused by ear problems, but I’m not comfortable putting "vertigo" as a dx. I just coded for the OM and Pharyngitis. Am I right?
Thanks for any insight you can offer!
Amy
Urgent Question:
For Mental Health/Behavioral Health/Substance Abuse Services- Nebraska Medicaid- will not allow this code to be billed but said to look for similar CPT codes that would service this purpose and are billable.
Does anyone know of other CPT codes that would cover the same type of service as 96127- for MDs, Nurse Practitioners, and Licensed Therapists?
Thanks.
Urgent Question:
For Mental Health/Behavioral Health/Substance Abuse Services- Nebraska Medicaid- will not allow this code to be billed but said to look for similar CPT codes that would service this purpose and are billable.
Does anyone know of other CPT codes that would cover the same type of service as 96127- for MDs, Nurse Practitioners, and Licensed Therapists?
Thanks.