Patient was seen in ER and splint was applied. Next day the patient came to the Ortho office as a new patient where a new splint was applied, xrays reviewed, care instructions given and follow up apt made. Doctor billed 26600 fracture care code, can we bill for an e/m with 57 as well since patient was new and decision for fracture care was made at that time? And if there’s any credible sources/articles I can reference? Thank you in advance!
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Tag Archives: bill
Bill for physican assistants rounding in the hospital
I wanted to know what other practices are doing who employ Physician Assistants. We have about 20 in our group. When a community based surgeon dose a surgery that one of our PAs DOES NOT assist on is it ok to charge for an in-patient rounding visit if our PA rounds on that patient? There are sometimes when one of our PAs will assist the community surgeons and then they are in a global period, but if no-one from our group assists in the surgery can it be charged.
I have been told that if the PA is rounding on a surgical patient regardless if one of our group has assisted in the surgery or not that it can not be charged out, but I was not given anything in writing from any organization that shows this. I do have this from Medicare:
The global surgical package, also called global surgery, includes all necessary services normally furnished by a surgeon before, during, and after a procedure. Medicare payment for the surgical procedure includes the preoperative, intra-operative, and post-operative services routinely performed by the surgeon or by members of the same group with the same specialty. Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician
These providers are not in the same group.
Any thoughts are greatly appreciated.
thank you
Can you bill for UA done in office with only documentation being the results?
A patient came in to PCP’s office to do a urine sample- the MA did a urine dip. They billed for 81002 but I do not have documentation by a nurse or doc indicating the patient was here…. I know the patient was because the results are in chart. My question is are the urine results proper documentation to support billing 81002? At my previous practice the MA always did a note with why patient coming in for urine sample and what physician was in the office…etc. and included the results. Newer to auditing and needing some advice. Thank you!
Can you bill for a Vaginosis Panel performed in our FQHC office and if so what code w
Can you bill for a Vaginosis Panel performed in our FQHC office and if so what code would we use?
How to Bill 2 Mental Health Visits on same day for FQHC
Does anyone know how to Bill 2 Mental Health Visits on the same day for FQHC electronically? The codes I have are 90792(telemedicine visit) and 90837 and the G code of G0470 automatically populates with each one as it is added.
I have billed an E/M Office visit code and mental health code before but I cant get this one to work and it says that a modifier can’t be used. Any suggestions will be greatly appreciated! TIA!
Can you bill both a preventive well check AND an annual wellness visit?
If I have a patient with primary UHC and secondary Medicare, can I bill a preventive visit (99387) to be paid by UHC AND an AWV G0438 to be paid by Medicare? This would be assuming all aspects of both services are being performed.
Thanks!
Emily
substance abuse assessment and type of bill questions for detox and residential
Please help
I am new to the substance abuse field and have a few things I wanted to run by anyone who is willing to help. I switched over from cardiology, integ, and podiatry and am now billing for a detox facility, residential and php facility. I was curious if you could help me with two things.
First where can i find the type of bill code for box 4 required for bc claims? I have been searching all over their website and can’t find anything. I read one thread that said to use 11X but i’m not sure if that’s correct or if it would be 86X since we are not a hospital?
The other question I have is the previous billing company was billing intake assessments with the code H0001 and H0002 and they are all denied from all the insurance companies or reimbursing at a really low rate. Would I be able to use an e/m code such as 99408 or 99409? or is there a better code for an initial assessment and also a discharge assesment?
I would really appreciate the help.
Thank you
Sarah CPC
you can respond on here or feel free to email me at [email protected]
detox assessments and type of bill
I am new to the substance abuse field and you seen to have a lot of experience. I switched over from cardiology, integ, and podiatry and am now billing for a detox facility, residential and php facility. I was curious if you could help me with two things.
First where can i find the type of bill code for box 4 required for bc claims? I have been searching all over their website and can’t find anything. I read one thread that said to use 11X but i’m not sure if that’s correct or if it would be 86X since we are not a hospital?
The other question I have is the previous billing company was billing intake assessments with the code H0001 and H0002 and they are all denied from all the insurance companies or reimbursing at a really low rate. Would I be able to use an e/m code such as 99408 or 99409? or is there a better code for an initial assessment and also a discharge assesment?
I would really appreciate the help.
Thank you
Sarah CPC
you can respond on here or feel free to email me at [email protected]
Do you bill for the SAVI or just the insertion?
I have a breast surgeon who inserted a SAVI catheter in the office.
Is there a code for the device in addition to the insertion code?
Thanks for your help!
can i bill for CTO vessel unsuccessful?
I attest that moderate conscious sedation was provided under my direct supervision with the sedation trained nurse using 1 mg of intravenous Versed and 50 mcg of fentanyl to sedate the patient. Start time was 8:47 AM and end time was 9:58 AM. There were no complications. See nurse’s sedation sheet, for complete pre-and post service details.
Hemodynamics:
*
The aortic pressure was 100/57 mmHg.
*
Coronary Angiography:
*
Right coronary artery is medium caliber dominant vessel with severe diffuse disease and 100% mid vessel CTO. Distal vessels filling via collaterals from left to right and right to right.
*
Left Main coronary arteries pain with mild diffuse disease.
*
Left anterior descending is a medium caliber vessel with ostial 99% calcified lesion. Mid mild diffuse disease. Distal focal 60-70% disease.
*
Left circumflex is a medium caliber vessel with mild proximal disease. AV groove circumflex is a small size vessel with severe diffuse disease. Obtuse marginal 1 is a large caliber vessel with tubular 70-80% disease.
*
The patient was then transferred to the recovery area in stable condition:
*
Summary conclusion:
*
1. severe multivessel coronary disease.
2. Ischemic cardiomyopathy
3. Exertional angina
4. Hypertension
5. Dyslipidemia
*
Recommendation:
*
Planned PCI of left circumflex in the setting of ischemic heart myopathy and exertional angina.
*
6 French EBU 3.75 guide was used to engage left coronary system. run through wire was advanced into distal left circumflex. Lesion was predilated using a 2.5 x 15 mm semi-compliant balloon. Resolute integrity 2.5 x 22 mm stent was deployed into left circumflex/OM1. Stent was postdilated using a 2.75 x 8 mm noncompliant balloon. Post procedure there was TIMI-3 flow noted in distal vessel without evidence of perforation or dissection.
*
6 French AL 0.75 guide was used to engage right coronary system. Fielder FC wire was advanced through a 1.5 mm over-the-wire balloon into the proximal RCA. Wire escalation technique was used to cross the CTO which was unsuccessful due to lack of guide support and equipment. Procedure was aborted and postprocedure angiography did not reveal evidence of perforation or dissection. Patient remained hemodynamically stable throughout the procedure.
*
thanks in advance
I am thinking c9600-lc but can I also bill for cto vessel 92943-74? I bill for hospital.
Hemodynamics:
*
The aortic pressure was 100/57 mmHg.
*
Coronary Angiography:
*
Right coronary artery is medium caliber dominant vessel with severe diffuse disease and 100% mid vessel CTO. Distal vessels filling via collaterals from left to right and right to right.
*
Left Main coronary arteries pain with mild diffuse disease.
*
Left anterior descending is a medium caliber vessel with ostial 99% calcified lesion. Mid mild diffuse disease. Distal focal 60-70% disease.
*
Left circumflex is a medium caliber vessel with mild proximal disease. AV groove circumflex is a small size vessel with severe diffuse disease. Obtuse marginal 1 is a large caliber vessel with tubular 70-80% disease.
*
The patient was then transferred to the recovery area in stable condition:
*
Summary conclusion:
*
1. severe multivessel coronary disease.
2. Ischemic cardiomyopathy
3. Exertional angina
4. Hypertension
5. Dyslipidemia
*
Recommendation:
*
Planned PCI of left circumflex in the setting of ischemic heart myopathy and exertional angina.
*
6 French EBU 3.75 guide was used to engage left coronary system. run through wire was advanced into distal left circumflex. Lesion was predilated using a 2.5 x 15 mm semi-compliant balloon. Resolute integrity 2.5 x 22 mm stent was deployed into left circumflex/OM1. Stent was postdilated using a 2.75 x 8 mm noncompliant balloon. Post procedure there was TIMI-3 flow noted in distal vessel without evidence of perforation or dissection.
*
6 French AL 0.75 guide was used to engage right coronary system. Fielder FC wire was advanced through a 1.5 mm over-the-wire balloon into the proximal RCA. Wire escalation technique was used to cross the CTO which was unsuccessful due to lack of guide support and equipment. Procedure was aborted and postprocedure angiography did not reveal evidence of perforation or dissection. Patient remained hemodynamically stable throughout the procedure.
*
thanks in advance
I am thinking c9600-lc but can I also bill for cto vessel 92943-74? I bill for hospital.