I have a claim that was not paid by Medicare for a patients routinely scheduled remote 90 day device check (93297 and 93299). The patient was inpatient at one of our facilities at the same time (for another reason), by our Cardiologist billed a visit for that date too. A/R is stating that we cannot bill for the remote check since the patient was in the hospital. I don’t recall coming across this issue before…….any input/clarification/resources from my fellow Cardio coders would be appreciated.
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Tag Archives: Check
Weight Check 99211
Chief complaint: weight check
ordered as incident to service provided by nurse; 99211
ordered as incident to service provided by nurse; 99211
assessment plan: patient is gaining weight appropriately. Come back in 2 weeks for weight check newborn.
Z00.111 is the code used.
Does this meet the guidelines for incident to reporting? Weight check is not a diagnosis with a designated plan of care? Is this a billable service?
Thanks!
Check Remittance Advice for MIPS Payment Adjustments
With this being the first payment year of the Merit-based Incentive Payment System (MIPS), MIPS eligible clinicians and clinician groups should start tracking payment adjustments in their Medicare Part B claims. Billing staff also may want to prepare for questions from patients who are privy to the information. Lots at Stake Based on performance in […]
The post Check Remittance Advice for MIPS Payment Adjustments appeared first on AAPC Knowledge Center.
ICD 10 code for Wound Check ~Status Post C-Section
If the wound check is done 6 days after delivery, wouldn’t it be part of the global period for the c-section? Or can we still bill a 99212 with dx Z48.89?
Providers have “affirmative duty” to check updated LEIE database
sPlease check your coding!
This is a sort of a personal rant but also professional.
A family member has Diabetes and numerous associated complications. Recently diagnosed with charcots arthropathy in her lower extremity joints and can barely walk or move with out pain. She has applied for disability and was denied due to the diagnosis. I asked what the diagnosis was.. she looked at her paperwork and from the ortho office they submitted
A52.16 Charcots arthropathy as the primary and
E11.40 Diabetic neuropathy unspecified as the secondary.
Now you may think that all looks really good.. However
A52 is the catergory for Late Syphilis !!!
and
A52.1 is the subcategory for symptomatic neurosyphilis
making A52.16 a condition caused by syphilis!!!
From an ortho coder!
The correct code is so easy to find under diabetes type 2 with arthropathy or charcot arthropathy and must be coded as E11.610.
I see this so many times where things are mis coded and they just don’t care, they don’t see how it affects the patient in the long run. Now she has to spend money to have test done that are not covered to prove that she does not have this condition and has never has syphilis.
It is not just about getting a claim paid.. it is doing your job correctly.
I am putting this out there to try to make this point to all who will read this and care. It does not matter if the provider but this code on or if the software assigned it.. A coder let this diagnosis leave her desk as an appropriate code and that is shameful!!
A family member has Diabetes and numerous associated complications. Recently diagnosed with charcots arthropathy in her lower extremity joints and can barely walk or move with out pain. She has applied for disability and was denied due to the diagnosis. I asked what the diagnosis was.. she looked at her paperwork and from the ortho office they submitted
A52.16 Charcots arthropathy as the primary and
E11.40 Diabetic neuropathy unspecified as the secondary.
Now you may think that all looks really good.. However
A52 is the catergory for Late Syphilis !!!
and
A52.1 is the subcategory for symptomatic neurosyphilis
making A52.16 a condition caused by syphilis!!!
From an ortho coder!
The correct code is so easy to find under diabetes type 2 with arthropathy or charcot arthropathy and must be coded as E11.610.
I see this so many times where things are mis coded and they just don’t care, they don’t see how it affects the patient in the long run. Now she has to spend money to have test done that are not covered to prove that she does not have this condition and has never has syphilis.
It is not just about getting a claim paid.. it is doing your job correctly.
I am putting this out there to try to make this point to all who will read this and care. It does not matter if the provider but this code on or if the software assigned it.. A coder let this diagnosis leave her desk as an appropriate code and that is shameful!!
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
HCC = Big check from Medicare?
I have a coworker in the office that is promoting HCC Risk Adjustment. She claims that Medicare will send us a big check every year for using the HCC ICD10 codes. I understand that higher risk will increase the level of E/M but find it hard to believe that Medicare will send us additional money at the end of the year. I can find nothing that states this is an actual thing.
Is she correct?
Also, with the new proposed E/M payment policy, will this HCC even affect payment if it passes?
Confused.
The “Book Check Start Time” is Now Available Online for Examinees
When officers schedule exam dates they now are required to state the time the book check will begin. This will clear up any questions examinees may have about the time to arrive for the exam. While this new field is a requirement for any new exams created online, officers are encouraged to add this information […]
AAPC Knowledge Center
Unprocessed CMS-1500 Claims? Check the Date
Medicare claims that do not meet date format requirements will be rejected. The Centers for Medicare & Medicaid Services (CMS) has released date formatting guidelines for the CMS-1500 claim form, which are effective for claims received on or after July 30. When date formatting requirements are not met, Medicare Administrative Contractors will return claims as “unprocessable” with the following messages: Claim/Service […]
AAPC Knowledge Center