Hi. Would it be safe to say that the primary codes in this set could be considered "cosmetic", and the secondary codes "medically necessary" because the field of vision is likely being affected?:confused:
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Tag Archives: clarification
Clarification on occipital block
Need clarification on Occipital Block, whether not mention greater or lesser occipital block. what CPT code use this procedure?
Clarification for With/In ICD-10 guidelines
15. With
The word with or in should be interpreted to mean associated with or
due to when it appears in a code title, the Alphabetic Index (either under a
main term or subterm), or an instructional note in the Tabular List. The
classification presumes a causal relationship between the two conditions linked
by these terms in the Alphabetic Index or Tabular List. These conditions
should be coded as related even in the absence of provider documentation
explicitly linking them, unless the documentation clearly states the conditions
are unrelated [/B]or when another guideline exists that specifically requires a
documented linkage between two conditions (e.g., sepsis guideline for acute
organ dysfunction that is not clearly associated with the sepsis).
The word with or in should be interpreted to mean associated with or
due to when it appears in a code title, the Alphabetic Index (either under a
main term or subterm), or an instructional note in the Tabular List. The
classification presumes a causal relationship between the two conditions linked
by these terms in the Alphabetic Index or Tabular List. These conditions
should be coded as related even in the absence of provider documentation
explicitly linking them, unless the documentation clearly states the conditions
are unrelated [/B]or when another guideline exists that specifically requires a
documented linkage between two conditions (e.g., sepsis guideline for acute
organ dysfunction that is not clearly associated with the sepsis).
– I have a case, the patient has vitamin b12 deficiency, and dementia. Dr. does not document a causal relationship. However, in the alphabetic index of ICD-10 under term dementia, subterm "in", Vitamin B12 deficiency is listed. According to the above mentioned guideline, should i report E53.8, and F02.80?
Please Help, Thank You.
clarification for electron microscopy pathology coding
Hello fellow coders
This is an issue that I have had difficulty understanding and have had a hard time finding someone to explain to me for some time. Our pathologists send renal transplant specimens to an outside facility for electron microscopy analysis. The outside facility emails back to us the powerpoint images along with the microscopic description of the tissue. We enter the description into the report and the pathologists read the images and enter their findings into the pathology report under the final diagnosis. How do I code cases like this? The pathologists say because they interpret the images it should be coded 88348-TC ,and Professional and 88300 for the specimen we send to the outside facility. Do you agree?
This is an issue that I have had difficulty understanding and have had a hard time finding someone to explain to me for some time. Our pathologists send renal transplant specimens to an outside facility for electron microscopy analysis. The outside facility emails back to us the powerpoint images along with the microscopic description of the tissue. We enter the description into the report and the pathologists read the images and enter their findings into the pathology report under the final diagnosis. How do I code cases like this? The pathologists say because they interpret the images it should be coded 88348-TC ,and Professional and 88300 for the specimen we send to the outside facility. Do you agree?
FY and TC modifier clarification
The company I work for does Xrays in our lab, but we only provide the technical component. The images are sent to a radiology group to be read. There is a bit of debate regarding the FY modifier. Would the FY modifier be used with the TC modifier or does it replace the TC modifier. It seems to me since we are not billing for the global service, we would still have to use the TC modifier. Am I reading all of the information wrong? Please help.
Clarification for denial (76641/76642)
I’ve recently been having problems with insurances paying for 76641/76642 when billed together. I use modifier -59 on CPT 76642. This hasn’t been an issue in the past, within the last month or two my claims has been denied.
Any help, suggestions are welcome please advise.
Any help, suggestions are welcome please advise.
Thank you
Need Clarification Please
Scenario:
Our NP sees the patient in consult during the night (lets say 8:00pm on Jan 1), and our physician sees the patient the next morning (Jan 2) and adds to the NP note that he sees and agrees etc, is this considered shared?
Our NP sees the patient in consult during the night (lets say 8:00pm on Jan 1), and our physician sees the patient the next morning (Jan 2) and adds to the NP note that he sees and agrees etc, is this considered shared?
Do I need to bill the consult for the NP on Jan 1 and give the physician a round on Jan 2 or am I able to bill for just the consult for the physician on Jan 2?
I can’t seem to find any clarification on this so any information would be greatly appreciated.
IV push same drug 30 minute rule clarification
The patient was given Morphine at 1153, 1215 and 1233. There are less than 30 minutes between each dose but there are more than 30 minutes between the first and third dose. Can we charge 96376 one time for the 30 plus minutes between the first and third doses?
Incident-to Clarification
I need some clarification on Billing Incident-to. I say that in order to BILL Incident-to Correctly the Physician MUST be in the same building as the PA/NP. My practice wants to utilize our PA/NP at a Satellite Office (and Bill Incident-to) without a Physician Present but available by phone because the scope of Practice for a PA per GA Composite Medical Board states " The supervising physician need not be physically present at the time of the services but shall be immediately available by telecommunications". My opinion is that Scope of Practice and Billing are different. You need to follow the Insurance Companies definition of Incident-to. Please help clarify this for me. Paula
Physician Infusion Services, CHONC Practice Exam Clarification.
Hello,
I was hoping for clarification on a topic that has me torn as to the true and correct coding method. The below scenario and rationale comes directly from the CHONC Specialty Practice Exam.
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Prior to this I have previously been taught that we can only bill a IV push as primary to a hydration infusion (Facility Hierarchy rules), but per the AAPC rationale provided because I am in a physician practice (not a facility) I can bill a 96360 and 96375 in a real life scenario.
Has anyone ever tried this? Or do hey have any experience with physician infusion guidelines being different than facility guidelines?
The AMA CPT Guidelines for hydration and therapeutic infusions do state that When these codes are reported by the physician or other qualified healthcare professional, the initial code that best describes the key or primary reason for the encounter should always be reported irrespective of the order in which the infusions of injects occur.
Any input is greatly appreciated!!
Thank you,
Asia