My cardiologists have recently started billing the tobacco cessation counseling codes 99406 and 99407. I know when billing these codes with a separate E&M, we need the 25 modifier on the E&M. Sometimes, an EKG 93000 is also done. My question is, do we need a 59 modifier on the EKG when billing all three codes together? I’ve found one online source that specifically says we do need the 59 in this scenario, but nothing else addressing billing the three services on the same date by the same doctor. Any help with this would be appreciated!
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Tag Archives: Counseling
Tobacco counseling billing
UHC has new issue. They stated that tobacco use counseling covered under optim dx and recommended claim submission to rx. Does anyone already bill 99406 to rx? Thank you
Codes DOAC (Direct Oral Anticoagulant) Counseling
How do you code/bill for DOAC (Direct Oral Anticoagulant) safety counseling with patients? What are the proper codes. I was only able to find codes for warfarin and INR monitoring (93792 & 93793). Thank you!
Billing for time spent counseling for Morbid obesity when done during a Physical
Provider documents
Morbid obesity – E66.01, (HCC), 50 minutes spent with the patient, with over 50% of that spent on discussion of morbid obesity, her attempts at weight loss, the risks and benefits of bariatric surgery. Patient would like to proceed with evaluation.
This was outside of the patients AW visit of 30 minutes
The excludes note for 99404 indicates not allowed with her Physical 99395
The 50 minutes fall short of a prolonged service code
Would it be appropriate to add an E/M for weight loss counsel consideration for Bariatric surgery during her Wellness visit?
Cheri
Morbid obesity – E66.01, (HCC), 50 minutes spent with the patient, with over 50% of that spent on discussion of morbid obesity, her attempts at weight loss, the risks and benefits of bariatric surgery. Patient would like to proceed with evaluation.
This was outside of the patients AW visit of 30 minutes
The excludes note for 99404 indicates not allowed with her Physical 99395
The 50 minutes fall short of a prolonged service code
Would it be appropriate to add an E/M for weight loss counsel consideration for Bariatric surgery during her Wellness visit?
Cheri
Lung Cancer Screening Counseling and Annual Screening for Lung Cancer With Low Dose C
Do any private health insurance companies reimburse for these procedures?
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)
G0297 Low dose ct scan (ldct) for lung cancer screening
Genetic counseling
I need to know what elements are required for 99395. Secondly, a patient came because he wants to have blood work done because of a concern of family history of CAD. The Dr didn’t do any blood work. What elements are required?
Tobacco Abuse Counseling when done with Physicals
Wondering if when billing for Physical understanding that lifestyle counseling ,and age approriate health screening ,etc are elements of Physical. Can a seperate CPT code be used for Tobacco abuse couseling when time spent is documented is the required 3-10 minutes?This of course is for a patient who does smoke
It’s one thing to counsel regarding lifestyle choices and risk of same for those who do not smoke .For those who already smoke the focus is different with discussion of medications,goals support grups etc.
Hoping for some direction
Cher
It’s one thing to counsel regarding lifestyle choices and risk of same for those who do not smoke .For those who already smoke the focus is different with discussion of medications,goals support grups etc.
Hoping for some direction
Cher
When time spent counseling is the driving factor for E/M and a procedure is done
I’m hoping someone can advise me on this dilemma
I have a provider who will use time spent counseling as the driving factor for E/M.
Example
Pt her for f/u DM,HTN,Hyperlipidemia etc, ROS HPI PFSH and Exam are comprehensive to detailed ,med changes made counseled on diet ….
However sometimes the patient will request a joint injection or lesion removal during the appt and the procedure is done during the visit
he documents 30 minute appointment with >than 50% face to face etc-99214
adding 20610-50 for bilateral knee injections
Am I wrong in thinking that in that 30 minutes the knees were injected as well ?
I’d like to address this with him ,however I know that this will not be received well so I’m hoping someone can confirm or not whether I’m right or wrong
and if there is any information I can use to support changing
Thany you in advance
Cheri
I have a provider who will use time spent counseling as the driving factor for E/M.
Example
Pt her for f/u DM,HTN,Hyperlipidemia etc, ROS HPI PFSH and Exam are comprehensive to detailed ,med changes made counseled on diet ….
However sometimes the patient will request a joint injection or lesion removal during the appt and the procedure is done during the visit
he documents 30 minute appointment with >than 50% face to face etc-99214
adding 20610-50 for bilateral knee injections
Am I wrong in thinking that in that 30 minutes the knees were injected as well ?
I’d like to address this with him ,however I know that this will not be received well so I’m hoping someone can confirm or not whether I’m right or wrong
and if there is any information I can use to support changing
Thany you in advance
Cheri
Obesity Preventative Counseling
We are billing G0447 to medicare in place of the standard 99202 code. Medicare is stating we need a modifier but we can’t figure out which one.
We have tried 33 and got denied already.
We use modifier 25 for the 99212 code already.
We have tried 33 and got denied already.
We use modifier 25 for the 99212 code already.
What modifier can we use to get reimbursement?
Inpatient – Telepsychiatry counseling appointments – denial from Medicare
Does anyone know the revenue code for billing the CPT code (90834) on a UB04? Would it happen to be 0780 or 0789?
The facility is Part A Medicare Provider and all their claims were rejected. They are located in FL. Would we have to call Medicare in FL to find out how to reprocess these claims. If anyone has a phone number to share that would be very helpful.
I have looked all over the internet and was not able to find how to bill this correctly.
Thank you.