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When assigning a ICD-10-CM diagnosis code(s) for a surgical complication, report the code for the complication first, followed by any additional diagnosis code(s) required to report the patient’s condition. Example 1: Complication from a surgical procedure for treatment of a neoplasm. The complication is the listed first, followed by a code for the neoplasm or […]
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Valid claims submitted by physical therapists (PTs) in private practice are being denied by some Part B Medicare Administrative Contractors (MACs), according to the Centers for Medicare & Medicaid Services (CMS). These claims are for the professional component (PC) or global code for certain diagnostic services involving electromyography (EMG), nerve conduction velocity (NCV), and sensory-evoked […]
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77067 – screening mammogram
77063 – 3d tomo
77066 – diagnostic mammogram
g0279 – 3d tomo
Here is what I am coding for – 77067 & 77063 for the screening mammograms (59 modifier on each) and 77066 and g0279 for the diagnostic mammogram (GG on each for Medicare claims only)
We are getting denials for the g0279.
Can we bill tomo twice per day if its used for a screening mammogram and a diagnostic mammogram?
Thanks,
Jo
I wanted to get other’s opinions on the much debatable issue of diagnostic versus preventative colonoscopy in my office. I have several providers within my office that like to order "screening" colonoscopies for the below scenarios.
1. Pt says they are here for a screening colon, first colon ever, but in the medical record physician documents symptomatic issues of constipation, rectal bleeding, diarrhea, etc. My provider feels that since the patient has not had a screening colon that they can order the procedure as such. I advise the provider that since the patient presented with symptoms then it is not a screening, per several articles I have found on the web from AAPC. How many other coders/billers have come across this issue and how did you handle this situation?
2. Patient comes in for screening colonoscopy. Provider documents that patient has "stable" chronic constipation. How would you code? In my opinion, patient has an issue and thus would be diagnostic, but the providers states that since it is stable it can be coded as a screening. Opinions?
Thank you all for your thoughts and opinions.
Diagnostic laparoscopy, explant of Angelchik device.
Operative Technique:
After obtaining informed consent, the patient was taken to the operating room and placed in the supine position. Following the smooth induction of general endotracheal anesthesia and a surgical time-out, the abdomen was prepped and draped in a standard and sterile manner. Hasson technique was utilized to enter the peritoneal cavity supraumbilically, and pneumoperitoneum was established to 15 mmHg. A 10mm, 30-degree laparoscope was introduced and intraabdominal adhesions were present throughout.
Fortunately, the left upper quadrant was relatively free of adhesions, and two 5 mm ports were placed in the left lateral abdomen under direct vision. Inspection in the epigastrium revealed a Silastic or silicone-appearing ring free-floating in the left upper quadrant. The right structure was consistent with an Angelchik device, and it was grasped by the tail and removed from the left upper quadrant through the Hasson port without difficulty. Inspection of the surgical field revealed excellent hemostasis.
Pneumoperitoneum was taken down under direct vision as the ports were removed. Port sites were irrigated and re-anesthetized, and the fascia at the Hasson site was closed with a 0 Vicryl employing 3 interrupted sutres. The skin was closed with a 4-0 Monocryl and sealed with skin glue.
Thank you so much for all your help:)
It is expected that testing facilities will not routinely modify diagnostic test orders from the ordering physician. Although diagnostic test orders may conditionally request an additional diagnostic test, the conditional request must come from the ordering physician. New orders must be obtained when a test is determined to be clinically inappropriate or suboptimal, or when […]
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