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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

CMN and DIF Forms Discontinued in 2023

Starting Jan. 1, Certificates of Medical Necessity and DME Information Forms will no longer be required. If you are a provider, supplier, biller, or vendor who bills durable medical equipment (DME) Medicare Administrative Contractors (MACs) for services and supplies you provide to Medicare patients, there is a change coming in the new year. Beginning Jan. […]

The post CMN and DIF Forms Discontinued in 2023 appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Discontinued Procedure and repeat?

I have a patient whose procedure was discontinued today after the administration of anesthesia, so we are billing with the discontinued procedure modifier. However, the patient is coming back in a few days again for the procedure. Do we need to bill a repeat procedure modifier or will the insurance accept both claims?

Also, the procedure was 29881 and I saw in Supercoder that 53 is an acceptable modifier to bill discontinued procedure for the surgeon, but the modifier I was considering for the ASC side, 74, was not listed. Does anyone know why?

Thank you!! :)

Medical Billing and Coding Forum

discontinued colonoscopy

Where is the best place to find current rules on coding a screening colonoscopy that was discontinued because the provider was unable to advance passed the sigmoid colon due to tissue obstruction. A biopsy was done at the sigmoid colon. I have found things that say add modifiers to the colonoscopy code and other places say code as a sigmoidoscopy. Thank you!

Medical Billing and Coding Forum

Palmetto ASC Discontinued Procedure Documentation

Just seeing if anyone has an example of the discontinued procedure (74) documentation that you are sending to Palmetto GBA to cover all their requirements to get this procedure paid for. They sent me to the following URL:https://www.palmettogba.com/palmetto…t-B~8EELE32452

ASC claims that involve a terminated surgery must be accompanied by an operative report that specifies all of the following:
Reason for termination of surgery
Description of services actually performed
Description of supplies actually provided
Services not performed that would have been if surgery had not been terminated
Supplies that would have been provided if the surgery had not been terminated
Time actually spent in each stage (e.g., pre-op, operative, post-op)
Time that would have been spent in each of these stages if the surgery had not been terminated
CPT code for procedures that were scheduled to be performed

I am curious if you have given them all of the above in order to get paid.

Thanks for your help in advance

Medical Billing and Coding Forum

Discontinued Procedure Modifier

Hello, This is for a ASC facility claim. There was a Spinal Cord Stimulator trial and two leads were suppose to be used for the trial, however the doctor was unable to advance the second lead after a two tries because of some anatomical issue. The doctor decided to go ahead with the SCS trial with one lead only. The one other lead was wasted. This was billed to medicare as 63650×1 and 63650 with modifier 74 times 1. The 63650 with modifier 74 did not pay. Was this billed correctly and what would be the best way to indicate a wasted lead?

Any help with this will be appreciated.

Medical Billing and Coding Forum

Bilateral procedure- one side discontinued

I’m hoping to get an opinion on the correct coding for this. Physician performed 64483 bilaterally on one level, however, had issues and could not complete the left side. It was billed as 64483-RT, 64483-53-59-LT. Medicare paid the right side, but denied the left as information submitted does not support this many/frequency of services. Documentation was sent, but it still denied.

I thought about changing the left to 64484-53-LT, although the definition of 64484 is for each additional level and this was the same level as the right side. The only other thing I can think of is to bill the bilateral as 64483-53-50, but I wasn’t sure if the completed side would get paid at the full rate if I do this.

Thanks!
Susan

Medical Billing and Coding Forum

Discontinued Excision of Cyst

I am hoping for some help/reassurance with CPT code/modifier selection on a procedure. The patient presented to our family practice clinic to have a cyst removed from scalp. The physician started to excise the cyst but noted that it went further into the skull than she had anticipated. She stopped the procedure and repaired the defect (5 cm). Would it be appropriate to bill the cpt code for the cyst excision and append modifier 53 discontinued procedure?

Thank you in advance for your help!!

Medical Billing and Coding Forum