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Tag Archives: during

Coding both G0439 and 9939- to Medicare during the same year

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We are having an issue with one of our primary care practices. There is a new provider who is part of an IPA and they state that they bill out to Medicare an Annual Wellness Visit under G0438/G0439 with medical diagnosis codes and then at another time during the year the same patient comes in for their Preventative Annual and they bill 9939- using the Z00.00 and that they get paid for both visits.
I have never heard of this and am not sure if this is something that can be done.
Does anyone have any insight into this type of situation?
Thank you in advance.

Medical Billing and Coding Forum

Additional Excisions during same DOS for MOHS

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For those of you who work in dermatology with a provider who performs MOHS surgeries, I have a question. How common or uncommon is it for a patient who is having a MOHS procedure to also have other lesions excised during the same DOS. The other lesions excised would be non-Mohs excision, i.e. CPT 11401-11406, 11600-11606, etc.

Medical Billing and Coding Forum

Multiple Injections during same office visit

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I am trying to correctly file for multiple injections such as a Rocephin, Depomedrol, and Tordol. However, I am finding it impossible to get paid for the second and third injection administration fees. Can someone assist me in getting paid for this? Is this impossible?

I am using modifier "25" for the OV and "59" for shot administration numbers 2 and 3. I don’t believe any of the "X" modifiers could be used instead of the "59" and I believe "76" would be inappropriate since the shots are in the same office visit. Any help would be appreciated. Thank you!

Medical Billing and Coding Forum

Incidential findings during screening colon

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I have a question regarding incidental diagnosis codes but can’t find a policy.

During a screening colonoscopy, if the provider finds hemorrhoids and states that they are incidental due to the prep, we do not have to add the hemorrhoid diagnosis code. Is that correct?

Thanks!

Medical Billing and Coding Forum

Aortogram during Left heart cath

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PLEASE HELP!

I am new to cardiology and trying to get these concepts down.

Patient had a Left Heart Cath done, access obtained through the right femoral artery. Doctor dictates then that a "Right femoral arteriogram was performed, then a right femoral arteriogram with runoff to the foot was performed."

What codes do I use for this? I think he is duplicating his dictation?

Medical Billing and Coding Forum

Dilations and Biopsies during EGD

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My physicians will very seldom require to use an alternate method of dilation when one doesn’t produce the result they desire. For example, they will perform a 43248(guide wire) and a 43249(balloon) in the same session. Most recently, we billed those two codes along with a 43239(biopsy) and received a denial only for the biopsy. Both dilations were allowed and paid. Is anyone aware of a new CCI edit or otherwise restricting these code parings? If we were to bill only one dilation with the biopsy we would be paid substantially more then the payments received for both dilations which makes no sense. Thoughts appreciated.

Medical Billing and Coding Forum

GA modifier during Home Health Episode

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Hi! I am having an issue with one of my practices that provides wheelchair management services by PT’s and OT’s for people with long term disabilities. They are occasionally running into discovering that the patient is within a Home Health Care episode. The services they provide CAN NOT be provided by the Home Health agency. It was suggested to get an ABN and use the GA modifier. This would be valid I suppose, but would leave the cost as the patient responsibility. I am wondering if there is a way to indicate that these services should not be included in the Home Health Episode and have Medicare view them separately? Thank you for any information. I have a meeting with the practice today and have not had any luck finding what I need to know!

Medical Billing and Coding Forum

Billing for TCM services during post op period by non-surgeon physician

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I’m trying to find definitive guidance from CMS or in the Federal Regs that indicates a physician can bill for TCM services during the post op period as long as they are not the surgeon. I understand TCM would be covered by the global period for the surgeon. In this case, the patient’s PCP is providing TCM services post-op and would like to bill for it. An article from the AAFP in 2013 mentions that this is allowed but I can’t find anything directly from CMS that supports it and I would prefer direct supporting documentation. Thanks!

Karen

Medical Billing and Coding Forum