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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!
I understand that when it comes to pathology and diagnosis coding, the provider can wait for the pathology report to come back in order to supply a definitive diagnosis. Likewise, as a coder you can code from the path report.
If Dr. A sees the patient at 9am, and Dr. B performs the EGD at 1pm. The coder doesn’t code the notes until 14 days later (long after the patient has been discharged from the hospital). Can the coder still pull the diagnosis from the EGD report for Dr. A’s claim or would the coder have to report the signs/symptoms for Dr. As claim because technically the patient didnt have a definitive diagnosis at 9am??…If this logic is true, it just seems to contradict the pathology rule.
I’m speaking from the pro-fee inpatient side.
Thank you
I do the billing for a PCP. She has JUST started sending patients home with Sleep machines. When the patient brings it back, she then sends it to a different dr/company that reads and interprets it. My question is, when she gets the reports back and has the patient come in for the "review of findings", is there a special code for this? OR is a standard E/M?
I am lost. Please help.
Thank you,
Stephanie
We recently performed an audit with our weight loss clinic (wellness clinic). The provider goes over the lab orders from the PCP with the patient. There is not a way to attached the lab finding with the valves to the patients chart. The provider would like to document without the values. For example patient has evaluated cholesterol levels, with supervised diet blah, blah. Would this be correct documentation? Or would the provider need to state patients cholesterol level, 249, with supervised diet blah, blah. Or would this one be correct? Provider is addressing all the lab issues because they have a connection to the weight, but not treating the issues, the PCP is doing that.