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In the August Officer News we encouraged officers to host virtual meetings as part of the six required education events sponsored. We want to remind you again of the three steps to follow: Step 1 – Email [email protected] to reserve a date for the virtual meeting. Include: The name of the chapter The name of […]
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If you have any resources will you please share them?
HISTORY OF PRESENT ILLNESS: ….. is a 55-year-old male who
comes to the office on 01/31/2019 for a followup for a
colonoscopy. The colonoscopy, the patient states that he had a
good prep. It did not make him sick. He does not remember the
procedure, and he had no ill effects from the procedure. He is
in zero type pain at the present time.
PHYSICAL EXAMINATION: General: Demonstrates a 55-year-old
white male, oriented x3, pleasant and cooperative.
Vital Signs: Temperature 97.6, pulse 57, respirations 20, BP of
132/78, 6 feet tall, 248 pounds, 97% on room air. 0 pain at the
present time.
Lungs: Clear to auscultation bilaterally. No rales, rhonchi or
friction rubs. No wheezing. Normal respiratory effort. No
shortness of breath.
Heart: Regular rate and rhythm. No S3 or S4 sounds are heard.
No chest pain during the examination. No bruits heard over the
carotids or aorta. No swelling to the lower extremities.
Abdomen: No masses in the abdomen. No tenderness. No
organomegaly. No evidence of hernia.
We reviewed the following material for this visit.
CURRENT MEDICATIONS: We reviewed his medication list.
IMAGING: We reviewed the chest x-ray from 01/04/2019.
LABORATORY: We reviewed his blood work from January 4, 2019.
We reviewed his colonoscopy from 01/25/2019, which demonstrated
2 polyps. We reviewed the pathology report from 01/25/2019,
which demonstrated the 2 polyps to be adenomatous polyps. One
is a pure adenoma, the other one was a tubular adenoma. No
evidence of dysplasia, metaplasia or cancer.
We reviewed the consultation from 01/02/2019.
IMPRESSION: We have a healthy 55-year-old white male who grows
adenomatous polyps.
RECOMMENDATIONS: A repeat colonoscopy in 2 years.
We have a Diabetes Educator (DM-E) on staff who sees any patient that our PCP’s have referred to her for services. Our ops team is looking to have the DM-E call our patients and follow-up on their progress (diet, meds etc.) through a survey after they receive her initial face-to-face services. The coding education team has looked at the CCM codes (99490-99491) and ruled them out since DM is the only thing that the DM-E would be following. (we considered that the PCP would be able to count the survey time toward the CCM codes since they do manage all chronic conditions)
We have looked at 99453-99454, 99457 and 99091. What we found in our research is that 99457 would not qualify since CMS states that it only accounts for professional time (even though it lists staff in the code description) and "therefore cannot be furnished by auxiliary personnel incident to a practitioner’s professional services." 99453-99454 seem to work only if the glucose monitors continually transmit to the MD, but this seems to count out what we are trying to bill for since the educator would not be monitoring the actual information transmitted. She is only going to be calling the patients and asking questions on their progress since their last visit with her.
We are not accredited through Medicare to use G0108 or G0109. We are currently billing her face-to-face services with 99211.
Another thing that the ops team is looking into doing is hiring an NP/PA that will also provide DM education and we were not sure how this would impact the coding either.
We are looking to bill these services as incident to under the ordering provider’s credentials.
If anyone has another perspective on the guidelines or can offer another code for what we are trying to bill, we would very much appreciate it.
Step #1 – Hold an officers’ meeting: Get acquainted with one another. The most successful chapters have leaders who work as a team and communicate openly. Together, review the responsibilities and general expectations of each officer as outlined in the 2019 Local Chapter Handbook. Allow each person to fulfill his or her respective role. Respect […]
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