My clinic has a patient who is on home health and hasn’t been seen in our office in some time. WE provided two Rocephin injections to the home health agency nurse to be given at home. Do we bill that to the home health facility so we are reimbursed by them or bill to insurance ?
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Tag Archives: Given
Determining if pre and post medication adm given during an ER procedure are billable
Hello,
We are trying to determine if we are allowed to bill separately for the administration of medications prior to and after a procedure such as a laceration repair or a wrist reduction done in the ER. Often after a wrist reduction in the ER the patient will receive Zofran for nausea and Dilaudid for pain control. Any insights would be greatly appreciated.
In Office PX, no sedation/anesthesia given
I do anesthesia billing and just took my CPC exam last Saturday, so I am brand new to this. I have a question about coding an in-office case where my anesthesiologist went in to provide sedation for a GYN patient during her hysteroscopy/ablation. The patient wanted to try to do it without any sedation/anesthesia, so my anesth did the exam/history etc and inserted the IV. He had her on monitors and he gave her ketorolac and ondansetron and that was it. No sedation/anesthesia, but he was there the whole time to provide it, if needed.
How do I accurately code the services the anesthesiologist provided? My instinct is to code a consult code with a 25, the IV and the meds.
CPT for double dose of Recombivax B pediatric/adolesc strength given to an adult
When we are out of the adult strength Hep B and an adult needs a vaccination, we use two 0.5 ml vials of Recombivax B, pediatric/adolescent strength (5mcg/0.5ml), in one 1.0 ml injection so that the adult patient gets the proper adult dose of 10mcg. Billing for this has always been a challenge. If we bill 90744×2 some insurance companies deny the claim as an age mismatch. If we bill 90746 the claim may deny because the NDC does not match. What is the correct way to code this?
Botox given to patient same dos as another specialist
Our provider gave Botox 155mg and 45mg JW for waste due to pain in cervical region. Medicare denied due to another ENT provider also billing Botox on same dos in the throat. Our claim is being denied because the ENT already billed the botox on the same dos and was paid. The ENT is a totally separate clinic and specialty, we didn’t know patient even saw that provider. Noridian is saying we need a modifier to bypass but I cannot think of an appropriate modifier in this situation. Do we just appeal the denial without a modifier?
Multiple IM’s (CPT 96372) given at the same time in the ER
Hello,
Can someone please let me know if we are allowed to charge for multiple IM’s given at the same time but documented in different sites? I know it technically couldn’t happen but it would be due to nurse documentation.
For example:
Ativan IM Right Arm at 15:00
Ketorolac IM Left Arm at 15:00
New Practices Given Opportunity to Join APM
The ink on the Merit-based Incentive Payment System (MIPS) and Alternate Payment Model (APM) final rule is barely dry and already the Centers for Medicare & Medicaid Services (CMS) is making good on their promise to establish additional opportunities for eligible clinicians to join APMs. CMS announced today that it expects to re-open applications for […]
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