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Tag Archives: levels

checking testosterone levels in a FTM transgender patient

Posted on by
I’m hoping someone can offer some input.

Provider wants to check the testosterone levels in a FTM transgender pt. He is using the dx of male hypogonadism.

The coders in our office are wondering if this is an appropriate dx?

Our thinking is that since he is taking testosterone externally, the issue is not about testosterone production or, if it is about testosterone production, it is not produced in the testes. We don’t have enough of his medical history, so we are unsure if ovaries are intact, but are assuming they are not.

We’ve been researching this and have found lots of information about the importance of checking his testosterone levels, but nothing about what dx to use for the testing.

Does anyone have any information about this?
Thanks in advance,
Lisa

Medical Billing and Coding Forum

Spine coding across levels

Posted on by
Patient has the following procedure, how would this be coded?

T10 to ilium fusion, patient has previous fusion of L2-L5
Screw placement bilaterally at T10-L1 & S1, iliac screw
L1-L2 & L5-S1 TLIF
L1-L2 laminectomy & bilateral facetectomy, L5-S1 unilateral foraminotomy with facetectomy and partial laminectomy

Medical Billing and Coding Forum

HELP with understanding levels and in/out pt. coding

Posted on by
Help I’m a new coder. My Boss hands me a chart to help me code in/out pt. according to the level(1,2,3,) and consults level and if the pt. is private pay or Medicare, and if the pt. is Medicare age code a Medicare code. The chart is confusing me. Does anyone have a chart I can look at, or can you explain. My Boss is training me but she Is so busy i’m learning in a round about way. Any suggestions or comments will help. Thank You Ollie

Medical Billing and Coding Forum

3 different levels exam

Posted on by
I have another question hopefully this will clear up the CONFUSIONS in my head!!1

So, if patient has a detail history, EPF exam, Moderate risk – I can code a 99214
other example is Detail history, Problem Focus exam and Moderate risk – I can throw out the to lowest and code the highest correct?

when exactly do i use that rule? is it just when I have 3 different levels of exam ? did i just answer my question? HELP!

Medical Billing and Coding Forum

Axillary Lymph Node Dissection Levels 1-3

Posted on by
Good afternoon,

My provider performed an axillary lymph node dissection of levels 1-3 NOT in conjunction with mastectomy.
Does code 38745 include the level 3 nodes? Coding Companion lists only levels 1 & 2. NCCI edits allow the use
of 38525-59 for the level 3 nodes but with it being all on one side with one incision is it appropriate to do this??
If not would it be appropriate to append -22?

Medical Billing and Coding Forum

How to bill a TF with additional levels for Humana

Posted on by
Humana requires all levels to have a location modifier. For example if my provider preformed the following injections:
right L2-L3, left L4-L5 and bilateral L3-L4 Transforaminal ESI
we would bill most carriers as follows

64483-50 / 64484 2 units

but Humana wants the additional levels to have a location modifier, so how would this be billed to Humana?

64483-50 / 64484-50 ?
I know that the additional levels are not on the same location but it was done RT/LT. If it was LT/LT or RT/RT I know we would do 2 units but since it is not I feel my only option is 50 for bilateral. I am correct in thinking this? our would we bill:
64483-50 / 64484-RT / 64484-LT?

Medical Billing & Coding Forum | AAPC