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Tag Archives: match….

Inusurance Guidelines don’t match CCI

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I work in a dermatology practice and lately we have seen several denials when codes 11102, 17000 and 17003 are billed together. I am putting the 59 modifier on 17000 per the CCI edits. The claims are then coming back paying on the 17000 and 17003 but denying the 11102 saying it is included in the payment for 17003. If we put a 59 on the 11102 the claims are being paid, but this doesn’t seem correct. My managers are asking me if we should be putting the 59 on the 11102 before billing these out as a rule, but this goes against the CCI. Has anyone else been seeing this or can anyone offer me any guidance in this situation?

Thank you!

Medical Billing and Coding Forum

Joint Commission updates EM standards to match CMS

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In response to CMS’ final emergency preparedness rule issued earlier this month, The Joint Commission announced revisions to its Emergency Management (EM) standards. CMS is expected to approve the updated standards before they go into effect November 15.

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CPC changing CPT to match documention

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I am wondering if anyone has found anything in writing that states, a certified coder is able to change a CPT code so that it reflects the documentation without informing the physician every single time.

I have recently started working for a facility that currently stops coding and goes to seek out the physician to change the CPT code. This seems a little crazy to me since we are hired with the credentials and certification so that we can help make sure claims go out with the correct coding that is supported by the documentation. The last facility I worked for the physicians were more focused on the patient than the coding of the CPT, therefore if their note did not support a 99214 but did support 99212 it was changed on the back end by the CPC before being sent to the insurance company and vice versa.

Please help so that I may be able to help make things streamlined for my new employer.

Medical Billing and Coding Forum

E/M Coding Course rationale and correct answer do not match….

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E/M Coding Course Question:
Question 1
SUBJECTIVE: The patient has no known allergies. She is diabetic since 2002. She takes 81 mg of aspirin daily. Medication list is noted. The patient is here for annual diabetic foot check. She does have diabetic shoes. She denies cigarette use or tobacco use.

OBJECTIVE: On examination, she has elongated thickened toenails 1 through 5 bilaterally, mycotic appearing. Finding is consistent with fungal toenails. We discussed diabetic foot care do’s and don’ts. She has intact sensation with 128 cycles per second tuning fork at the level of great toe. She has intact sensation with 5.07 monofilament plantar foot. No foot ulceration is seen. DP and PT pulses are palpable.

IMPRESSION:
1.Onychomycosis
2.Diabetes mellitus.

PLAN: I reduced toenails 1 through 5 manually and with electric grinder. I will see her back for followup in 10-12 weeks

What diagnoses would be reported?

A. E11.9, B35.1
B. E11.40, B35.1
C. B35.1, E11.9
D. B35.1, E11.621

The rationale for this question states Onychomycosis is sequenced first; However, that shows as incorrect when graded. When E11.9 is sequenced first followed by B35.1, the answer shows as correct. What is the correct sequencing for this question.

Medical Billing and Coding Forum