Is it appropriate to use Z79.899 to account for Benadryl taken 30-minutes prior to presentation when a patient is having an allergic reaction (rash) to food ingested. This patient has a history of an allergy to the same food and the medication is NOT listed on the patients long-term (current) medication list.
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Tag Archives: Medication
H2010 — Comprehensive Medication Services
Does anyone know what the limit is for billable units for H2010 (Comprehensive Medication Services per 15 minutes)? I am receiving a denial for 3 units which is appropriately documented.
Thank you!
Diabetes medication report codes
opinions please… Senior coders in my facility have said that we need to add the Z code for oral med and for insulin use in ALL patients diagnosed with E (diabetes) series codes.
I see in the October Primary Care Coding newsletter where it states only if diabetes is a secondary diagnosis, i.e. caused by adverse drug effect, pulmonary fibrosis, etc. And then if the patient is on both oral and insulin, only code the insulin.
Any clarification out there? I have been adding Z79.84 for oral, Z79.4 for insulin, Z79.899 for other injectable-non insulin. Thanks in advance! Jeanette Remmers–coder in a FQHC clinic
I see in the October Primary Care Coding newsletter where it states only if diabetes is a secondary diagnosis, i.e. caused by adverse drug effect, pulmonary fibrosis, etc. And then if the patient is on both oral and insulin, only code the insulin.
Any clarification out there? I have been adding Z79.84 for oral, Z79.4 for insulin, Z79.899 for other injectable-non insulin. Thanks in advance! Jeanette Remmers–coder in a FQHC clinic
Apprehension Level Dictates Medication Dosage And Type
It has always been around in the area of dental care but recently, oral conscious sedation is becoming more popular in some areas. A local area dentist said this has been part of his management for years now. The benefits that comfortable pulling of wisdom teeth, root canal and crowns can never be ignored.
Patients will become quite drowsy and relaxed, or even fall asleep, but enough consciousness will be spared to follow instructions and to respond to stimuli. A patient’s dosage and medication type does not necessarily need to be the other’s drug specification as well. It is customized for each of them depending on their level of fear or anxiousness. A pill may work for some patients but other patients will require a little more.
A responding dentist is confident in saying she has yet to encounter a problem related to oral conscious sedation. Training definitely does a lot with the assurance of safety to use this technique. You only start worrying once you took over 35 pills. As long as you are not pregnant and you are not a nursing mom, you need not worry.
Almost 145 million Americans keep themselves away from the dentists because of terror. A woman recalls her fear of the dentist originated during her high school days. All she remembers was the great pain, yet she has forgotten the particular procedure.
Not all patients you see in the dental clinics, however, are there because of anxiety. A stretched and complex procedure without the pain is the primary purpose of sedation dentistry. There are patients who copes well through the entire session even without the medication.
She said she is not afraid of the dentist. She always make it to her twice a year checkup for routine cleaning, though she admits to having had three sedation occasions for crowns. She was sleeping throughout the procedure but she can still manage to turn her head or open wider as she was told. If there is one inconvenience, it would be the need to have someone to pick them from the dentist’s office and drive them home.
Had you asked this dentist some years ago, you would not have any interesting detail from him pertaining to sedation dentistry. It was his intention to learn and educate others that pushed him to attend a course tackling the said procedure. After returning to his office, three people there volunteered to be his first patients, and he was sold.
Everything a patient goes through in the clinic entails the involvement of the whole team in the procedure. The dental team should be able to manage the clients once they have been sedated. In addition to the pleasant experience promised to the fearful and anxious patients, this process can actually extinguishing the cycle of fear. There are some patients who will need sedation even for simple procedures like cleaning and more so on challenging procedures. Impending dental problems that have long been ignored may be avoided by doing this.
Obtain further advice on cosmetic dentistry sydney and the subject of dentistry.More expert dentistry information is located at smile dentist.
MAC without any medication
I’m trying to find out how common this practice is— I work for a payer (workers’ comp) and there is one certain pain management practice that always bills for what they call monitored anesthesia care by a CRNA for every patient who gets a facet joint injection, sacroiliac joint injection, and maybe transforaminal ESIs too. The anesthesia record shows only monitoring of blood pressure, O2 sat, and pulse. It has brief notations of medical history such as hypertension or type 2 diabetes. It will state that no IV was started and clearly mark that no drugs were given. We have denied these and in appeals the provider says they are required by ASA guidelines to do "MAC" because of risk factors such as high blood pressure or spikes in blood sugar due to the steroids, or possible movement during the procedure due to severe pain.
If this were only in a few cases I might find it more credible, but it seems to be all of their patients. There are some patients who opt for sedation— other providers usually give moderate sedation by the physician with an RN doing the monitoring. In this practice when they do actually give sedation it’s always billed as "MAC" (01992) never moderate sedation (99152). But the main ones I’m curious about are the ones that are only monitoring. If they claim to be watching for such things as spikes in blood sugar, why do they not show any testing of blood sugar? The idea of MAC is that the anesthesia provider needs to be ready and able to increase or reduce the level of sedation quickly if there are problems. How would you do that if no IV has been started?
I’m only aware of one provider doing this regularly. I searched this forum and found a post from a few years ago saying that MAC can be for monitoring only, but the idea seems to be that it would be high risk patients. And most descriptions of monitored anesthesia care describe it as some level of sedation that due to risk factors may need to be increased or decreased. It’s never described as no sedation at all with a CRNA monitoring the patient.
Very curious to hear from people with more knowledge in this area- thanks:)
Medication count
Can 99211 be billed along with the Urine Drug Screen test when the patient sees the nurse and a suboxione count is done? No vitals are preformed. The Dr will review the note later and prescribe refills. There is no documentation from the Dr on this encounter. Our office is evenly split between yes and no.
Thanks for the help with this sticky problem,
Jennifer
Medication infusion and hydration billing
Good evening,
I would greatly appreciate any advice on the following topic:
In the oncology department some patients receive hydration as well as their medication either due to dehydration, or due to the renal toxicity of the chemo. Hydration is given per the doctor’s order. Previously our billers were consulted and advised that they should credit the hydration hours from the infusion. Now we have different opinions, and we are trying to clarify this issue.
In short the question is:
When a patient is receiving an infusion of medication and also IVF for hydration is the time of the hydration deducted from the infusion hours?
Thank you in advance,
Judith
Patient-Administered Injection of Clinic-Provided medication under direction of LPN
I reviewed a chart note in which the nurse documented that the patient administered his own IM injection under the direction of the LPN (who directed the patient on good aseptic technique, safety rules, and understanding the principles of giving intramuscular injections in the patient’s thigh.)
Since the medication was provided by the clinic but the patient administered the IM injection under the direction of the LPN, what codes can be submitted?:confused:
CVA on medication
Dear All,
I am a bit confused about the coding guideline for CVA. Patient had CVA on 2013 and he is taking blood thinner since then. I couldn’t code history as he is taking medication for the condition.
Kindly help me..:confused:
Coding for medication waste
I would like some assistance in coding for medication waste because I believe there may have been some changes that I have missed.
I bill for a family practice office.
I have been billing the medication code with # of unitsof medication, the administration fee, and the medication code,JW with the # of units waste.
This has been paying until the middle of October and now the waste is being denied.
Any suggestions because I have looked and I am not able to find anything?
Edited to add: This is for an allergy injection where the medication is in a single use vial.
Thank you.
Melissa