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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Neurology General Coding/Billing & Billing for E/M, EEG, LP done same day in hospital

Am working in office for neurologist who does consultations in hospital. Was told only ICD-10 codes related to neurology should be listed on claim when billing CPT E/M Consult/Followup and Procedures codes for services provided to patients while in hospital by our doctor.

Question 1: Was informed we should first list the "admitting diagnosis" (not the "principal diagnosis") found on the hospital’s billing summary along with only the neurology codes listed. Does this sound right?

Question 2: Should we be listing ICD-10 codes for co-morbidities and/or complications that affect the neurologist’s treatment/medical management of patient? For example, patient has stroke and also has AFib. Shouldn’t we list the ICD-10 codes for both stroke and AFib?

Question 3: When a consult or followup are done on the same date of service as an EEG and/or lumbar puncture (spinal tap) as an inpatient, what modifiers should be attached to E/M and/or procedure codes for the neurology specialist performing them? Debating use of modifier 59 vs. XE when FUp, EEG, and lumbar puncture are done at different times on same date of service. Also, do we have to use HCPCS code AF on E/M or procedure codes to indicate specialist physician service as well as -59 or -XE modifier?

Any helpful advice/guidelines would be appreciated. Thank you.

Medical Billing and Coding Forum

Gait/Balance assessment CPT code for neurology

Hello everyone,
I have been working in the world of Multiple Sclerosis for the past year, which is a big change for me after spending 20 + years in direct care of the world of Developmental Disabilities. My role these days involves chasing after prior authorizations. I am still fairly new to the world of coding but this past year has helped me to understand the CPT codes much more. ICD-10 did not scare or bother me thanks to my previous roles with developmental disabilities.
Today before the end of the day I was asked to help billing decipher which CPT code they should be using for the new Gait and fall risk assessment room we now have.The codes they have billed under are not covered under neurology. I am guessing they should have been looking under the Therapeutic procedures, but that is just a guess as I have no idea what they are working with in the Gait and fall/risk room as far as machines. I’m at a loss until I go back in tomorrow morning and find out more details. However, I thought I would give this forum a shot to see if anyone else out there in the world of neurology has had experience in billing fo this type of assessment. I work with the infusion drugs so this is really a foggy area for me since this is my first involvement with it.

Thank you for any guidance.

Medical Billing and Coding Forum

Critical Care Time- Neurology

I have researched the CMS website, specialist websites, and my local MAC ( first coast). I understand that if the time spent in direct care of life threatening situation is documented, the organ system that is in threat is documented, and the care that was provided excluding billable procedures was documented that the visit may qualify for critical care. As long as the medical decision making is considered high. My issue is that with specialties, such as Neurology, the hospitalist sees a lot of consultations with high-risk diagnoses. What resources or tools do you use to determine if a visit is critical care? A huge bulk of these patients have symptoms of or have strokes, or seizures. I know that when a patient is given tPA, monitored for drug therapy, or has emergency surgery they will be considered for critical care. Do you have any helpful resources, tools, or tips for critical care time?

Medical Billing and Coding Forum