Hello, this is my first time using the forum, so I wasn’t sure how to make a post/thread. Hopefully someone can help me out or point me in the right direction. I bill for an Internal Med office and the doc says there is a modifier to use when a patient is seen in the office and then later transported to the hospital. I have one now that was seen for new pt visit but half way through, the ambulance was called and transported the pt to hospital. The doc wants me to bill 99204-AI-25 with 99354, can anyone provide any insight, please?
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Tag Archives: office
New patient office visit with new patient physical/preventive
For commercial insurance, is it better to have patient come back for an annual PE just after patient presents as a new patient? (for 2 separate visits)
In other words, when a patient moves to a new area, and they are due for a Physical/preventive, is it usual for practices to schedule a new patient visit and have the patient come back another day for their annual?
Or, if they are to be billed together, (regarding non-Medicare only, not Wellness) what are the requirements necessary for the providers to document in order to bill both on same day? (PE-annual and office visit same day billing)
Thank you
In other words, when a patient moves to a new area, and they are due for a Physical/preventive, is it usual for practices to schedule a new patient visit and have the patient come back another day for their annual?
Or, if they are to be billed together, (regarding non-Medicare only, not Wellness) what are the requirements necessary for the providers to document in order to bill both on same day? (PE-annual and office visit same day billing)
Thank you
Diagnostic Ultrasound Services Performed in the Office
Ultrasound Technicians are employees of the practice.
Ultrasound equipment is owned by the practice.
The Technicians write the reports/impressions – physicians finalize the read.
Who is the billing/rendering provider?
Ultrasound equipment is owned by the practice.
The Technicians write the reports/impressions – physicians finalize the read.
Who is the billing/rendering provider?
Billing Office Visit + other and then only getting reimbursed the smaller amount
I’m trying to bill a 99213 along with an 81000. I’m getting messages from the carrier that they’re paying for the 81000 and bundling the 99213 under it (so I’m being reimbursed less than $ 10 for a service over $ 100). Is providing a modifier 25 for 81000 a way to get around this?
Thank you!!
Need Help Coding Podiatry Office Visit
Hi Everyone –
Can someone please assist with coding this visit note? I am getting 5 different answers from my coding team of 5 coders.
99212 – is this separately reportable, why or why not?
11720 – is this separately reportable, why or why not?
G0127-XU – is this separately reportable, why or why not?
In your opinion, what would be the final coding.
Link to office visit note: https://drive.google.com/file/d/1IvO…ew?usp=sharing
This is for WYOMING MEDICARE
Thanks in advance for any help with this.
Billing Medicare Wellness with office visit
I work for a group of family practice providers. One has asked me if he could charge a subsequent Medicare wellness visit (G0439) with a NEW patient office visit (99204) for the same encounter. Commercial payers will let me charge an office visit with a NEW patient wellness visit, BUT ONLY IF the office visit used is an established code (ex: 99386+99213=OK; 99386+99203=NOT ok). Is Medicare the same? That is, G0439+99213=ok, but G0349+99203=NOT ok? I haven’t found any CMS policy one way of the other on this, it’s just how I was trained. If you know the answer, great! If you have a reference, even better. (This particular provider wants very much to document and code properly, but he’s very much into "prove it to me/show me the guideline.") Thank you,
EKG’s in MFM office
I was just hired by an Maternal Fetal Medicine physicians office. I do have prior OB/GYN Experience and have come to realize that MFM is just a tad different because they primarily deal with more complex pregnancies. My provider just informed me that he is planning on conducting EKG’s in the office with them being read by an cardiologist for a flat rate. He states he is having to refer patients out frequently for those EKG’s to be conducted at an cardio, family physician or hospital.
My question is would there be some kind of compliance issue with this? Do you think that it would be cost effective and bring in a little more revenue?
Thanks
EKG’s in MFM office
I was just hired by an Maternal Fetal Medicine physicians office. I do have prior OB/GYN Experience and have come to realize that MFM is just a tad different because they primarily deal with more complex pregnancies. My provider just informed me that he is planning on conducting EKG’s in the office with them being read by an cardiologist for a flat rate. He states he is having to refer patients out frequently for those EKG’s to be conducted at an cardio, family physician or hospital.
My question is would there be some kind of compliance issue with this? Do you think that it would be cost effective and bring in a little more revenue?
thanks
Billing for RN services with no supervising provider in the office
I work in an outpatient medical and mental health clinic with 2 locations. My location is mainly admin staff and social workers. We do have an ANP and an RN at this location, but the ANP is moving his office to our other location. The problem is that the nurse wants to remain here and continue to perform med injections and lab draws. Is this allowed? I don’t see how we can bill for these services with no supervising provider present. This is a totally new experience for me so I am totally confused about this. Most of our patients are Medicaid and Medicare, but we do see some other insurances as well.
26040 in office setting
Hi everyone!
I have a claim for 26040 that Medicare denied, saying that "the procedure is inconsistent with the place of service." The POS was 11, office setting. Is this correct? Can this procedure really not be performed in an office?
Thanks for the help in advance 