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Tag Archives: Physical

Coding a Medicare Wellness Exam & Complete Physical Together

Posted on by
I’m hoping someone can answer this because I am finding conflicting information in other post or on-line and there is a debate in our office with providers on how to do this. If a patient comes in for their Annual Medicare Exam (G0439) and request a physical as well how would you code both exams? Would you code it as G0439 with an E/M code plus modifier 25 or G0439 with an age preventive visit code with modifier 25?

Thank you,
Lisa

Medical Billing and Coding Forum

Aenta Medicare Reimbursement for Physical Therapy Code

Posted on by
Is anyone having any issues with Aetna Medicare reimbursing for G0283. We keep getting denials and they are stating that it is due to the LCD 35222 stating that the DX is not covered and we have used several DX that should be covered. When we look up LCD 35222 it doesn’t give us much information.

Medical Billing and Coding Forum

Physical Therapy concern

Posted on by
Hi! I recevied this inquiry from our physical therapy department.. any input on this situation would be greatly appreciated!
We have had some difficulty understanding how the per body part per lifetime insurance works. We understand that with a right hip diagnosis, this is going to count towards the right hip. Last week, when we called BCBS, they told us that anytime we add a general code to the chart such as generalized weakness or difficulty walking, it counts towards ALL body parts. Will you help us find out if this is true please?

Thanks in advanced!
Sally, CPC, COSC

Medical Billing and Coding Forum

Physical Therapy concern

Posted on by
Hi! I recevied this inquiry from our physical therapy department.. any input on this situation would be greatly appreciated!
We have had some difficulty understanding how the per body part per lifetime insurance works. We understand that with a right hip diagnosis, this is going to count towards the right hip. Last week, when we called BCBS, they told us that anytime we add a general code to the chart such as generalized weakness or difficulty walking, it counts towards ALL body parts. Will you help us find out if this is true please?

Thanks in advanced!
Sally, CPC, COSC

Medical Billing and Coding Forum

Inpatient physical medicine docs diagnosis

Posted on by
Hi,

I am new to coding for physical medicine doctors. Many of whom, see inpatients before they are and then when they transferred to a rehab floor. My question is how to discern what is the focus of their visit. Typically, these patients have either fallen and broken an leg/arm, or they’ve had a stroke or heart attack. In my opinion, these types of physicians are not treating the underlying illness or injury, but rather the residuals- difficulty walking/malaise/dysphasia/functional decline etc… My physicians list 8-10 +diagnosis and I am not sure what to list first.
If anyone can help me to better understand, I’d truly appreciate it!

Thanks!
-Kathleen

Medical Billing and Coding Forum

Absent/Removed organs: do we credit bullets in the Physical Exam?

Posted on by
Hi everyone,

I need a CMS, AMA or other official reference source for the above question. I found an article in the Supercoder website stating: "If your physician examines a patient who has had an organ removed, you can still count that organ toward the physical exam or review of systems (ROS) in scoring the evaluation and management level, say experts." I’m looking for support on this policy.

I would appreciate if someone could provide a reference for crediting physical exam bullets for absent organs.

Thank you.

Medical Billing and Coding Forum