Will they use the guidelines that suits THEM or will they always use the guidelines that benefits the physicians?
Also, if it’s an established patient and you need 2 out of 3…history and exam are perfect-comprehensive but MDM lacks complexity, can you still do a moderate using the history and exam, and not MDM?
And if I’m in a urology specialty but the patient has diabetes, CHF, COPD, basically things that the dr doesn’t necessarily treat, but might need to make medical decisions around that, can I bill those diagnoses? Or is it a matter of IF they put it in the assessment and plan? What if they put it there and list it. Can I count those as a point for established problem?
Do they actively have to be treating it on that encounter date? Where I’m struggeling is that they are not ‘treating’ the diabetes, etc. but it could be a factor in decision making.
I’m creating some coding FAQs for dentist who are participating Medicare DME suppliers. They provide Oral appliance therapy for OSA. They have been told after the initial 90 day delivery of the DME device, they should bill Medicare Part B for follow-up visits. I think that’s incorrect because Medicare doesn’t recognize dentist as MDs and Medicare also doesn’t cover dental visits.
Can someone clarify that an DDS/DMD can not bill CPT e/m services to Medicare?
Thank you in advance!
I realize that I can only bill the Therapeutic IV 96365 code, and not hydration administration. But as far as the J-codes Im not sure if I can bill for both?
Thank you so much
Patient placed under general anesthesia. Started the procedure with cystoscopy examining the urethra and bladder. Used cone-tip Cather to inject contrast to outline the ureter and stone. Used open-ended Cather to advance a guide wire through the left ureter, regular guide wire would not go above the stone so they used a glide wire instead. Once the ureter Cather and cytoscope were removed they introduced a #12 french sheath and a #8 french flexible ureterscope up the ureter until stone was identified. Use a french laser fiber pulse to break stone and use the basket to remove fragments. The went up over the ureter up to the kidney to inspected, no more fragments found. Verified by flouroscopy and cystoscopy. No Foley left in place.
Thank you in advance for all your help!
My physician did the following Peripheral Intervention. I am overwhelmed and would appreciate help in coding this. If you know of any good reference…
Medical Billing and Coding Forum
I’m hoping someone can assist with this issue. I have a provider that has gone to a skilled nursing facility to review a patients records, discuss patient care with the SNF, and download information from a BIPAP machine. Is there any billable charges in this scenario?
Also, is there any billable charges when the provider has a phone conversation/encounter with the SNF to discuss patient care?
If this is a billable situation. Can you please tell me what codes should be used and what documentation needs to be done. Our provider is not affiliated with the skilled nursing facility.
Thank you in advance for any advice and assistance you can give.