Also, the procedure was 29881 and I saw in Supercoder that 53 is an acceptable modifier to bill discontinued procedure for the surgeon, but the modifier I was considering for the ASC side, 74, was not listed. Does anyone know why?
Thank you!!
Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 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 Click here for more sample CPC practice exam questions and answers with full rationaleAlso, the procedure was 29881 and I saw in Supercoder that 53 is an acceptable modifier to bill discontinued procedure for the surgeon, but the modifier I was considering for the ASC side, 74, was not listed. Does anyone know why?
Thank you!!
Surgeon performed Laparotomy w/right hemicolectomy without anastomosis with the intent to repeat laparotomy with abdominal washout and ileocolic anastomosis the next day.
How would I code these 2 procedures?
Thank you for any direction.
JoAnna Mooney, CPC
I’m trying to determine if this is correct. The patient underwent 46040 a few days ago and due to the complexity of the abscess, they brought the patient back to the OR to perform washout and placement of a JP drain to facilitate healing.
Would I still report 11004 if he’s not actually documenting any debridement?? How do you capture revenue for bringing the patient back to the OR if he’s basically just performing wound care under anesthesia?
Op report states:
we prepped and draped the area and after our final verification we proceeded. We washed out the wound copiously with saline. We then again identified the tracking down towards the perineum close to the perianal area.
Due to the complexity of the wound and tracking, as well as difficulty with packing, I elected to leave a Penrose drain by making a small counterincision slightly into the perianal area. I made a small counterincision a couple of inches away from the already existing scrotal wound. I passed a one-inch Penrose through the deepest part of the already existing abscess cavity and once I did that we secured hemostasis. We washed out the wound further. I secured the Penrose on itself so it was looped and then placed some one-inch packing into both wounds. There were no other complications. We placed a dry gauze as well as a scrotal support and the patient tolerated the procedure well. He was taken out of lithotomy and extubated
thank you,
Kellie
If a patient patient has had recurrent miscarriages and the doctor has trended her hcg levels down to zero with the recommendation that a repeat sono or hsg be repeated after the zero lab draw, would it be appropriate to use z31.41 again? (initially used as a diagnostic test)
Thanks fellow coders!
United Healthcare doesn’t like modifier 76 for a repeat surgical procedure when billed in a postop period of a previous unrelated service which also requires modifier 79
For example…
UHC has no problems billing this…
11401
11401 -76 (repeat excision)
No problem billing this…
11401 -79 (excision billed in a 10 or 90 day postop period of a previously unrelated procedure)
UHC doesn’t like this.
11401 -79
11401 -76 -79 (they don’t like 76 and 79 on the same line)
The second is excision is a repeat procedure and is also in a postop period for a previous unrelated service. Both modifiers are appropriate. They will pay the first, but not the second.
What’s the best way around this? Modifier 59 isn’t appropriate as they aren’t bundled procedures according to the NCCI edits.
There are other carriers that don’t like 76 and 79 together, but UHC is a biggie.
What say ye?
Patient discharged on 4/4/16 17:47, patient later presents to the ER and is seen by the ER physician on 4/4/16 22:16 but a physician order to admit the patient as an inpatient is not completed until 4/5/16 1:14
CMS IOM Medicare Claims Processing Manual – Chapter 3 – Section 40.2.5 – Repeat Admissions When a patient is discharged/transferred from an acute care Prospective Payment System (PPS) hospital, and is readmitted to the same acute care PPS hospital on the same day for symptoms related to, or for evaluation and management of, the prior stays medical condition, hospitals shall adjust the original claim generated by the original stay by combining the original and subsequent stay onto a single claim.