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

Billing for time spent counseling for Morbid obesity when done during a Physical

Provider documents
Morbid obesity – E66.01, (HCC), 50 minutes spent with the patient, with over 50% of that spent on discussion of morbid obesity, her attempts at weight loss, the risks and benefits of bariatric surgery. Patient would like to proceed with evaluation.
This was outside of the patients AW visit of 30 minutes
The excludes note for 99404 indicates not allowed with her Physical 99395
The 50 minutes fall short of a prolonged service code
Would it be appropriate to add an E/M for weight loss counsel consideration for Bariatric surgery during her Wellness visit?
Cheri

Medical Billing and Coding Forum

When time spent counseling is the driving factor for E/M and a procedure is done

I’m hoping someone can advise me on this dilemma
I have a provider who will use time spent counseling as the driving factor for E/M.
Example
Pt her for f/u DM,HTN,Hyperlipidemia etc, ROS HPI PFSH and Exam are comprehensive to detailed ,med changes made counseled on diet ….
However sometimes the patient will request a joint injection or lesion removal during the appt and the procedure is done during the visit
he documents 30 minute appointment with >than 50% face to face etc-99214
adding 20610-50 for bilateral knee injections
Am I wrong in thinking that in that 30 minutes the knees were injected as well ?
I’d like to address this with him ,however I know that this will not be received well so I’m hoping someone can confirm or not whether I’m right or wrong
and if there is any information I can use to support changing
Thany you in advance
Cheri

Medical Billing and Coding Forum

query for time spent with patient?

I have this encounter for a procedure as outpatient, the procedure was canceled because the patient’s INR was too high and the patient was sent to ER, our doctor called ER and described the patient’s problem and what they were doing to remedy it.
I was told that I have to query for time spent with the patient since there is no ROS, examination, don’t even a diagnosis on record (just high INR)
Is that considered a leading query?
Please advise

Medical Billing and Coding Forum

How I Spent My Summer, by the Coder Coach (Y93.E6)

I really don’t care if I ever see another cardboard box as long as I live.  After a summer of botched real estate closings and not one, but – count them – two moves spaced two weeks apart (complete with my office and two cats), I think I’ve arrived in my new home with everything except for potentially my sanity. 

I’m not sure which was more foolish – deciding to move the summer before we enter the home stretch of the last year before ICD-10 implementation or deciding to plan a wedding that will occur just a couple of weeks before ICD-10 implementation.  Just for good measure, I decided to do both.  The comforting thing is, ICD-10 is still there waiting for me even after the dust has settled from all of those cardboard boxes and I never did lose sight of my ICD-10 codebooks during the move – er moves.  In fact, my training calendar is booking up fast between now and September of next year!

I was pretty excited to find that there was indeed an ICD-10 code to describe how I spent my summer:

  • Y93.E6, Activity, residential relocation

This code includes packing up and unpacking involved in moving to a new residence.  I wish there was a code for hernia acquired by moving boxes of code books.  I swear those things multiply like rabbits.  And for the record, I have informed my fiancé that we are never moving.  Ever. Again.
Coder Coach