When billing the interpretation for a home sleep study, should we bill 90586-26 or G0399-26? We originally billed G0399-26 with POS 22 but Medicare is denying for POS not matching. I’m also seeing old threads stating it isn’t appropriate to bill G0399 with a 26 modifier but have not found concrete evidence to support this. Any help is greatly appreciated!
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Tag Archives: studies
Technical Component for Sleep Studies
HELP!
I’m a newer billing and still learning so much. The sleep center that my doctor always used just closed and he is wanting to start his own. He is looking into getting a HST machine and hiring a sleep tech to manage it right from our office.
My question is being a physician office and not a facility are we still able to do modifier TC so we can get reimbursed for the technical component?
Case Studies: Modifier 59 and X[ESPU] Use
When I last wrote “Modifier 59 – To Use or Not to Use”, I promised to follow it up with some real-life examples of when we should be using the 59 or the new Medicare X[ESPU] modifiers. Let’s look at some clinical examples and first determine if the 59 is applicable, and then assume it […]
AAPC Knowledge Center
FEES Studies Q&A with Stefanie Corbett, postacute regulatory specialist at HCPro
Once Read, Imaging Studies Can’t Be Re-Billed
Question: Can a physicians code separately for reading X-rays or imaging studies taken elsewhere? For instance, could we report the appropriate X-ray CPT® code with modifier 26 Professional component attached? Answer: If another provider (e.g., hospital radiologist) previously read/interpreted the image, and has issued a report, your physician cannot separately code or be paid for […]
AAPC Blog
Nerve Condutions Test/ Number of studies.
The following was performed:
Right Sup Peron Anti Sensory
Left Sural Anti Sensory
Right Sural Anti Sensory
Left Peroneal Motor
Right Peroneal Motor
Left Tibial Motor
Right Tibial Motor
Right Sup Peron Anti Sensory
Left Sural Anti Sensory
Right Sural Anti Sensory
Left Peroneal Motor
Right Peroneal Motor
Left Tibial Motor
Right Tibial Motor
H Reflex Studies
Left Tibial (Gastroc)
Right Tibial (Gastroc)
Provider stays that code is 95911 (9-10) studies, because he counts H-Reflexes as 2 separate studies.
The coder states that the code is 95910 (7-8) studies, because H Reflexes are not billed separately.
I would appreciate anyone help on correct number of studies to be reported.
Practicode question. Radiology studies during ER visit
Hey everyone, new grad here and I just started Practicode with mixed emotions haha but I am getting better. Before I continue I noticed on two of the scenarios I missed points for coding for radiology exams during an ER visit (i.e. a chest xray was ordered for a patient with syncope but the correct answer was coded for the ER visit and an EKG that was ordered). Was this an error or this true to reality? I am on one now that is an ER visit with 3 radiology studies due to an MVA so I dont want to miss all those points if we are not supposed to be coding the radiology studies.
Thanks!
~Tim