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Tag Archives: Subsequent

Rapid Strep with subsequent Strep Screen by Bacitracin

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If an office does a rapid strep test (87081) and then subsequently performed a strep screen by bacitracin (87880), do we bill both of these? We have been billing both and I’m noticing some denials coming back saying that 87081 unbundles to 87880, but there is no CCI edit and I have been unable to find anything that addresses this or says we shouldn’t bill these together without a modifier. I think this is how this has normally been billed by all the offices but I am just now seeing some denials.

Thanks.

Samantha

Medical Billing and Coding Forum

Subsequent observation during gloabl period by other physician

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Hi all,

I need a little clarification on this situation.

Patient placed in obs for dehydration, stomach pain and undergoes 90 day global procedure by a specialist outside of our group while in observation. Observation was ordered by my physician.. If an outside physician performs surgery during an observation stay, can my physician still bill for their subsequent visits and discharge?

Medical Billing and Coding Forum

Initial vs subsequent vs sequela

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If a patient was treated in a nearby ER or Hospital for a bone fracture, and then comes to an internal medicine office as an established patient to be treated for the bone fracture, is the fracture treatment/evaluation considered an initial or subsequent visit to the internal medicine office? In other words, is it initial or subsequent if it is the first time patient is in the office for the bone fracture that was diagnosed and evaluated at the nearby ER?
Sequela is late effects so how many months/years need to go by when a subsequent visit/illness becomes a sequela?
thank you

Medical Billing and Coding Forum

BCBS denial for Subsequent observation care

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Patient is BC Medicare, Cardiologist called in for a consult to observation I billed 99218 and was paid. His note states will follow up in AM of no significant arrhythmias okay to discharge from cardiac point of view. So he followed up on day 2 and patient ok for discharge, so I billed 99225 Subsequent observation care. The patients regular Doctor then discharged him. At first BC paid us but then they requested a refund for the 99225 stating can not have a 99225 and a 99217 on the same day. I appealed stating We are a different TIN, office and provider type. They upheld their decision. Is there any other way to get paid for the 99225?
Thanks
Kay

Medical Billing and Coding Forum

routine healing surgical wound, subsequent care at second facility

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I need help getting started on the right track for coding a healing abdominal surgical wound. This patient had lysis of adhesions two days prior to transfer to another hospital. The patient was transferred for an unrelated condition to the abdominal surgery, nevertheless did receive attention to the wound which included removal of some of the staples. There were no complications of surgery, so where do I start in looking for the proper code for the abdominal wound. Is it considered a laceration and what external code would be appropriate?

Medical Billing and Coding Forum