Does inconsistent lab results warrant an upcoding in the definitive CPT code? Ex: if we tested 7 drug classes (G0480) and the patient tested positive on 5 of those classes in which we performed additional testing to test the quantity, does that warrant a G0481 due to the additional testing?
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HIV quantification is achieved through the use of a number of different assays which measure the amount of circulating viral RNA. Assays vary both in methods used to detect viral RNA as well as in ability to detect viral levels at lower limits. However, all employ some type of nucleic acid amplification technique to enhance sensitivity, and results are expressed as the HIV copy number.
Quantification assays of HIV plasma RNA are used prognostically to assess relative risk for disease progression and predict time to death, as well as to assess efficacy of anti-retroviral therapies over time. HIV quantification is often performed together with CD4+ T cell counts which provide information on extent of HIV induced immune system damage already incurred.
Other Names
HIV-1 or HIV-2 quantification or viral load
CPT Codes
87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification
87539 Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification
See also: ICD-10-CM Codes that Support Medical Necessity
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Tag Archives: Testing
Review of Vanderbilt testing
Does anyone know if there is a code to bill for review of Vanderbilt testing. (ADD testings)
Bacteria and fungal testing on nail clippings
Hi,
I am totally new to pathology coding. I have been doing some research and have become even more confused. I have a list of pathogens to test for and I need the CPT codes. We test nail clippings for fungi and bacteria. Does anyone know where to find these codes? For example Onychocola canadensis, I believe the code to test for this is 87101. Any advice/help would be greatly appreciated.
Thank You
Melanie
Clarification on cardiac diagnostic testing
I am having a discussion with someone about the billing of diagnostic cardiac testing such as Echos, Stress tests, etc…
When it comes to observation/IP patients do you bill the date the test is actually done or the date the physician gets around to signing the chart? Help would be appreciated on this!
Thanks,
Laura
When it comes to observation/IP patients do you bill the date the test is actually done or the date the physician gets around to signing the chart? Help would be appreciated on this!
Thanks,
Laura
Concussion testing in Peds using 96118, 96116, 96120
Hi everyone,
We’re looking at systems to use in our pediatric practice for concussion management. There are two: ClearEdge and ImPACT Pediatric.
Has anyone out there used these in their practice? If yes, have you had any success billing cpt 96118, 96120, 96116, or even 96119 (TC)?
Of course the reps say it will be a positive cash flow addition, but I’d like to hear from the trenches.
We would be the first Peds practice in our area. It’s $ $ $ so I would appreciate anything anyone can share. THANK YOU
We’re looking at systems to use in our pediatric practice for concussion management. There are two: ClearEdge and ImPACT Pediatric.
Has anyone out there used these in their practice? If yes, have you had any success billing cpt 96118, 96120, 96116, or even 96119 (TC)?
Of course the reps say it will be a positive cash flow addition, but I’d like to hear from the trenches.
We would be the first Peds practice in our area. It’s $ $ $ so I would appreciate anything anyone can share. THANK YOU
Drug testing
I have not billed this in awhile an employer supplied urine drug kit do we bill for the collection only?
We do qualify for cLIA wavier for Work Comp 80305QW.
Thank you
We do qualify for cLIA wavier for Work Comp 80305QW.
Thank you
Nuclear testing- ndc units for j2785
Can someone help me with the NDC units for J2785? Is it just 4 units or do you have to convert the mgs to mls? If it’s mls, what is the # of ml?
NCD Released: NGS Testing OK with Medicare
Providers can now be reimbursed for Next Generation Sequencing (NGS) tests for specific cancer situations, a national coverage determination (NCD) by Medicare, the Centers for Medicare & Medicaid Services recently announced. For medical coders working with advanced cancer patients who may be able to be treated based on the genetic makeup of the cancer, this […]
AAPC Knowledge Center
CPT code for HIV Testing
HIV quantification is achieved through the use of a number of different assays which measure the amount of circulating viral RNA. Assays vary both in methods used to detect viral RNA as well as in ability to detect viral levels at lower limits. However, all employ some type of nucleic acid amplification technique to enhance sensitivity, and results are expressed as the HIV copy number.
Quantification assays of HIV plasma RNA are used prognostically to assess relative risk for disease progression and predict time to death, as well as to assess efficacy of anti-retroviral therapies over time. HIV quantification is often performed together with CD4+ T cell counts which provide information on extent of HIV induced immune system damage already incurred.
Other Names
HIV-1 or HIV-2 quantification or viral load
CPT Codes
87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification
87539 Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification
See also: ICD-10-CM Codes that Support Medical Necessity
pf-NCS testing & Documentation
I am looking for any documentation from AMA or AASEM, or anyone, regarding the proper documentation and requirements of pf-Ncs testing. I have so many chiropractors overusing and I can’t prove it. I always though CPT code 95904 required all components mentioned in the description to be correctly identified, but someone is telling me that’s not true.
Providers use 95999 to report pf-NCS, but report 18 or 16 units for each nerve tested. I have been using 0110T as a relatively consistent code to reference for this service and unlisted code, which also changes the unit options to "how many extremities tested". Also, since WC does not have a RVU for this code either, I have used 95904 RVU as a reference for reimbursement.
Is this correct? Or can the provider simply go straight to 95904 and report by nerve. I also do not have medical records, simply working off denials.
Any ideas? Thanks