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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

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

ED Consult with Closed Treatment

Good Morning And Happy Friday:

I need some clarification please on the following scenario:
Patient was seen in the ED Dept for consult on 3/27/19 by Ortho diagnosed with Right Radial Head Fracture, she will be taken to OR 04/08/19. Dr. wants to charge for closed treatment w/consult??? Is this possible???:confused:

TIA,

Medical Billing and Coding Forum

Fracture and dislocation treatment

Does anyone know if we can code a closed reduction of both a fracture AND dislocation at the same site? It looks like the codes I am considering are not bundled, but I’m still not sure if it is technically correct to report both…

The doctor dictated a closed reduction and percutaneous fixation of metacarpal dislocation (26676) and closed reduction and percutaneous fixation of MCP fracture of right small finger (26608). Dx is "baby Bennett’s fracture dislocation right small finger metacarpal" S62.316A and S63.064A.

And it’s not clear in the body of the OP report if those were two separate reductions. It says "A closed reduction of the fracture dislocation was performed by pulling traction on the ring and small fingers and pushing from dorsal to volar at the CMC joint. Fracture reduction was checked in PA and lateral views with mini C arm fluoroscopic imaging. The X-ray images demonstrated excellent reduction of the fracture dislocation of the CMC joint of the right small finger. Next, 3 percutaneously placed K-wires were placed across the fracture from a ulnar to radial direction."

Any suggestions? Thank you! :)

Medical Billing and Coding Forum

17260 Total Treatment diameter vs. lesion size? HELP

Help! I have a dermatology provider who is always billing for malignant destruction lesions. She will document in her note something like this:

The lesion was then prepped with chlorhexidine, and anesthetized with buffered 1 % lidocaine with epinephrine, followed by electrodesiccation and curettage 3 times, achieving 4 mm margins, giving total treatment diameter of 3.3 cm.

I know margins are included per the excision codes (114xx, 116xx) but I have never heard of anyone billing a margin for a destruction (same as a wart)

Is "total treatment area" justifiable as a lesion size or is it only appropriate to bill for the actual size of the lesion only? I’m getting push back from the provider but compliance agrees with us.
CPT assist also states lesion size only and no margins.

Anyone else have any thoughts or solutions

Thanks!

Medical Billing and Coding Forum

Pulse ox with office visit or nebulizer treatment

Please help. Is it "proper" billing to bill 94760 with an office visit (99213/99214) or a nebulizer treatment (94640)? I know if you add modifiers you might get paid . In our situation a medical assistant will take a patients pulse ox and record it in the medical record. We use to do this (with modifier 59 on pulse ox) and got audited by BCBS and they took back payment made for 94760. Now being told to do it again??? (I’m concerned that this would just be unbundling inappropriately.)

Medical Billing and Coding Forum

Billing Room and Board for Residential Treatment

HCPCS H0019 excludes Room and Board so how do you bill for the Room and Board for LOC 3.3 or 3.5 Long Term Residential Substance Abuse Treatment?

Or is there a different HCPCS code to use that includes Room and Board?

Another pressing question that I need an answer to as soon as possible.

I have spent a large amount of time researching this and can’t find this anywhere.

Thxs.

Medical Billing and Coding Forum

Nebulizer treatment 94060-documentation requirements

Does anyone know exactly what must be documented to report a nebulizer treatment. I know the drug is billable separately and the drug, amount and things must be documented, but are there specific requirements for what must be documented to report the treatment itself?

Medical Billing and Coding Forum

Closed Treatment of a Distal Ulna Fx

My Dr’s have a couple patients with a fx of the distal ulna, and per their treatment, they should be in fx care. I have sent for clarification, asking the Dr if the fx is at the distal end of the shaft, or at the ulnar styloid, and they have responded stating the ‘distal ulna’. what fx care code do I use? I have reviewed online and haven’t found a consistent answer.

Medical Billing and Coding Forum