If a patient is triage by the nurse but does not stay to see the physician nor receives labs, etc. can we bill for an ED Level 1 visit? I am getting conflicting information from in-house coders and our outside coding vendor. Any guidance you can provide is appreciated. Also, if you have a link to what is correct either way, even more appreciated.
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Tag Archives: without
Restarted Infusion Without Documented Stop BEforehand
Hello All,
I’m hoping to get some opinions regarding how to handle an unusual documented infusion entry. The patient received an infusion of lactated ringers, with frequency documented as Continuous. The times are documented as follows:
3/19 1117 New Bag 100mL/hr
3/19 1338 New Bag 100mL/hr
3/19 1444 Rate/Dose Verify 100mL/hr
3/19 2051 New Bag 100mL/hr
3/20 0028 Rate/Dose Verify 100mL/hr
3/20 0343 Restarted 100mL/hr
3/20 0613 Canceled Entry 100mL/hr
3/20 0614 Stopped 0mL/hr
3/20 0628 New Bag 100mL/hr
Normally, since this was documented as a continuous frequency infusion, I would count from the first entry on 3/19 1117 through 3/20 at 0614; However, with the "Restarted" entry and no "Stopped" time before that, I think I can only charge from the Restarted Time of 3/20 0343 through the Stopped Time 3/20 0614. The other question we had was whether the documented infusion time prior to the "Restarted" entry can be coded at all, mainly as IV pushes as opposed to infusion.
I appreciate any suggestions you may have 
Tracy
Colonoscopy without anesthesia…
Hi,
I have a screening colonoscopy where a medicare patient refused anesthesia. Does this need anything special?? modifier?? DX code?? Or just the CPT and screening DX?? I have never come across this and hoping someone has.
Thanks!
Getting Through an Operative Report, Without Crying
One of the things I love about the mentoring I do for coding students is it reminds me of what it was like to be a newbie. And I don’t just mean the excitement of being on the cusp of a new coding career. I am also grateful to be humbled and reminded that I […]
The post Getting Through an Operative Report, Without Crying appeared first on AAPC Knowledge Center.
Placement of Inguinal Mesh without hernia repair
Good morning,
I am in a quandary…any insight will be appreciated.
The provider clearly documents no hernia, no defect, no areas of weakness…but then places mesh anyway?
How can I capture the mesh insertion without hernia repair…am leaning toward 154xx from integumentary system codes but not sure???
POST-OP DX: Right Cord Lipoma
PX: Open Right Inguinal Hernia Repair with Mesh
*inspected the floor of the inguinal canal and identified no defects or areas of weakness
*no hernia sac was identified and the internal ring was well intact
*prior mesh repair of the laparoscopic hernia repair – intact
*identified a cord lipoma distally, and resected that from the spermatic cord.
** then placed a piece of ProGrip mesh and secured to the pubic tubercle
Post Op Note:
informed him that his prior repair was intact and that his bulge was likely from a cord lipoma
Thanks in advance…
BPP with and without NST
Looking for some guidance. We have midwives who perform the NST on the same day as the MD performing the BPP. Each service provider is trying to bill for their services. We cannot find anythign that shows they can split the billing, we are under the impression it is part of the incident-to guidelines. Does anyone else have any suggestions on the PROPER way this should be billed/coded? We are also seeing CCI edits when done on the same day and same POS of office.
CPT 91122 without physician supervision
My physician is considering billing for 91122 done/performed by his MA, so can we do that without his direct supervision, as code description states: performed by physician?
Employment Opportunities Without Healthcare Setting Experience
Hello. I’m feeling frustrated and thought I’d reach out.
I have a 2 year degree, CCA certification, and CPC-A certification. I’m located just north of the twin cities metro area (MN). I’ve applied for every coding position I come across. I don’t even get a call back for a telephone interview. Many times I get an e-mailed response stating that they require 2 years of healthcare office experience. I’ve been applying and networking and giving it my all – but I’m feeling defeated. I’ve looked into the Project Xtern opportunities, however, none of them are in my metro area. I’m not sure where to go from here. Any feedback / suggestions would be much appreciated. Thank you~
Billing an E&M without patient being present
If we have a patient that has signed permission for daughter to get health status. and we’ve met with daughter to discuss patients status and on what to plan for future. Can we bill an E&M for this encounter without the patient being present?
NCS with or without EMG
HELP!!
I have a new client that has been getting denials for Nerve conduction studies from Medicare. We have gotten some denials on the recent charges we submitted as well.
Medicare is denying 95907-95913 for invalid per LCD when I call I get two different reasons for the actual denial
1) it was not billed with a carpal tunnel dx, this is not a valid denial as 95905 is the only one on the LCD that will only accept Carpal tunnel, the rest will take multiple other dx codes including carpal tunnel. There is no * at the end of the DX code list to indicate that carpal tunnel is required.
2) it was not billed on the same DOS as an EMG, NOWHERE in the LCD does it state that these two test HAVE to be done on the same day. This doctor does the EMG first then reschedules the patient for the NCS.
Then it goes back to the carpal tunnel denial. They quote the following from the LCD:
When a beneficiary has a high pre-test or a priori probability for having the diagnosis of Carpal Tunnel Syndrome, the NC- Stat system (alone) will be allowed, one service per arm, using CPT code 95905, the diagnosis code G56.00-G56.03 should be used. All other diagnosis will be denied as not medical necessary.
This says specifically 95905- the rep I spoke to said its for the range of codes, I said it does not say a range it says 95905.
My issue is I don’t want to appeal the 27 claims I have for them to say ok we will pay then I have to appeal EVERY claim for 95907-95913 that they incorrectly deny, that time and money the provider should NOT have to spend.
Not to mention they lost out on thousands from their charges prior to us taking over their billing that its too late for me to go back and fight. These would have also been incorrectly denied