Month: October 2018

Are You Posting Discounts Right?
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Are You Posting Discounts Right?

October 16, 2018 Many aesthetic practices we visit do not. To verify that you are posting correctly, review these three essentials for posting discounts: 1. Post the full, standard charge for the code or service being discounted. Never change the fee. When you change the fee, you lose the ability to track the true value of...

Physician Compensation
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Physician Compensation

October 10, 2018 Today’s blog addresses compensation and benefits; a complicated subject of upmost interest to our clients. The blog touches on major points to consider regarding compensation and benefits. Physicians and physician groups must consult with compensation experts and legal counsel to insure that they understand the best possible, regulatory compliant compensation model for...

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Adjacent Tissue Transfer

October 4, 2018 Question: If our docs perform two adjacent tissue transfers on two separate lesions in the same anatomic group by CPT standards, do we add the ATTs together and report one code like with the repair codes?  Answer: No, if two lesions from the same anatomic group are removed and both require separate...

Diagnosis Coding for Suspicious Skin Lesion
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Diagnosis Coding for Suspicious Skin Lesion

October 4, 2018 Question: My billing service is waiting for the pathology report and assigning the diagnosis and procedure code for benign or malignant skin lesion removal.  This I completely understand.  However, they are asking me to amend my procedure note accordingly once the pathology report is back.  This is a lot of extra work...

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Nurse Visit Code for SLIT

October 4, 2018 Question: What do you think about a practice charging a nurse visit (99211) when a patient comes in for SLIT? Answer: What is the nurse doing separately to support 99211?  If the intent of the services is to provide the vial of sublingual immunotherapy (SLIT) and instruct the patient how to take...

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Coding Mesentery Repair

October 4, 2018 Question: Documentation states that the mesentery was repaired as part of where the liver was packed. How is this reported? Answer: Code 44850, Suture of mesentery (separate procedure) is designated as a separate procedure and therefore is included in the more comprehensive procedure, the liver packing.  The separate procedure designation means that...

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CERT Reviews for Arthroscopic Rotator Cuff Repairs

October 4, 2018 Question: We recently heard about Medicare doing CERT reviews for CPT code 29827 (arthroscopic rotator cuff repair).   We are not sure this is true and are wondering how we might find out more information? Answer: The information you heard is correct.  We cannot address Medicare’s Scope of CERT reviews but are aware this...

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Modifier 22

October 4, 2018 Question: My neurosurgeon just came back from surgery – he had a really bad day.  He wants me to use modifier 22 on a case but to list it twice because the procedure was twice as difficult.  I wasn’t sure about that. Answer: Oh this is a new one!  Modifier 22 would...

Ultrasound Documentation
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Ultrasound Documentation

October 4, 2018 Question: What needs to be documented when I perform a procedure using ultrasound guidance?  The insurance company denied the service after requesting my procedure note saying it was not documented and will not pay for the service.  Are there any guidelines for this? Answer: According to the CPT guidelines for Radiology services,...

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Repeat Carotid Endarterectomy Coding

October 4, 2018 Question: How is a repeat carotid endarterectomy reported; a few years after the first? Answer: Code 35301, thromboendarterectomy, including patch graft, if performed, carotid, vertebral, subclavian, by neck incision is reported along with the add-on code +35390, re-do carotid endarterectomy at least one month after the original procedure. *This response is based...

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