Month: October 2019

New Patient, or Not?
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New Patient, or Not?

October 31, 2019 Question: If I see a new patient in consultation for a suspicious skin lesion and release them to their primary care provider and they come back to see my partner for eczema one year later on their own, can she report the encounter as a new patient visit?   We are the same...

How do you define “No Qualified Resident Available”?
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How do you define “No Qualified Resident Available”?

October 31, 2019 Question: Our physicians utilize residents during surgery but we have a discrepancy in what is considered a “Qualified Resident”. Some physicians consider a resident qualified to assist day 1 of their residency rotation, while others consider only 4th and 5th year residents as qualified to assist. Can you guide us to documentation...

Thyroidectomy and Parathyroidectomy
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Thyroidectomy and Parathyroidectomy

October 31, 2019 Question: Can we charge a thyroidectomy (e.g., 60240) when we do a parathyroidectomy (60500) Answer: Yes, but only if there is different pathology to support 60500.  The CPT Assistant from December 2012 states the following: When a thyroidectomy is performed for malignancy, the parathyroid glands may also be removed, and because this...

Modifier 58 or 78
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Modifier 58 or 78

October 31, 2019 Question: We have a patient scheduled for manipulation under anesthesia for arthrofibrosis during the post-operative period for a total knee arthroplasty. The patient was informed prior to the TKA surgery that they may need to have the manipulation done post op. Is it appropriate to use modifier 58 for the manipulation because...

Providing the exposure for a neurosurgeon. How is it coded?
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Providing the exposure for a neurosurgeon. How is it coded?

  October 31, 2019 Question: Our vascular surgeon provided exposure for a neurosurgeon for a 3 level anterior spine procedure. We were told to bill 22558 only. Is that correct? Answer: No. If exposure for three levels is performed, the vascular surgeon may report 22558 Arthrodesis, anterior interbody technique for the first level, and the...

Consultation Request
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Consultation Request

  October 31, 2019 Question: Would you mind giving your opinion? I saw a patient from urgent care yesterday with no formal referral order put in. But the patient says they sent her over and the Urgent Care nurse practitioner note says “follow up” with our service in the plan. My billers are telling me...

Augmentation of Pedicle Screws
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Augmentation of Pedicle Screws

October 31, 2019 Question: I injected cement into the pedicles to augment screws in a patient with osteoporosis. My coder suggested using +22859 (Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary...

Mastering the Phone Inquiry
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Mastering the Phone Inquiry

Real Feedback from Mystery Shopping Phone Calls October 29, 2019 Aesthetic surgeons allocate countless dollars on advertising and promotion with the goal of getting the phone to ring. But the ringing phone itself doesn’t equate to success. The goal of that first call is not only to turn “prospects” into “patients” and schedule a consultation....

Why Your Practice Needs a Line of Credit
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Why Your Practice Needs a Line of Credit

October 23, 2019 For decades our firm has recommended that physicians secure a line of credit as part of good financial management. We recently spoke with Kevin T. Wills, CPA, CMPE, Sr. Vice President of Healthcare Business Banking at PNC Bank, to hear his take on why practices need this important financial insurance and the...

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