January 9, 2020 Question: I have a question about post op visits for PE tubes (code 69436). As you know, these have a 10 day global period but my group of physicians prefer to see these patients back in 4-6 weeks. They state 10 days is not enough time to verify the tubes are working....
December 19, 2019 Question: We are hiring a scribe for the doctor because it will help improve his documentation. Is there anything we need to know about how to document this? Answer: Yes, absolutely. This situation should be clearly delineated so a third party reviewer can identify the provider who performed the service, and the...
December 5, 2019 Question: Is it ok to code 69641, 69642, and 69643 for procedures performed on the same ear at the same operative session? Answer: Absolutely not. Use only one CPT code – whichever represents the procedure performed. *This response is based on the best information available as of 12/05/19. [/cmsmasters_text][/cmsmasters_column][/cmsmasters_row]
November 14, 2019 Question: I oftentimes bill and E/M code with modifier 25 for an office visit and 92504-50 (1 unit) for the binocular microscopy to Medicare. I get denied on 92504-50 but I am paid on 99212. The denial code is “CO-4 The procedure code is inconsistent with the modifier used or a required...
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...
October 17, 2019 Question: A patient had a T&A and had a bleed. She came to office and saw my doctor. My doctor wants to charge an office visit with a 24 modifier for an unrelated E/M service in the global period. He states that the bleed is not related because is it not usual after...
July 11, 2019 Question: What’s the best way to do the diagnosis coding for postop visits? I mean, does it really matter since we aren’t billing for a visit? Answer: The ICD-10-CM guidelines for postop/aftercare include the following: If the original diagnosis is trauma (eg, using an S diagnosis code) or a code that requires...
October 3, 2019 Question: The surgeon I work with has a question regarding billing. Some of the hospitals in the area have a Nurse Practitioner or Physician Assistant on staff that see the ENT consults for us. My ENT will see the consult patient too. The mid-level writes the note but my doctor goes in...
September 19, 2019 Question: We get calls from patients to renew their medications. When the patient comes to office to pick up prescription, can we bill for a nurse visit with 99211? Answer: No. CPT makes it very clear that picking up a prescription does not constitute a billable E/M service. *This response is based...
September 5, 2019 Question: I understand that the new FNA with ultrasound code, 10005, includes the ultrasound guidance for the FNA. But, can we also charge 76536? Answer: Yes, if you have performed a separate diagnostic ultrasound to support 76536. Remember, this is a radiology code. So if you are reporting 76536 without any modifiers...
