July 9, 2020 Question: I took out 3 deep cervical nodes for biopsy on the left side. Can I bill 38510 x 3? Answer: No – you’d report 38510 once for any number of nodes removed from the same incision. *This response is based on the best information available as of 07/09/20.
June 25, 2020 Question: We are starting to do cosmetic facial plastic procedures in our ENT practice. How do I code/bill a cosmetic procedure such as a rhinoplasty versus when it gets billed to insurance? Answer: We recommend practices use a dummy code to track cosmetic procedures in the practice management system. For example, a...
June 11, 2020 Question: Are we able to bill for laryngeal nerve monitoring with thyroidectomy procedure? Answer: No – CPT is very clear in that intraoperative monitoring (e.g., 95940, 95941) is included in the global surgical package for the surgeon and should not be separately reported. *This response is based on the best information available...
May 28, 2020 Question: Can we charge a 31231 and a 30901, 30903, or 30905 if the scope is withdrawn and then the cautery is done? Answer: No. CPT 31231 is a diagnostic procedure and includes the parenthetical statement “separate procedure.” That means 31231 is included in a more definitive therapeutic/treatment procedure at the same...
May 14, 2020 Question: In an effort to phase our office “re-opening” to patients during the COVID pandemic, allergy serum that needs to be mixed in preparation must be done and at times there may not be on-site direct supervision by a physician or QHP. Medicare states direct supervision is required. Can we use virtual...
April 30, 2020 Question: What documentation is needed to bill for a phone only visit besides time? Answer: There aren’t any specific rules about documenting telephone calls for covered telephone call services during the current public health emergency, but the general principles of documentation should be your guide. Remember that medical necessity should be documented,...
April 16, 2020 Question: Can we bill telephone calls to Medicare now that we can’t see the patient face- to- face because of COVID-19? Answer: For dates of service March 1st and after, telephone calls (99441-99443 and 98968-98969) are now a covered service temporarily during this public health emergency. However, CMS does not view telephone...
April 2, 2020 Question: Can we bill telehealth visits by time alone? Answer: Yes, if indicated by the code billed. Telemedicine visits have the same documentation requirements as any face-to-face visit, according to the code the provider chooses. Of course medical necessity is the overarching criterion for all visits. *This response is based on the...
March 19, 2020 Question: At a recent KZA coding course, you discussed being able to charge an office visit after an allergy test if a plan for immunotherapy treatment was discussed. Insurance companies are denying this even if we are using a 25 modifier. How can I get this paid if I use the allergy...
March 5, 2020 Question: One of our major payors will not pay a 92504. They state that it is included in the office visit. Any suggestions on how we can get this paid? Answer: You could appeal by saying “even Medicare pays for it.” Otherwise, if you are contracted with the payor, then you’ve agreed...
