April 2, 2020 Question: I heard that Medicare patients don’t have to pay their deductible or coinsurance if they have a telemedicine visit. Is this true? Answer: Medicare is not waiving deductibles or co-insurance. However, they are allowing providers to do so at their discretion without penalty for telemedicine visits. This means the provider will...
March 19, 2020 Question: For patients that are having surgery that day, I’ve been doing pre-op visits that morning (coming in earlier), and not doing a pre-op visit in clinic the week before surgery. Can I bill a follow up visit for the meeting/note (H&P) that occurs the morning of surgery? Answer: No—a routine pre-op...
March 5, 2020 Question: I sent a patient out to the hospital for a CT scan and the patient brought in the actual images and the radiologist’s report for me to review. Can I charge 76140 (Consultation on X-ray examination made elsewhere, written report) when I personally interpret those images and write my own report?...
February 20, 2020 Question: A couple of doctors asked me if they can bill for the cervical collar at the end of surgery. I thought that was bundled into the surgery and we could not bill for that, but wanted to double check. Answer: No, placement of a cast, brace and/or dressing at the end...
February 6, 2020 Question: Can we bill the 92242 for the indocyanine green video angiography we do with the pterional craniotomy clipping of an aneurysm? Can I bill for the injection using 15860? We do this to confirm patency of all branch vessels. Answer: No, this service is included in the craniotomy for aneurysm clipping...
January 23, 2020 Question: Our Medicare specialist has advised us to add modifier XU (modifier 59) to CPT code 95970 when billing DBS battery change (61885/61886). It looks to me to be inclusive to the battery placement/change. Is it okay to unbundle this code? If not, when is it ok for us to bill 95970?...
January 9, 2020 Question: We have a new physician who has joined our practice and is documenting use of cross links as well as the pedicle screws and rods is there an additional CPT I should be using for this? Answer: There is not a separate code for this as it is included in the...
December 19, 2019 Question: What would be the appropriate diagnosis code (ICD-10-CM) for “end of life battery” when we have to change the generator in a deep brain stimulator patient. I have gotten mixed responses previously whether or not to bill “mechanical complication” vs “encounter for adjustment”. Or are both of these incorrect? Answer: We...
December 5, 2019 Question: We had a patient show up in our office, after an MRI ordered by another physician, and wanted their shunt settings checked. We checked the shunt and reprogrammed the shunt to the appropriate settings. We’ve never seen this patient before. Would we bill both the consultation code and the shunt reprogramming...
November 14, 2019 Question: I had to replace the ventricular catheter and the valve on a patient with a VP shunt. What code should I use? Answer: Actually you get two codes! CPT 62225 is used for the ventricular catheter replacement and 62230 for the valve replacement. Both codes are appropriate in this scenario. *This...
