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...
August 22, 2019 Question: We have a new ENT and he’s doing a procedure my other guys don’t perform. The patient goes to radiology for injection of radioactive isotopes then to the operating room where he then excises the skin cancer and then injects blue dye and uses a gamma probe to identify a sentinel...
August 8, 2019 Question: What happened to the skin biopsy codes? I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.” Answer: CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the following six new codes: 11102 Tangential biopsy of skin (eg,...
