June 30, 2022 Question: The guidelines that came out in 2021 for E/M services is for all types of E/M services, right? Answer: No. The 2021 E/M guidelines are for office/outpatient visit codes only (99202-99215). You will still need to use the 1995/1997 guidelines for all other E/M services, even consultations in the office. *This...
June 16, 2022 Question: Thank you so much for all the information you gave out in Chicago at the KZA Convention. We always have great take-a-ways when we leave there. I do have a question for you regarding incident-to billing for Medicare. One of my physicians is stating that her attorney told her being “under...
June 2, 2022 Question: I was at your conference this past weekend and I was wondering if you could clarify something for me. When a physician sees a Medicare patient in the hospital, and it is their first time seeing the patient however they are NOT the admitting physician, they can only bill a subsequent...
May 19, 2022 Question: Since we have to bring the patients back in for COVID testing and H&P for Joint Commission, can we bill for this visit even though it’s another pre-op visit? Answer: Yes, since the original surgery was canceled and is now under consideration for rescheduling due to the pandemic and needs to...
May 5, 2022 Question: What code do I use for a vocal fold injection for augmentation in the office? Can I also bill for the injection material? Answer: Good questions! The correct code is 31574, Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral when performed via flexible laryngoscopy. If you’re in place of...
April 21, 2022 Question: I did an inpatient consultation and coded 99253 (non-Medicare). I did not need to follow the patient so I signed off. They asked me to re-consult a week later. What is the code for a re-consult? Answer: There are no specific E/M codes for an inpatient re-consultation. You’ll use the subsequent...
April 7, 2022 Question: A few years ago I was at your coding workshop in Chicago – you were great, Kim! I remember discussing the adjacent tissue transfer or rearrangement codes and you said we need a size dimension to code for CPT 14040 or 14041 or any of the ATT codes. Do you have...
March 24, 2022 Question: What code do we charge for an ER visit when our physician was called to the ER by the ER doctor? The patient has Medicare. Answer: If the patient was not admitted by you to the hospital (e.g., they were admitted by another service or discharged), then you code it as...
March 10, 2022 Question: We frequently do a flexible laryngoscopy (31575) or nasal endoscopy (31231) when we see a patient. We always bill the office visit code with modifier 25. Lately, we seem to be getting more denials and have to send in our note for justification. We don’t always get paid. Can you shed...
February 24, 2022 Question: One of our physicians is scheduling a nasal wall reconstruction with Latera®. He is wanting to use code 30465 (repair nasal vestibular stenosis). I know there is a code for Latera which is 30468 and I feel we should use this code. Please give me your opinion. Answer: CPT 30468 was...
