Category: Physiatry

ER Visit Coding
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ER Visit Coding

May 5, 2022 Question: What code do use when our pain doctor sees a patient in the emergency department for a consultation at the request of the ED physician? Our pain doctor treated the patient and discharged the patient from the ED. Answer: Since the patient was not admitted your physician to the hospital you...

Billing for a Neurostimulator Implant
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Billing for a Neurostimulator Implant

April 7, 2022 Question: My physician billed implanted a neurostimulator into the sacral nerve for urinary incontinence. We billed CPT codes 64562 and 95972 for a Medicare patient. Medicare denied CPT 95972 for the analysis and programming. My physician says it should be paid and we should appeal. Can you provide advice? Answer: Based on...

Counting Problems Addressed for Medical Decision Making
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Counting Problems Addressed for Medical Decision Making

February 24, 2022 Question: If a patient has one stable chronic illness and one acute uncomplicated illness without systemic symptoms, can we “up” the level of Problems Addressed to Moderate? Answer: No, sorry, unfortunately it does not work that way. The problems are no additive or cumulative. One stable chronic illness and one acute uncomplicated...

Inpatient E/M Coding
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Inpatient E/M Coding

February 10, 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 will use the...

Waiving Medicare Cost-share for Telehealth Visits
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Waiving Medicare Cost-share for Telehealth Visits

January 27, 2022 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...

2021 E/M Guidelines MDM Table
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2021 E/M Guidelines MDM Table

December 16, 2021 Question: We are using the 2021 E/M guidelines in the office and in most cases base the level of service on medical decision making. If I have a patient with a chronic condition that is stable who also has diabetes in which the Internist (nor our specialty) is managing, can I assume...

Use of a Scribe
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Use of a Scribe

December 2, 2021 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 record...

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