Reader Question: Understand When G0268 Outweighs 69210
Question: I billed G0268 with 92511 and had the appropriate documentation for support. One of our private payers denied the G0268 because the “related qualifying service” (Audiologic Function Testing)...
View ArticleReader Question: Sometimes 20552 Applies Instead of 27096
Question: Our physician did an SI injection in the office without any image guidance as the C-arm was not functioning. Should I bill 20552 or 20610? Minnesota Subscriber Answer: Actually, neither code...
View ArticleReader Question: Choose Best Code for Follow-Ups, Not Just 99212
Question: We recently finished our first internal audit and found a potential issue: One of the doctors told me that he only chooses level 99212 when it is a follow-up from Read More...
View ArticleReader Question: Beware Fundoplication Bundles
Question: We had a case where the surgeon had to “redo” an old fundoplication while performing a laparoscopic hiatal hernia repair with placement of Sirgisis mesh. How should we code this, Read More...
View ArticleReader Question: Turn To 64493 for Lumbar Pars Injection
Question: For a patient who is diagnosed with lumbar pars defect, can we report code 64493 for a lumbar pars injection? Is this the correct CPT® code? North Carolina Subscriber Answer: Read More...
View ArticleReader Question: PPD Test May Warrant E/M
Question: Our insurance company bundles an office visit with the code for PPD administration and paying one or the other, but not both. Should we file something differently? North Carolina Subscriber...
View ArticleReader Question: Single Lesion Removal Using Different Techniques
Question: Our internal medicine physician recently performed removal of a plantar wart approximately 5mm in diameter. He initially shaved the lesion and then cauterized it with silver nitrate. He...
View ArticleReader Question: Find Out Whose Chart Gets the Fetal Fracture Dx
Question: Patient was about 6cm and began to have decelerations into the 80’s. They decided to perform an emergency C-section. Because the fetal head was wedged tightly into the pelvis, the Read More...
View ArticleReader Question: Select Glucose Code by Method
Question: We’re getting denials when we bill a blood glucose test with 82962. The payer says that the test isn’t payable under contractual agreement. Is this the correct code? SuperCoder Subscriber...
View ArticleReader Question: Don’t Make This $104 Mistake
Question: Our surgeon removed a mass from a patient’s nose (1.3 cm, including margins), and the pathologist diagnosed it as a dermoid cyst. Should we report 11442 for the service? Nevada Subscriber...
View ArticleReader Question: Stick with 52282 for Permanent Stent
Question: I saw your article on new 2015 codes 52441 and 52442. Is there a specific code for a permanent intra-urethral urethral stent or prostatic stent? Will I be able to Read More...
View ArticleReader Question: Bill for X-rays and Contrast in Prostate Cystogram
Question: How should I report prostate cyst aspiration and prostate cystogram? How do we report for the injection of contrast into the prostatic cyst? Virginia Subscriber Answer: You report code 10021...
View ArticleReader Question: Get Clarification on “Dilation” and 58100
Question: The Feb. 2012 issue of the Ob-gyn Coding Alert has an example of CPT® 58100-endometrial sampling (biopsy) as: “…plastic catheter into the uterus and suctions out a small amount of Read More...
View ArticleReader’s Question: Swine Flu Out of Pandemic Vaccine List
Question: Our practice has been receiving queries for H1N1 vaccinations. What are our coding options and restrictions? New Jersey Subscriber Answer: You should now code H1N1 vaccination as you would...
View ArticleReader Question: Document Donor Site to Code Advancement Flaps
Question: Our surgeon closed a deep abdominal wall defect that was approximately 440 sq. cm. using 300 sq. cm. flaps on each side. Should I report just the repair, or Read More...
View ArticleReader Question: Demonstrate Distinct Multiple Procedures to Unbundle CCI Edits
Question: Our podiatrist visited an established patient at a nursing home but noted an infection and tinea pedis not previously seen. His notes describe an I&D on the left hallux, and Read More...
View ArticleReader Question: CCI Edits Direct Whether 96372 Is Allowed With Scope
Question: When the otolaryngologist performs a scope in the office and also gives a shot (using 96372 for administration and a separate code for the medication), is there any reason to Read More...
View ArticleReader Question: Procedure Specifics Dictate Whether 96372 Can Be Billed With...
Question: A patient visited our office for therapeutic injections of Toradol and Kenalog. Do I report the injection codes or HCPCS medication codes? Would they be billable with an epidural injection?...
View ArticleReader Question: Don’t Prioritize Mass of Uterus
Question: I’ve heard that the mass of a uterus is important for choosing the proper code, so how do I use that information in my code selection for the pathologist’s uterus Read More...
View ArticleReader Question: Meet All the Criteria Before Reporting Bilateral Injections
Question: We have been facing challenges for reporting bilateral procedures like injection codes 64483 (Injection[s], anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance...
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