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Category Archives: How-To
Q&A: Unattended Home Sleep Study
Q. We have submitted unattended sleep study interpretations with code G0399 with Modifier 26 but have received some denials from Medicare and other commercial carriers. Is it appropriate to use one of the following codes 95800, 95801 or 95806 with a … Continue reading
Posted in How-To, Medicare, Noridian, Q & A, Q & A with RMC
Tagged advice, answers, assistance, billing, claim, CMS, coding, compliance, CPT, medicare, noridian, physician, questions, reimbursement
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HPI Element: Modifying Factor
A modifying factor is something that is being done to help or alleviate the problem. In order to qualify this element, there should be some notation of the patient’s response to that which was done. For example: patient has knee … Continue reading
Posted in How-To, News, Q & A, Q & A with RMC, RMC
Tagged advice, answers, assistance, CMS, coder, codes, coding, compliance, component, CPT, documentation, E/M, education, element, Evaluation and Management, history, HPI, medical coding, medicare, physician, physicians, practice, questions, reimbursement, support
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Exam Finding: Skin Turgor
Skin turgor is the skin’s ability to change shape and return to normal (elasticity). Skin turgor is a sign commonly used by health care workers to assess the degree of fluid loss or dehydration. To determine skin turgor, the health … Continue reading
Modifier 22 – Noridian Administrative Services Processing Change
On January 31, 2012, Noridian Administrative Services (NAS) posted a Medicare Part B News update to Issue 274 dated November 16, 2011. OF NOTE: NAS no longer requests additional documentation on procedure codes when billed with modifier 22. Following the initial … Continue reading
Posted in How-To, Medicare, News, Q & A, Q & A with RMC, RMC
Tagged claim, CPT, documentation, E/M, global, modifier, noridian, operative report, Part B, payment, redetermination, surgical procedure
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D-dimer Test Coding Q&A
Question: “What is the best code for elevated D-dimer test?” Answer: Currently there is no official determination as to the best code for this test. 790.6, other abnormal blood chemistry, relates to chemicals/elements in the blood such as cobalt, copper, … Continue reading
Coding Question: Modifier 25
Q.1. I have a question regarding chemo administration and an E&M on the same day. Due to our remote area, many patients see the physician for their cancer follow up visits on the same day they may be getting chemotherapy. … Continue reading
Posted in How-To, Medicare, Q & A, Q & A with RMC, RMC
Tagged billing, chemotherapy, claim, CMS-1500, coding, documentation, E/M, facility, hospital, modifier 25, physician, UB-04
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Documentation Question: Use of Scribes
Q.1. Will you please describe medical record documentation rules regarding use of a scribe? Apparently this is something that some of our providers are doing. A.1. Use of a scribe is something we’re seeing more and more, especially … Continue reading
Posted in How-To, Medicare, Q & A, Q & A with RMC, RMC
Tagged CMS, documentation, EHR, EMR, scribe, scribing
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Coding Question: Urgent Care
Our hospital has an off-campus urgent care center. When patients come in for suture repair, may we bill both an E&M visit and a suture repair code if sutures are placed? The answer is two-fold to this question. First, (and … Continue reading
Posted in How-To, Q & A with RMC
Tagged advice, answers, coding, E/M, Evaluation and Management, facility, medicare, questions, sutures, urgent care
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Coding Question: OB Billing
Question: I was reading your “As the Practice Codes” October 2011 issue about OB billing. I have a mother that delivered on September 22, 2011. My doctors in the clinic have performed the prenatal and delivery. The patient had scheduled … Continue reading
Posted in How-To, Newsletters, Q & A, RMC
Tagged 59409, 59425, 59426, 59514, 59612, 59620, antepartum, billing, delivery, E/M, global, inpatient, OB, obstetric, outpatient, physician, postdelivery, postpartum
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MUCH ADO ABOUT E/M: Medical Decision Making Q&A
Thank you all for listening to the MUCH ADO ABOUT E/M series! We hope to offer more great topics of interest to physicians and their coders so please let us know if there is a particular area that you’d like … Continue reading
