Search found 441 matches

by admin
Mon Apr 15, 2019 3:11 pm
Forum: Medical Auditing Forum
Topic: NAMAS Webinar Q&A: Specialty Auditing: OB/GYN 04/02/19
Replies: 0
Views: 7

NAMAS Webinar Q&A: Specialty Auditing: OB/GYN 04/02/19

Below are the questions received during our recent webinar, Specialty Auditing: OB/GYN originally presented on April 2, 2019. These questions have been answered by the webinar presenter, Grant Huang, CPC, CPMA. Question 1: Auditing an OB flowsheet would be very helpful for those payers that bill per...
by admin
Fri Mar 01, 2019 10:48 am
Forum: Medical Auditing Forum
Topic: Subspeciality codes
Replies: 1
Views: 95

Re: Subspeciality codes

Hello, To my knowledge, there are no subspecialty codes per se. There are some specialty codes that break out some recognized subspecialty codes. (for example, there is a specialty code for hand surgeon that is independent of the orthopaedic specialty code) Your question has been answered by Pam Van...
by admin
Thu Feb 21, 2019 3:24 pm
Forum: Medical Auditing Forum
Topic: Crisis Codes 90839, 90840
Replies: 2
Views: 118

Re: Crisis Codes 90839, 90840

Hello, While the code indicates “physician or other qualified professional” in the CPT introduction for these codes, it should be expected that a provider who normally provides psychotherapy would be providing and billing for this service. Your question has been answered by J. Paul Spencer, CPC, COC
by admin
Mon Feb 11, 2019 8:07 am
Forum: Medical Auditing Forum
Topic: CPT for crushing concha bullosa endoscopically (ENT question)
Replies: 1
Views: 93

Re: CPT for crushing concha bullosa endoscopically (ENT question)

Hello, In my opinion I would not use 30117 as the RVUs are significantly higher than for 31240. There is currently no code that more appropriately describes the crush method, in which no tissue excision occurs. The payers could argue this is less work and thus not want to reimburse using 31240, but ...
by admin
Thu Feb 07, 2019 1:33 pm
Forum: Medical Auditing Forum
Topic: 2019 Documentation Changes
Replies: 1
Views: 114

Re: 2019 Documentation Changes

Hi there, The work of collecting the HPI is expected to be the work of the provider, but there is nothing to preclude auxiliary staff from recording the information gathered by the provider. Here is a good article resource that our NAMAS president, Shannon DeConda, published with RACMonitor in Janua...
by admin
Wed Feb 06, 2019 9:32 am
Forum: Medical Auditing Forum
Topic: Reporting 95951 when performed for 48 hours
Replies: 1
Views: 89

Re: Reporting 95951 when performed for 48 hours

Hi, There is an article in CPT Assistant from February 2011 which states the following: “Codes 95951 and 95956 are used for recordings in which interpretations can be made throughout the recording time, with interventions to alter or end the recording or to alter the patient care during the recordin...
by admin
Wed Jan 30, 2019 9:22 am
Forum: Medical Auditing Forum
Topic: Using the NAMAS Methodology to Train my Physicians
Replies: 1
Views: 143

Re: Using the NAMAS Methodology to Train my Physicians

Hypertensive urgency does sound like it is level 5 worthy and potentially- based on the rest of the documentation, could even support critical care. To support both- we would have to be able to support the level 5 by documentation and medical necessity and then also support critical care separate an...
by admin
Tue Jan 22, 2019 10:08 am
Forum: Medical Auditing Forum
Topic: Critical Care Coding
Replies: 2
Views: 163

Re: Critical Care Coding

Hello,

A provider cannot bill critical care and an E/M service on the same date if the critical care service is done first. Subsequent care can be billed first and then critical care. I hope that helps!

Your question has been answered by Scott Kraft, CPC, CPMA
by admin
Mon Jan 21, 2019 9:42 am
Forum: Medical Auditing Forum
Topic: Verbal consent for 99451-99452, 99446-99449, G2010, G2012
Replies: 1
Views: 117

Re: Verbal consent for 99451-99452, 99446-99449, G2010, G2012

The CPT guidelines for this new section of electronic consultation codes speaks only to documentation of the written or verbal request of the referring provider to the consulting provider be documented. Since these codes are for communications between the providers, the patient may not even be aware...
by admin
Thu Jan 17, 2019 9:21 am
Forum: Medical Auditing Forum
Topic: 3 chronic or inactive conditions
Replies: 1
Views: 138

Re: 3 chronic or inactive conditions

Hello, HPI is part of the subjective part of the visit. How sick is the patient according to the patient? The information to support the status of three chronic conditions would be the provider documenting the responses of the patient about how they are being effected by the presenting problems. Lab...