Search found 44 matches

by JJones
Tue Jul 10, 2018 1:40 pm
Forum: Medical Auditing Forum
Topic: Prolonged Care 99356
Replies: 1
Views: 739

Prolonged Care 99356

Hello! In the past we have been dinged with errors from outside auditors for allowing conversations with physicians and phone calls with patient family towards prolonged care code (99356). The reason stated only face-to-face can count towards prolonged care. Unit floor time would be for the base cod...
by JJones
Fri Jun 15, 2018 9:01 am
Forum: Medical Auditing Forum
Topic: Non OB related surgical procedures - primary dx
Replies: 0
Views: 865

Non OB related surgical procedures - primary dx

Hello! A coding situation has come up in our office where a maternity patient needed her gallbladder removed. The surgical coder is saying that she was told that the O codes are not required in this case and she applied non-chapter 15 codes. My understanding from the ICD-10 Coding Quidelines is that...
by JJones
Tue Jun 05, 2018 2:39 pm
Forum: Medical Auditing Forum
Topic: Context
Replies: 1
Views: 731

Context

Hello!

Thank you in advance for any help or direction.

If you can consider in HPI that exposure to Strep is context, can the reverse also be used for context - "No known exposure to strep"? The CC is a sore throat.

Thanks again,

J Jones
by JJones
Tue Apr 03, 2018 2:59 pm
Forum: Medical Auditing Forum
Topic: Can a patients spoken language count for Social Hx?
Replies: 2
Views: 1124

Can a patients spoken language count for Social Hx?

Hello!

Can the patient's spoken language count as Social History? We have not been able to find anything saying one way or the other, but many of our providers appear to be using it this way.

Thank you for any help given!

JJones
by JJones
Wed Mar 14, 2018 9:18 am
Forum: Medical Auditing Forum
Topic: Prolonged Services Provider Documentation
Replies: 2
Views: 940

Re: Prolonged Services Provider Documentation

Hello!

The providers don’t have a problem with office visits as they know 100% has to be face-to-face to bill codes 99354 and 99355. It is the inpatient services 99223 and 99233 that are the issue.

Thank you,

J Jones
by JJones
Tue Mar 06, 2018 6:43 pm
Forum: Medical Auditing Forum
Topic: Additional Work-up definition
Replies: 1
Views: 790

Additional Work-up definition

Hello, When a patient presents with a new problem to the provider, and the provider refers them to a specialist (For example, a female patient presenting with abdominal related pains), I would consider this 4 points on the audit tool for a new problem to the provider with additional workup planned. ...
by JJones
Sun Mar 04, 2018 8:23 am
Forum: Medical Auditing Forum
Topic: Prolonged Services Provider Documentation
Replies: 2
Views: 940

Prolonged Services Provider Documentation

Hello! We have several different providers who frequently submit charges for prolonged services due to the nature of their specialties. We want to be sure the way they are documenting the time element of this is correct. The following are 3 examples that we see: 1.Total time 70 minutes with >50% spe...
by JJones
Wed Jan 24, 2018 11:53 am
Forum: Medical Auditing Forum
Topic: Interdisciplinary Team Conference Billing
Replies: 1
Views: 815

Interdisciplinary Team Conference Billing

Hello! Thank you in advance for any help you can provide - we have a provider of Inpatient Rehab Services that has the following question. Due to some time constraints, we would like to get an answer back to him as soon as possible. His question is: "Three days per week, including Tuesdays, we do pa...
by JJones
Fri Dec 01, 2017 12:44 pm
Forum: Medical Auditing Forum
Topic: Medication Refills - Use of Z76.0
Replies: 0
Views: 1192

Medication Refills - Use of Z76.0

Hello! We have a scenario that seems grey to me and I appreciate any direction to be sure we are coding correctly. One of our CC providers saw a patient for a separate condition, and the patient also asked that this provider refill her Januvia, Lantus and Norvasc. He also provided a rx for colostomy...
by JJones
Wed Sep 20, 2017 9:12 am
Forum: Medical Auditing Forum
Topic: F07.81 - Postconcussional Syndrome
Replies: 1
Views: 1228

F07.81 - Postconcussional Syndrome

Hello! Has anyone received a denial when using the F07.81 alone? One of our coders recently did, due to the "Code First" note under F06 which states to "Code first the underlying physiological condition". (There is no mention of "if applicable" to this note, making it sound as though there should be...