Search found 45 matches

by JJones
Wed Sep 20, 2017 9:12 am
Forum: Medical Auditing Forum
Topic: F07.81 - Postconcussional Syndrome
Replies: 1
Views: 1351

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...
by JJones
Tue Sep 19, 2017 4:22 pm
Forum: Medical Auditing Forum
Topic: Co-morbidity factoring for MDM
Replies: 1
Views: 996

Co-morbidity factoring for MDM

Hello! Thank you in advance for your help. We have a patient who is being treated for a pressure ulcer which she has had since June (approximately 4 months). In addition, she is diabetic. The question is in counting the correct number of diagnosis or treatment options for this patient. The provider ...
by JJones
Wed Aug 30, 2017 8:57 am
Forum: Medical Auditing Forum
Topic: ACP billed in addition to E/M service
Replies: 0
Views: 1176

ACP billed in addition to E/M service

Hello! Our coding team has received the following question from one of our Palliative providers regarding billing Medicare for Goals of Care and Advanced Care Planning performed on the same day. Can anyone help with this question? Thank you in advance! I am including a scenario below "For an initial...
by JJones
Sun Aug 27, 2017 1:19 pm
Forum: Medical Auditing Forum
Topic: New or Established PROBLEM w/no tx after 2 years
Replies: 1
Views: 964

New or Established PROBLEM w/no tx after 2 years

Hello! We have a patient that saw our provider 2 years previously needing a referral for a stomach issue. He went to the referred provider and found that he had to have a series of blood tests that his insurance would not pay for, so he did not pursue any more treatment until now, 2 years later. He ...
by JJones
Wed Aug 16, 2017 6:28 pm
Forum: Medical Auditing Forum
Topic: Clarification - New or Est Problem to provider?
Replies: 1
Views: 937

Clarification - New or Est Problem to provider?

Hello! One of our coders has come across an interesting scenario today, and we are not sure how to proceed to bill correctly. A patient came to one of our Family med providers in February of 2015. He knew he has a dx of hepatitis C, and was looking for a referral to a gastroenterologist, which our p...
by JJones
Tue Aug 08, 2017 6:29 pm
Forum: Medical Auditing Forum
Topic: Correct coding of Smoking - "Use" vs. "Dependence"
Replies: 1
Views: 879

Correct coding of Smoking - "Use" vs. "Dependence"

Hello! We are very interested in knowing the correct coding for these statements: 1. "Current every day smoker, .25 packs a day, cigarettes, times 10 years". This example was taken from the medical record history that was noted as reviewed by the provider. Is it acceptable to use information strictl...
by JJones
Wed Aug 02, 2017 3:22 pm
Forum: Medical Auditing Forum
Topic: CRC Credential
Replies: 1
Views: 979

CRC Credential

Hello! Are there any NAMAS members that have this credential and are currently using it? I would be very interested in talking with you if so.

Thank you,

JJones
by JJones
Tue Jun 27, 2017 4:12 pm
Forum: Medical Auditing Forum
Topic: HCC Auditing/Coding
Replies: 1
Views: 797

HCC Auditing/Coding

Hello! The group I work with is moving to HCC coding and auditing. We are going into this pretty blind, and I am hoping to connect with someone who does HCC auditing and also provider education. Any guidance would be appreciated! I am also looking for an audit tool specifically for HCC coding. I kno...
by JJones
Sun May 21, 2017 1:19 pm
Forum: Medical Auditing Forum
Topic: 99024 vs. problem visit
Replies: 2
Views: 1369

99024 vs. problem visit

Could someone please give advice on the following note? The scenario is that this note and charge was selected for a Provider's recent review. The coder and myself agreed originally that this should be billed as a 99024. The provider has rebutted saying that "I indicated in my note that the care I w...
by JJones
Thu Mar 09, 2017 7:37 am
Forum: Medical Auditing Forum
Topic: "Note must Stand Alone"
Replies: 1
Views: 1147

"Note must Stand Alone"

Hello! We are trying to locate the exact place where the phrase "all notes must stand alone" comes from. Is it a CMS directive? We have been unable to find anything while searching their website. Thank you in advance for any guidance and/or direction you can give.