Search found 450 matches

by admin
Wed Jan 16, 2019 11:48 am
Forum: Medical Auditing Forum
Topic: New Dermatology Biopsy Codes and Modifiers
Replies: 1
Views: 639

Re: New Dermatology Biopsy Codes and Modifiers

Hello, I have included slides from the CPT Changes 2019 Webinar presented by NAMAS that may help clarify the use of the new biopsy codes. All the information in the slides comes directly from the 2019 CPT code book. There are a lot more instructions in this area of the book that are not in the slide...
by admin
Thu Oct 25, 2018 9:40 am
Forum: Medical Auditing Forum
Topic: Dexamethasone Sodium Phosphate
Replies: 1
Views: 650

Re: Dexamethasone Sodium Phosphate

J8540 Dexamethasone, oral, .25 mg “The corticosteroid dexamethasone works in the body to control inflammation. One unit of this code represents 0.25 mg of dexamethasone. The route of administration is oral, which is given through the mouth.” “Brand names for this drug include: Baycadron Elixer, Deca...
by admin
Thu Oct 18, 2018 12:19 pm
Forum: Medical Auditing Forum
Topic: Endocrinology HPI and Exam
Replies: 4
Views: 966

Re: Endocrinology HPI and Exam

Hello,

It is true, but in this particular case, if you use the 1995 guidelines, you can use the stools for AS&S for the fat malabsorption.

J Paul Spencer
by admin
Wed Oct 17, 2018 10:54 am
Forum: Medical Auditing Forum
Topic: Endocrinology HPI and Exam
Replies: 4
Views: 966

Re: Endocrinology HPI and Exam

Without a clear date and time, the vitals documented in the second half of the question below can’t be credited. If there is a date and time, this counts as a Constitutional system under 1995 guidelines, or as one bullet under 1997. For 1997, this would qualify as the status of three chronic conditi...
by admin
Wed Oct 17, 2018 10:07 am
Forum: Medical Auditing Forum
Topic: Student catches baby during delivery
Replies: 1
Views: 675

Re: Student catches baby during delivery

Usually in the delivery room, the physician is in attendance, but a delivery nurse does the bulk of the work. As long as the physician is in the room, and upon delivery, works with the maternity team to stabilize the newborn postpartum, the delivery charge can be billed. Who caught the baby doesn’t ...
by admin
Wed Oct 10, 2018 9:29 am
Forum: Medical Auditing Forum
Topic: Auditing CAPD
Replies: 2
Views: 728

Re: Auditing CAPD

Good morning, I am most positive that we have not dealt with that specific service. I would encourage you to research any CPT Assistant article that might provide insight into the code specific guidance. However, please note that the code you mentioned is an unlisted procedure code and while they sh...
by admin
Mon Oct 08, 2018 8:08 am
Forum: Medical Auditing Forum
Topic: Co-surgeon 2 specialty requirement
Replies: 1
Views: 736

Re: Co-surgeon 2 specialty requirement

Good morning, It is possible some payers will not follow the guidance from CMS, but my experience with the major ones is they do. You will have to search your individual payer policies to know for sure. This may be as simple as a quick google search. For example, I googled BCBS co surgeon and the fi...
by admin
Thu Oct 04, 2018 1:59 pm
Forum: Medical Auditing Forum
Topic: Minimal sedation with E/M service
Replies: 1
Views: 620

Re: Minimal sedation with E/M service

Minimal sedation is included in the E/M services as it is done using medication, that does not require extensive independent monitoring, or injection services. Since it is not a separately billable service, and does not require independent monitoring, it does not have to be excluded when documentati...
by admin
Wed Sep 26, 2018 1:30 pm
Forum: Medical Auditing Forum
Topic: Prolonged Care same day as procedure
Replies: 1
Views: 705

Re: Prolonged Care same day as procedure

Each separately billable service is not part of the time for prolonged services. If the time documentation criteria is met then it would be ok. I have seen it, but the documentation needs to specifically exclude every other service that would be affecting the overall level of time. By "specifically"...
by admin
Thu Sep 20, 2018 11:30 am
Forum: Medical Auditing Forum
Topic: EPF Detailed Exam- Noridian Jurisdiction F
Replies: 1
Views: 626

Re: EPF Detailed Exam- Noridian Jurisdiction F

Hello, Based on the 95 guidelines, both EPF and detailed exams are documentation of 2-7 organ systems. The difference is a detailed exam also requires more detail in the exam of the affected organ system. This is usually 3-4 findings documented. If you are unclear about what an appropriate finding i...