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Question: I read about a doctor’s office that was destroyed in a fire, and it occurred to me that we don’t have a protocol for emergencies. What’s a good checklist?

Question: If a patient is brought into the office for the physician or non-physician practitioner (NPP) to develop the chronic care management (CCM) care plan, am I eligible to bill initiating visit code G0506 as well as an E/M office visit code?
We saw a patient who was recently in the emergency department (ED). The report states chest pain as the reason for visit/chief complaint. Can we use this as the chief complaint and location as an HPI element if the ED doctor does not restate it?
Question: I have a patient who is on Medicare but was until recently also covered under his wife’s group health plan at work, which made Medicare his secondary payer. He tells me his wife recently retired. She has kept up the insurance for both of them, but our understanding (and the patient’s) is that in this case, the group plan should now be the secondary and Medicare the primary. Medicare doesn’t acknowledge it, though. What to do?
Question: In the 2017 Medicare physician fee schedule, CMS specifically mentions that the newly billable G0505 (Cognition and functional assessment by the physician or other qualified health care professional in office or other outpatient) could be billed with chronic care management, transitional care management and other services. Under what circumstances would you legitimately bill CCM (99490) with G0505?
Question: An EKG was ordered as a pre-op screening before cataract surgery, but it revealed a right bundle branch block. What diagnosis code would you choose to submit with the claim for the EKG?

Question: We have a nurse practitioner (NP) starting who is not yet credentialed but is shadowing our doctors for both her and them to get comfortable with her and the process of the office. One of our doctors is letting her do procedures while she is in the room with her and the NP is dictating the visit, but we will be billing under the doctor. Is this allowed?


Question: When two surgeons are working a patient, when is modifier 62 (Two surgeons) appropriate and when is modifier 80 (Assistant surgeon) appropriate?

Question: Has anyone billed preventive medicine counseling codes 99401-99404 yet? If so, what was the payer response? Of course there was confusion among the physicians as to what these codes were (mixing them up with a physical), so we have not started using them yet.
Question: We got an email from a client who was unexpectedly told that there was a “systematic data error” in the quality calculation for their value modifier (VM) for 2015 and that they have been moved from a 2% negative adjustment to a 0% adjustment. What happened?


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