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Question: The latest version of procedure-to-procedure (PTP) edits contains hundreds of duplicate edit pairs. The only difference between the pairs is that the first is deleted and the second is valid. This is an example of what we’re seeing... The deletion date is always 12/31/2019. Is this a mistake or is there a reason some pairs look this way?
Question: Now that our joint surgeons are gearing back up to again perform elective procedures, if the surgeon sees the patient in the office and schedules an MRI for them, can we bill for a telehealth visit afterward to go over the results so the patient does not need to return to the office? Is there a particular telehealth code to report if the doctor calls them with the test results?
Question: If one of our physicians dies, what are we obliged to do besides notify the patients and invite them to transfer care to one of our other doctors?
Question: My patient is visiting aged relatives and wants a COVID test before she goes to reduce the chance of infecting them. How should I code this? And will Medicare deny the charge for lack of medical necessity, as my patient lacks any symptoms?
Question: I saw a recent report on telehealth that addresses a situation in which the telehealth patient refuses follow-up care. In the scenario, the patient is determined by the provider to require an office visit or a trip to the emergency room, but the patient refuses the follow-up. The authors say a “Refusal of Care” form should be filled out. We have never used such a form. Should we be doing this?
Question: Do you know where we can find a list of procedures that are allowed in an office setting?
Question: Like many practices, we’re doing a lot of telehealth during the public health emergency (PHE). Does this relieve or reduce our providers’ signature requirements for our Medicare claims?
Question: I have a doctor who’s billing critical care codes without putting the relevant times in his notes. We send these back to him and he amends them properly. Could this still be trouble for us down the road?
Question: I’m trying to figure out the impact of the new medically unlikely edits (MUE) for E/M codes 99201-99215. All codes have an MUE of 24. Does that mean a patient can see multiple physicians of the same specialty who bill under one tax ID on the same date of service? For example, could I bill two E/M visits if a patient saw Dr. Smith for shoulder pain and then saw Dr. Jones for knee pain?
Question: I understand there have been Stark Law waivers issued for the COVID-19 pandemic, and that one of the waivers covers rental arrangements that are under fair market value (FMV), which are usually forbidden under Stark. The shutdown has been hard on the finances of one of our clinics, and the health system that rents space to us, knowing it will be hard to find new tenants, has offered to forgive the rent on that clinic for a month or two to help it stay open. Would the Stark waivers allow such an arrangement?


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