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Question: Our surgeon did a knee replacement on a patient, which put her on a walker and crutches for an extended period of time. Using the crutches caused her back pain, and she saw the surgeon about it. Can the surgeon claim an E/M with modifier 24? Or is this considered a “related” condition?
Question: A patient with a history of hypertension and high cholesterol visits a cardiologist for an appointment, complaining of occasional chest discomfort during exercise. After the physician completes an office visit, it is determined that the patient needs a cardiovascular stress test, which is performed that day by the same physician. Would it be appropriate to report an E/M code for the visit with modifier 25 (Significant, separately identifiable E/M)?
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?


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