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Question: My doctor wants to bill 29125 (Application of short arm splint [forearm to hand]; static) with 29700 (Removal or bivalving; gauntlet, boot or body cast), and from what I understand these codes should not be paired together when the original cast was put on by the same physician. Is that correct policy? If they are not to be billed together, is there anything in writing I can show my providers?

Question: We had a patient walk out of an encounter before the doctor could complete her exam. Is there any way to bill for this?

Question: We have a physician assistant (PA) who sees a patient under the doctor’s supervision for the patient’s first few visits. During those visits, surgery is indicated and the patient then sees the physician to discuss and consent to surgery. Can the physician bill for this visit or is it considered part of the pre-op package? Sometimes surgery is already scheduled before the patient sees the physician. When the surgery is already scheduled but it is the physician’s first time seeing the patient, can this visit be billed?
Question: A surgeon performs a procedure at one practice location. He then leaves that practice, transitioning to a new practice during a patient’s 90-day global period. The second practice is an entirely new group with a new tax ID. When the physician starts at the new practice and sees his patient from the first practice for routine follow-up care, how do we report those post-op visits? Can they be reported separately?
Question: My office is having a debate. Let’s say a new patient has an office visit and physical at the same appointment. Is this coded with one new and one established code or two new codes?

Question: We often see patients who had surgery in St. Louis and come to us for post-operative X-rays rather than driving back for X-ray check-ups. One of our PAs recently saw a patient who falls into this scenario. The patient is still in the global period, but we are not taking over post-operative care. Can we charge an office visit or just the X-ray?

Question: We’re billing for a second surgeon who did light work on a procedure. What’s the difference between 80 (Assistant surgeon) and 81 (Minimum assistant surgeon)?
Question: Prolonged service code 99358 (Prolonged evaluation and management service before and/or after direct patient care; first hour) is now bundled into all the nursing facility codes (99304-99318). This doesn't make sense to me. Anybody know why?
Question: We've had a request from one of our physicians to report chronic care management (CCM) code 99490 using osteoarthritis as one of the qualifying factors. Has anyone used this in the orthopedic setting? The CCM guidelines mention three conditions that must be met to bill, and I’m wondering if the patient has to meet all three of the criteria and not just some or part of it.
Question: In the Quality Payment Program (QPP) proposed rule’s virtual groups section, CMS mentions “self-referral” a few times. Why did that come up?


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