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10/22/2018

Question: A nurse practitioner told a patient to return after an office visit if his chest pain worsened, and the provider ordered a nuclear stress test to take place the next day. Can my provider count the plan for the stress test in the medical decision-making for the previous encounter, even if the diagnosis isn’t made until eight days after the face-to-face encounter?

10/22/2018

Question: All of a sudden, I am getting denials from everyone for billing 99214-25 with 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device). Guidelines say billing the codes together is appropriate unless there is a recent change. Is anyone else seeing denials? Before this month, my claims were going through fine.

10/22/2018

Question: What do you know about payments for Zilretta injections? Anything specific that we need to know about billing?

08/20/2018

Question: I’m having a challenge with same-day billing. Here’s my situation: The doctor performs an injection with fluoroscopy at the hospital in the morning and then the patient comes to the office for a follow-up on the same day. The doctor would like to bill both services, but I feel like I’m double-dipping. Can I report both? Any help would be great!

08/20/2018

Question: A patient who steppad and cut herself on a piece of glass months earlier still complained of pain in the area, though the wound was healed. A CT scan showed increased density in the subcutaneous fat on the plantar aspect. Surgery revealed a large, thick, deep callus extending through the dermis down to the subcutaneous tissue and extensive scar tissue. These were excised but no foreign object was found. We’re using 28192 (Removal of foreign body, foot; deep) but is that correct — seeing as we didn’t actually find a foreign body?

07/09/2018
Question: How do I bill if a patient comes in and asks for help quitting e-cigarettes -- that is, vaping? The patient does not smoke regular cigarettes or any other traditional tobacco products; in fact, he says vaping helped him quit cigarettes.
06/25/2018

Question: The CCI edits bundle established patient visits (99211-99215) into the ear wax removal procedure. Per this explanation, I would expect a CCI edit for new patient visits, but I don’t sae them. Can you explain why the edits are not in the code set?

05/21/2018

Question: We have a podiatrist who is having custom orthotics made for his patients. We have been using L3000 (Foot, insert, removable, molded to patient model, ‘ucb’ type, berkeley shell, each) per his instructions, but Medicare is denying the claims. These orthotics are custom-molded insole inserts. What are we doing wrong?

05/14/2018
Question: If Medicare beneficiary enrolled in a skilled nursing facility (SNF) under Part A goes to see a practice physician in her office and the doctor performs E/M and an X-ray, orders a lab test and prescribes a drug, how would each of these services be billed by that physician’s office?
04/23/2018
Question: We have a non-physician practitioner (NPP) who works with our physicians, and all his work is claimed incident to. Sometimes I’m not sure it’s appropriate. I’m told that as long as the supervising physician is in the office when the NPP works and signs the claim, there’s no problem. Is that so?

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