Home | News & Analysis | Ask a PBN Expert
Ask a Part B News Expert
Question: May a locum tenens doctor fill in for a deceased doctor?
Question: My practice is seeing more and more cases of drug screening over the past several months. How can I stay compliant with these screens? Is there a national policy related to correct coding?
Question: Can you bill for a 69209 (Removal of cerumen using irrigation/lavage) when a medical assistant performs the service? The CPT Changes clinical example is for a nurse but my providers feel that it should be able to be billed for when a medical assistant performs it.
Question: In the following scenario, is critical-care code 99291 payable for the attending physician and add-on code 99292 payable for a non-physician practitioner (NPP)? Here’s what happened: The physician spent 60 minutes with the patient providing critical care. Later that day, the NPP spent 20 minutes with the patient providing critical care. How should they bill? 
Question: Can we claim transitional care management (TCM) codes 99495 or 99496 on a patient who is discharged to hospice?

Question: Our patient had a mastectomy and developed a seroma in the post-operative period. We performed drainage of the seroma in the doctor’s office. Can we bill with modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period)?

Question: We had a patient present with shoulder pain and joint stiffness that had not been evaluated on a previous visit. Our physician examined his shoulder, discussed and documented various treatment options, and they mutually agreed on a shoulder injection. Can the physician bill for an E/M and the procedure with modifier 25 (Significant, separately identifiable E/M service) or just for the procedure alone?
Question: Can a consulting psychiatrist and/or a psychologist bill HCPCS codes G0502, G0503 and G0504 for psychiatric collaborative care management (CoCM) services or is this for the patient’s primary care provider (PCP) only?
Question: When using the newly covered non-face-to-face prolonged service codes (99358, 99359), can you bill them with time that has been accumulated over several dates of service? I’m asking because this seems very conceivable from a clinical perspective.
Question: Has anyone seen any information regarding commercial payers and reimbursement for transitional care management (TCM) services? I thought I saw an article stating that these codes would now be reimbursed by commercial payers, but I am unable to confirm this information. Please help.


User Name:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Back to top