May 23, 2019 Question: We are hiring a scribe for the doctor because it will help improve his documentation. Is there anything we need to know about how to document this? Answer: Yes, absolutely. This situation should be clearly delineated so a third party reviewer can identify the provider who performed the service, and the...
May 9, 2019 Question: The plastic surgeon I work with has a question regarding billing. Some of the hospitals in the area have a Nurse Practitioner or Physician Assistant on staff that see the plastic surgery consults for us. My plastic surgeon will also see the consult patient. The mid-level writes the note but my...
April 25, 2019 Question: We get calls from patients to renew their medications. When the patient comes to office to pick up prescription, can we bill for a nurse visit with 99211? Answer: No. CPT makes it very clear that picking up a prescription does not constitute a billable E/M service. *This response is based...
April 11, 2019 Question: My plastic surgeon debrided an open burn wound that was 45 sq cm then placed a split thickness skin graft over the wound. Can I report 11042 (debridement skin and subcutaneous tissue, first 20 sq cm) and +11045 (each additional 20 sq cm) for the debridement in addition to the split...
March 28, 2019 Question: We have a new plastic surgeon and he’s doing a procedure my other guys don’t perform. The patient goes to radiology for injection of radioactive isotopes then to the operating room where my plastic surgeon excises the skin cancer and then injects blue dye and uses a gamma probe to identify...
March 14, 2019 Question: When you inject Botox for migraine headaches, can you bill the injection code more than one time? We normally go about this as a cosmetic procedure, but I just wanted to look into this to see if I could bill out CPT code 64615 for each muscle group that is injected?...
February 28, 2019 Question: What happened to the skin biopsy codes? I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.” Answer: CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the follow six new codes: Note that tangential biopsies are partial...
February 14, 2019 Question: Would you mind giving your two cents? I saw a patient from urgent care yesterday with no formal referral order put in. But the patient says they sent her over and the Urgent Care nurse practitioner note says “follow up” with our service in the plan. My billers are telling me...
January 31, 2019 Question: What’s the best way to do the diagnosis coding for postop visits? I mean, does it really matter since we aren’t billing for a visit? Answer: Yes, it is important to accurately code the diagnosis. The ICD-10-CM guidelines for postop/aftercare include the following: If the original diagnosis is trauma (eg, using...
January 17, 2019 Question: Can I bill for taking the patient back to the OR to explore and repair post-op hemorrhage on day 3 post-op? I heard that all complications are included in the payment of the original surgery. Answer: Yes, you may bill for this. CPT and Medicare agree that taking the patient back...
