Get free
resources
practice alerts
Coding Coaches
.
Secondary Payor Doesn't Recognize Consultations
January 19, 2023 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However,…
Secondary Payor Doesn't Recognize Consultations
January 19, 2023 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However,…
Modifier 52 vs. 53
January 19, 2023 Question: We are confused about the difference between modifier 52 and 53. What is the difference? Answer: Modifier 52 Reduced Services is used when the procedure or…
Consultations in 2023
January 19, 2023 Question: I am putting together E&M Guideline educational information for my providers based on the 2023 changes for reference throughout the year. I did some education in…
Forehead Flap
January 19, 2023 Question: Our Otolaryngologist routinely does repairs after Mohs surgery. What CPT code do I report for a paramedian forehead flap to reconstruct a nasal defect after Mohs…
Secondary Payor Doesn't Recognize Consultations
January 19, 2023 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However,…
Global Period for Debridement
January 19, 2023 Question: I thought the global period of debridement of muscle or bone was 10 days. Is that true? Answer: The debridement codes were revised in 2011 and…
E&M Coding Based on Time
January 19, 2023 Question: When choosing the level of E&M we are confused about the History and Exam. If we choose a level of E&M based on time, does this…
New vs Established Patient
December 15, 2022 Question: I am a contracted physician with a group practice (Practice A) in our town. I have an opportunity to contract with another practice (Practice B) not…
Consultation Coding in 2023
December 15, 2022 Question: In 2023, will the level of service be determined by history, exam and medical decision making, or will this change? I have heard it is changing.…
Consultation Coding in 2023
December 15, 2022 Question: In 2023, will the level of service be determined by history, exam and medical decision making, or will this change? I have heard it is changing.…
Retinacular Repairs
December 15, 2022 Question: Our surgeon documented a repair of the patella tendon with repair of the medial retinaculum repair. The surgeon wants to code for the retinacular repairs and…
Consultation Coding in 2023
December 15, 2022 Question: In 2023, will the level of service be determined by history, exam and medical decision making, or will this change? I have heard it is changing.…
Consultation Coding in 2023
December 15, 2022 Question: In 2023, will the level of service be determined by history, exam and medical decision making, or will this change? I have heard it is changing.…
Debridement Coding
December 15, 2022 Question: If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as…
Counting Laminectomy Levels
December 15, 2022 Question: I am confused and hoping you can clarify a coding question I have. I thought I understood how to report laminectomy levels, however, after recently reading…
Excisional Biopsy
December 1, 2022 Question: My physician is insisting that I bill an excision biopsy using a punch as a punch biopsy (11104). The documentation says the lesion was removed in…
2021 E/M Coding Guidelines
December 1, 2022 Question: In the 2021 E/M revision guidelines, how does Time affect billing for a teaching physician’s E/M service when the resident spends a great deal of time…
Oral Food Challenge
December 1, 2022 Question: What needs to be documented to support billing CPT code 95076/95079? Answer: Complete documentation is critical for oral challenges. Be sure to document: Time testing begins…
Coding for Trauma Resuscitation
December 1, 2022 Question: How do we bill for a trauma resuscitation? Are there codes for hanging fluids and packed cells? Can we use the CPR code 92950? Answer: There…
Foreign Body Removal
December 1, 2022 Question: A patient had a craniotomy a week ago and the provider is doing a removal of a retain drain of post op wound in the operating…
Secondary Payor Doesn't Recognize Consultations
December 1, 2022 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However,…
E/M Visit During the Global Period
November 17, 2022 Question: Can I bill an office visit in the global period if the diagnosis is different from why I did the original procedure? Answer: Yes, as long…
Cleft Lip Repair
November 17, 2022 Question: What CPT code do I use to report the repair of the cleft lip with a cross lip pedicle flap and sectioning and inserting the pedicle?…
Stent vs. Embolization or Both
November 17, 2022 Question: If the surgeon uses a covered stent and performs an embolization on a patient with a pseudoaneurysm, can we bill for both the stent and removal…
E&M Coding Based on Time
November 17, 2022 Question: Our physicians default to time for almost every office encounter. We are working with them on documentation and what work contributes to total time and what…
Billing an E/M Service on the Same Day as an Oral Food Challenge
November 17, 2022 Question: My physician always bills an E/M service with CPT codes 95076/95079. Is this allowed? Answer: It’s rare to bill an E/M code with an oral challenge…
Denial for 99214
November 17, 2022 Question: I work with Dermatologists. I have taken a couple of your online webinars. I have a question regarding a denial of office visit 99214, I hope…
What Does “Separate Procedure “Mean in a CPT Code Description?
November 17, 2022 Question: What does “separate procedure” mean when it follows a CPT code description? Answer: Per CPT: Some of the procedures or services listed in the CPT codebook…
Counting Laminectomy Levels
November 17, 2022 Question: I am confused and hoping you can clarify a coding question I have. I thought I understood how to report laminectomy levels, however, after recently reading…