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,…

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,…

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…

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…

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…

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,…

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…

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…

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…

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.…

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.…

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…

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.…

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.…

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…

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…

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…

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…

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…

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…

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…

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,…

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…

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?…

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…

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…

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…

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…

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…

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…