Recent content by Kristen Bensel

  1. K

    Wiki Class (II, III) Obesity with comorbidity - How many codes to use?

    I have a different kind of question about these new codes. One of my providers asked me about this type of scenario: The patient was seen for weight loss and during the initial visit, they were in class 2 obesity. Now that they have been using medication to aid with weight loss, they are now...
  2. K

    Wiki Do they Count- orders only referenced

    If a provider determines that the patient needs to be assessed by a specialist, orders medications, imaging or lab work... but the orders for these is not actually captured in the note as legit orders- does this still count? I know the orders can technically be seen in the medical record, but...
  3. K

    Wiki Am I Crazy?

    That seems risky to code a service that isn't fully supported in the documentation. I was taught that if a provider does not get all of the required documentation for a specific procedure in the original documentation, then it was not to be coded. how can it be coded if it isn't fully...
  4. K

    Wiki Eye Exam Documentation

    What exactly are you meaning for proof of purchase documentation- like an invoice or just a note? I work for a multi-specialty clinic and our EHR is not specialty specific, so we have to get creative sometimes with how certain things are captured. Glasses are one of those things. We have the...
  5. K

    Wiki Q4294 and Q4295

    I would suggest looking up the LCD for your specific MAC for skin substitutes. I had luck finding information for this kind of graft by looking up an application CPT like 15271 to pull up the LCD on Codify. I know that Noridian only covers 5 types (Q4101, Q4106, Q4172, Q4159, Q4160) I know I...
  6. K

    Wiki clearance for respite care admittance

    Good Morning- I have been wracking my brain trying to figure out the appropriate way to code a visit that was for an evaluation prior to admittance to a respite facility. The provider discussed all of the patients history with the family and then added all of the conditions the facility should...
  7. K

    Wiki MA providing Scribe and MA duties

    I have a question from a compliance stand point regarding the use of a medical assistant as a scribe. I understand that an MA can be used as a scribe, but my question is regarding the use of the MA as a scribe AND MA during the same visit. Meaning- the MA checks the patient in, does the regular...
  8. K

    Wiki 11750 Documentation

    my provider specifically states that it is a matrixectomy in her procedure note
  9. K

    Wiki Routine Foot Care and the LCDs

    The codes on the LCD are the codes they require to be covered. Medicare also requires a modifier to be used on those codes when the patient meets the qualifications- Q7, Q8 or Q9. The modifier is used to indicate that the routine foot care was medically necessary in the absence of a covered...
  10. K

    Wiki Co-management

    I would not recommend doing that- if the optometrist office is doing the postoperative care, then they should be billing and get the reimbursement that way. I am more curious if the billing agency is billing correctly. We do co-management with a few ophthalmologist for cataract surgery and I...
  11. K

    Wiki Coding in EMR...

    Not silly at all! ;) However, I had to re-read your question a couple times to make sure I fully understood your question. If I am understanding your question correctly- the phlebotomist puts a claim in the EMR for the venipuncture and uses a dx that is not the same as indicated in the...
  12. K

    Wiki Pharmacist billing time-based codes

    I work for a Tribal 638 clinic (IHS) and we utilize internal pharmacists for chronic care management services, but these encounters can not be billed higher than a 99211, and have to be done incident to the patients provider. This can be done due to the pharmacist being considered an ancillary...
  13. K

    Wiki Telemedicine Originating Site Billing Q3014

    Using the same DX as the outside provider was my original thought- as it would make sense that we are only hosting the patient for an outside providers visit so you would want the diagnosis to be the same- providing they send us the notes so we can know what they billed. But wanted to make sure...
  14. K

    Wiki In-house lab billing

    I currently work in a facility where we have an in house lab we own- we bill for the labs we perform, not for tests that we send out to our reference lab. My previous employer however had an outside lab that a was embedded in the office and they were responsible for billing their own services...
  15. K

    Wiki Telemedicine Originating Site Billing Q3014

    If our facility is billing for being the originating site for a telemedicine visit, what would you suggest the ICD-10 would be for this charge? Would you want to use the diagnosis associated with the visit that the billing provider would use at the distant site? Or maybe something more along the...
See more
Top