Recent content by Pam Warren

  1. Pam Warren

    Wiki Two surgeons performing a different surgery on one patient

    Yes, they are. This is different from co-surgery which is a single code where different aspects of that same surgery are performed by two surgeons. It's different also from surgical assists, where one provider is the attending and one is an assistant. Team surgery is a single code or group of...
  2. Pam Warren

    Question Do you try to correct codes that are wrong?

    There is a code for patients having both Type II and I.... (Type 1.5...look it up). I guess I am confused as to why if you are working as a coder you wouldn't be expected to code correctly. Is the provider giving you an ICD-10-CM code, or are you coding based on his note language? Either way...
  3. Pam Warren

    Wiki Bleph/ with Ptosis Repar

    My thoughts? Well, it's unfortunate for the patient to unbundle the charges. If the patient's insurance won't pay both, and the provider is credentialed with that payer, you cannot balance bill the patient. Changing the diagnosis to a cosmetic one just to get paid is hovering really close to...
  4. Pam Warren

    Wiki Billing G0463 together with 11042 during a wound clinic visit vs only billing 11042

    If this is provider-based billing for federal payers, you would report the procedure on both the 1500 and the UB. G0463 is the E&M equivalent on the facility side. If you did just the procedure on the professional side, you bill just the procedure on the facility side.
  5. Pam Warren

    Wiki Anticipatory Guidance, guidance

    Anticipatory guidance is going to be patient-specific. It refers to the patient/provider discussions related to any preventive or risk-reduction advice as relevant to the patient's current lifestyle. For example, I am a stained glass artist and my PCP recommends I be tested for serum lead...
  6. Pam Warren

    Wiki OCP Initiation Visit

    What procedure code are you billing? Some payers will not pay for routine/preventive care unless you also bill a routine CPT code (so not an E&M code). Some payers expect there to be a documented condition/complaint in order to pay for an E&M visit. Check payer policies, in this crazy...
  7. Pam Warren

    Wiki Is This Practicode Correct? OPD7245

    you don't need a -25 on the E&M with an EKG read, per the Social Security Act (and CCI edits, too). RVUs were adjusted to compensate for this. This is an ED visit. Check your E&M codes. You do want to submit the correct answers, but it's equally as helpful to learn and understand the...
  8. Pam Warren

    That LCD was retired in March of 2024. When's your date of service? A draft article is in...

    That LCD was retired in March of 2024. When's your date of service? A draft article is in process. DA59664.
  9. Pam Warren

    Wiki Home Care MSW

    Home health care is a payment model where all services are provided by the Home Health agency, and paid under a single consolidated payment that covers everything rendered to the patient. Generally, you cannot bill separately for services exclusively covered under the care plan and reimbursed...
  10. Pam Warren

    Wiki ATTN CPC-A

    My advice (as someone who has been in the field 30+ years and is a hiring manager) is that you should consider looking for other roles in the revenue cycle. It's very difficult to find a coding job without experience. Look at jobs in billing, medical records, front desk representative...
  11. Pam Warren

    Wiki Compliance Help

    reach out to Stephanie Thebarge on the NAB.
  12. Pam Warren

    Wiki Current vs Malignancy

    This is not an additional surgery for malignancy, since there is no current treatment, no prophylactic treatment, nor any indication of current cancer.
  13. Pam Warren

    Wiki Billing Question

    It depends. Does the procedure have any global days? Is the dizziness/anemia a result/complication of the procedure? Is your provider the attending for the admission? The initial hospital /discharge codes are in the E&M section of CPT.
  14. Pam Warren

    Wiki What coding certification would you recommend.

    Why is your manager threatening your job? Before you invest time/money in another certification, try to find out if this is the manager's (unfortunate) tactic, or if the manager is worried about your job performance. If it's the latter, you may want to focus on improving your coding skills in...
  15. Pam Warren

    Wiki HealthCon 2025

    AAPC has contracts with certain large hotel groups and has to schedule conferences within those venues. I do expect to see some variety in the future years, though. Additionally, with the National HealthCon, several things come into play.... a location that is able to accommodate at least...
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