Archive for the Week of June 15, 2007
Archive for the Week of June 15, 2007
Welcome to the medical billing blog archive for the week of June 15, 2007.
Here you will find links to every article added to the Outsource Management Group web site during the week of June 15, 2007.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Using Modifier 25 in Medical Billing
When claims require modifier 25, there are some simple tips you can use to know the modifier’s details, such as which code to append it to, as well as when to use the modifier. It is important to identify the claim makeup in order to solve the problem of which code to use modifier 25 with. Modifier 25 is a significant, separately identifiable evaluation and management service by the same physician on the same day as the procedure or other service. Do you attach modifier 25 to the well visit or to the sick code? Modifier 25 can be applicable on either code. Therefore, the answer depends on the claim …
Team Procedures
All too often, the problem in the case of team procedures, where multiple physicians are involved, is that the first physician’s claim that gets submitted wins. This is especially true when another provider takes credit for radiology services. Let’s take a look at a few examples, to help you figure out how to code your claims to make sure you get a radiology claim to your payer quickly. Example 1: Do both a radiologist and a speech language pathologist need to be present to code a modified barium swallow procedure? They may both need to be present. Guidelines recommend that the service be provided in a team setting. Note the …
Multiple Angiographies
It can sometimes be perplexing when a physician performs angiography on both legs and one arm. Which CPT codes should you use when reporting these procedures? You should report 75710 (which is Angiography, extremity, unilateral, radiological supervision and interpretation) as well as 75716 (angiography, extremity, bilateral radiological supervision and interpretation). Append modifier 59 (which is distinct procedural service) to code 75710. This will show that the procedures were in fact performed on different areas (the arm using the unilateral code and the legs using the bilateral code). The reason for this is that the National Correct Coding Initiative edits bundle unilateral angiogram code 75710 into bilateral angiogram code 75716 with …
E/M and Repair on Laceration Claims
Let’s say an otherwise healthy man reports to the ED with lacerated index and middle fingers on the palmar surface, but there is no significant bleeding. The patient cut himself on a table saw. There is a 1.5cm jagged laceration with protruding fat located on the pad of the distal phalanx of both fingers. The physician uses Marcaine to apply digital blocks to both fingers, explores the wounds and finds no foreign bodies, and then closes the wounds. This encounter should be coded with a pair of E codes, in order to identify the cause of injury. Report this claim as follows: Report 12002 for the wound closure (this is …
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