Listserv Lately 7
by Suzan Hvizdash, CPC, CRN Senior Auditor, Instructor
Boy, another huge week on the list serve! I was off the list for a day and when I read everything getting back, I realized that no one really sleeps; we just rest our eyes for a bit.
The week started with a question concerning coding situations in the ED. Can the ED doc bill for reading x-rays? What about fracture care? Neurovascular testing code used in the ED ? Well, as was the response and consensus, only one read will be reimbursed by most insurance companies. Medicare has defined this as the read that lead to the diagnosis. The fracture care situations are not as easily explained. This gets to be pretty heated pitting the ED docs vs. the Ortho docs. Physicians should bill for the services they provide if they are well documented and, obviously, a billable service. The situation between the ED and the other physicians should be worked out within the hospital setting.
Then the 51 vs. 59 modifier question. This line of question seems to be a common concern as I do see it from time-to-time come on the list. This time we had examples of Bronchoscopies being billed with Mediastinoscopies and Video-Thoracoscopies. What modifier is most appropriate? It seemed the logical answer on this was the -59, if it can easily be determined by the documentation that this was separately identifiable. Otherwise, it would be included in the fee for the other procedure being done.
What about the difference between billing a 90862 and an Evaluation and Management (E/M) code. In the example being questioned, the physicians had wanted to start using the 90862 and the coder wanted some further information. Quin, as always, pulled through for us on this one. He mentioned that the documentation is easier on the 90862, however, the evaluation had to include both the psychological effects as well as the physiological ones regarding the patient’s present therapy.
Lastly, we had a coder looking desperately for her CCS-P results from AHIMA. We all know what is like to wait for results on the many different certification examinations. Taking the test in July and still not having the results, is quite frustrating. We do hope Karen got her results and they were the results she was expecting. Keep us posted! We hope you did well!
Other coding questions were asked including questions concerning CCI, and CEUs. The alphabet soup was in abundance this week. But as always, I do hope you all got your questions answered. If you didn’t try again! Sometimes we miss a question or two as they are coming in.
Until next time,
Joining the list serve: $0
Asking questions on the list serve: $0
Advice received on the list serve: Priceless
Reading your weekly CRN newsletter: $0
The value of reading your weekly CRN newsletter: Priceless
Suzan