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Level 5 Office E/M Code
I was told that if I recommend surgery then I can automatically bill 99205 or 99215. This seems too good to be true. Please advise.
New Patient Visit Denied, What Should I Do?
One of our dermatologists saw a patient the first time in our office. We billed 99204. The insurance carried denied the service. I contacted the insurance carrier and was told that the patient was an established patient to the practice and should be reported as an established patient. The patient did see another dermatologist in our group practice who did an intralesional injection a year ago, but it was in another city. Is the insurance carrier correct or should I appeal this?
Adjacent Tissue Transfer
A few years ago I was at your coding workshop in Chicago – you were great, Kim! I remember discussing the adjacent tissue transfer or rearrangement codes and you said we need a size dimension to code for CPT 14040 or 14041 or any of the ATT codes. Do you have a specific guideline or a resource that I can find to support this? As always thank you so much for your guidance.
2021 EM Guidelines: Only for Medicare?
I work with a surgeon and we see just a few Medicare patients. The surgeon believes the revised 2021 E/M guidelines will not impact our office practice because of our low Medicare volume.
PA Billing ED Consult
Can a PA bill a consult if going to the ED at the request of the ED dr for a stroke? Assume this is a non-Medicare patient and the consult code gets paid.
Billing for a Neurostimulator Implant
My physician billed implanted a neurostimulator into the sacral nerve for urinary incontinence. We billed CPT codes 64562 and 95972 for a Medicare patient. Medicare denied CPT 95972 for the analysis and programming. My physician says it should be paid and we should appeal. Can you provide advice?
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