User id : 23222 on "New modifiers to replace modifier 59"
Which modifier would you use of the four we are given for CMS would you use for two colonoscopy procedures 45385/45380?
View ArticleSuperCoder on "New modifiers to replace modifier 59"
Use modifier XS – “Separate Structure, A service that is distinct because it was performed on a separate organ/structure”. This is applicable if
View ArticleUser id : 83704 on "Blocked biliary stent"
A patient with stricture of the biliary duct has stent exchange performed because of stent blockage. Is it correct to code 43276 with 576.2 as the pri
View ArticleUser id : 10697 on "EGD to stomach antrum w/Botox injection"
Physician performed an EGD to stomach atrum & did a Botox injection in the esophagus. I was going to bill 43236 for the EGD/injection & J0585
View ArticleSuperCoder on "EGD to stomach antrum w/Botox injection"
Thanks for your question. You are correct. To report esophagogastroscopy where the duodenum is deliberately not examined (eg, judged clinically not p
View ArticleSuperCoder on "Blocked biliary stent"
Thanks for your question. 43276; Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic d
View ArticleUser id : 27684 on "CPT codes for correct coding initiative"
Filed a insurance claim with Medicare for an inpatient the physician saw and Medicare payment was made as follows: 99223-25 - Paid 43255 - Denied a
View ArticleUser id : 27684 on "medicare modifiers"
Is modifier 59 still valid as modifier for following CPT codes used. 45385 45380-59 What is XS modifier used for? Oklahoma GI
View ArticleSuperCoder on "CPT codes for correct coding initiative"
Thanks for your question. The 59 modifier for distinct procedural service should have been appended to 43255; Esophagogastroduodenoscopy, flexible, t
View ArticleSuperCoder on "medicare modifiers"
Thanks for your question. The 59 modifier is still applicable for Medicare and can be used when there is not a more definitive X(EPSU) modifier to us
View ArticleUser id : 25979 on "screen colon thru stoma"
MD performed screening colon thru stoma. This is a Medicare pt. Pt has hx colon CA. There are no other ICD-9 codes to report w/V10.05. We submitted w/
View ArticleSuperCoder on "screen colon thru stoma"
Thanks for your question. The code you are looking for to represent the colonoscopy through stoma procedure is located in the "Endoscopy, Small Intes
View ArticleUser id : 34267 on "Endoscopic mucosal resection"
Why is there no RVU listed for CPT 45390 'endoscopic mucosal resection'? Is this not a payable code by Medicare or other payors?
View ArticleSuperCoder on "Endoscopic mucosal resection"
These codes with zero RVU are for items and/or services that CMS chose to exclude from the fee schedule payment by regulation. No RVUs or payment amou
View ArticleUser id : 79883 on "Assistant surgeon for CPT 11043 and 11046"
CPT 11046 is an add-on code for primary code 11043; since assistant surgeon (Mod-AS) is applicable for add-on code (11046) only not a primary code (11
View ArticleSuperCoder on "Assistant surgeon for CPT 11043 and 11046"
Thanks for your question. 11043; Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm
View ArticleUser id : 79883 on "Assistant surgeon for CPT 11043 and 11046"
Thanks for your reply. Since CPT 11046 is an add-on code and we cannot report this code alone;then it should be billed with CPT 11043 but this code is
View ArticleSuperCoder on "Assistant surgeon for CPT 11043 and 11046"
You should bill both codes with the AS modifier and allow the insurance company to process the claim according to their policy. You should bill it be
View ArticleUser id : 10697 on "EGD with biopsy to disrupt Schatzkis ring"
Physician performed EGD & pt was found to have a Schatzki's ring. This was "disrupted" at two points using biopsy forceps. The physician then perf
View ArticleUser id : 10697 on "Incomplete EGD"
Endoscope passed over tongue & upon entering the hypopharynx, marked edema is noted. Physician is unable to pass this area into the upper esophage
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