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In Transmittal 784, “January 2006 Outpatient Prospective Payment System Outpatient Code Editor (OPPS OCE) Specifications Version 7.0,” CMS states that Correct Coding Initiative (CCI) edits for ...
The response...
In section 230.2.B. of Chapter 4 of the Medicare Claims Processing Manual under the heading “Included Services,” as revised by Transmittal 785, hospitals are instructed that certain specified s...
Hospitals sh...
In the emergency department (ED), if the hospital chooses not to charge for a procedure like a lumbar puncture, would it be appropriate to increase the ED level?
...It would be ...
What would be the appropriate code for a tympanostomy done under IV sedation with monitored anesthesia (MAC) by an anesthesiologist? We identified two CPT codes that could possibly be reported for ...
Assign CPT c...
What is the proper CPT/HCPCS coding for a Greenlight Photoselective Vaporization of the Prostate (PVP)? When the specific descriptors such as “contact” or non contact” are not specified, can ...
Greenlight L...
A patient with a perianal abscess/fistula came to our facility for a reevaluation and tightening of Seton. A new perianal fistula was identified as well as an external hemorrhoid. The Seton appeare...
Report CPT c...
Prior to 2006, we had decided that IV infusion could not be charged if an antibiotic was given prior to a procedure as a prophylactic measure. In 2005, CPT code 90780 was defined as a therapeutic o...
CPT code 907...
We are in the process of building a single line item charge in a chargemaster to include the supply and the placement procedure for drug eluting stents. What would the appropriate revenue code be f...
HCPCS codes ...
At our facility we were using codes C1762 (Connective tissue human tissue lata) and C1763 (Connective tissue non-human) for sclera tissue purchased from the eye bank. What codes would I use n...
Effective Ja...
When a patient has a laboratory panel test (eg. 80053) and then due to an abnormal result has a repeat individual test performed (eg. 84520) which modifier is more appropriate to append to the CPT ...
When a patie...