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Resource Compliance Questions of the Week

medlearn.com from ICD-10 Monitor

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A weekly email update that answers difficult trending billing and coding questions in Radiology, Cardiology, Pharmacy, Laboratory and other specialties.
www.medlearnmedia.com www.medlearnmedia.com
SEPTEMBER 14, 2020


CARDIOLOGY

Question:
May we report code 0482T (absolute quantification) along with the new cardiac positron emission tomography (PET) codes in 2020?
READ THE ANSWER

LABORATORY

Question:
Can we perform repeat organ and disease-oriented panel procedures on a single day of service?
READ THE ANSWER

PHARMACY

Question:
Can we use hydration codes to report drug infusion?
READ THE ANSWER

RADIOLOGY

Question:
What are the anticipated changes to percutaneous core needle lung biopsy?
READ THE ANSWER

RESPIRATORY

Question:
Do you have any advice for billing oximetry trend studies?
READ THE ANSWER

GENERAL

Question:
A progress note from our nurse practitioner (NP) indicated that she was called by nursing to see a patient due to “unequal pupils.” The NP ordered a CT/CTA to rule out associated dissection or blood clot post angiogram earlier today. Would it be correct to assign a diagnosis code for unequal pupils as primary?
READ THE ANSWER
 
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FOR THE WEEK OF SEPTEMBER 21, 2020

CARDIOLOGY

Question:
May we report code 0482T (absolute quantification) along with the new cardiac positron emission tomography (PET) codes in 2020?
READ THE ANSWER
LABORATORY

Question:
Can we perform repeat organ and disease-oriented panel procedures on a single day of service?
READ THE ANSWER
PHARMACY

Question:
Can we use hydration codes to report drug infusion?
READ THE ANSWER
RADIOLOGY

Question:
What are the anticipated changes to percutaneous core needle lung biopsy?
READ THE ANSWER
RESPIRATORY

Question:
Do you have any advice for billing oximetry trend studies?
READ THE ANSWER
GENERAL

Question:
A progress note from our nurse practitioner (NP) indicated that she was called by nursing to see a patient due to “unequal pupils.” The NP ordered a CT/CTA to rule out associated dissection or blood clot post angiogram earlier today. Would it be correct to assign a diagnosis code for unequal pupils as primary?
READ THE ANSWER
 

FOR THE WEEK OF SEPTEMBER 28, 2020​


CARDIOLOGY​

​

Question:
Today we are implanting a BiVentricular Pacemaker (PPM). We attempted a Coronary Sinus (CS) lead, however, it would not work, and they had to use a different CS lead. Is the patient charged for both leads?
READ THE ANSWER

LABORATORY​

​

Question:
What penalties is CMS imposing if a lab fails to comply with the new CLIA COVID requirements?
READ THE ANSWER

PHARMACY​

​

Question:
How are no-cost drugs indicated for infusion services when following payer protocols?
READ THE ANSWER

RADIOLOGY​

​

Question:
Does code 78072 include CT for both attenuation correction and anatomic localization? Can we charge separately for diagnostic CT imaging?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can we unbundle the charge for applying CPAP when billing for polysomnography?
READ THE ANSWER

GENERAL​

​

Question:
When the technique of a nuclear medicine exam states that a whole-body exam was performed, must the doctor document each area of the body, or may the doctor dictate any issues found and then state “remainder of whole-body scan was unremarkable”?
READ THE ANSWER
 

FOR THE WEEK OF OCTOBER 5, 2020​


CARDIOLOGY​

​

Question:
Can codes 93563 and 93564 be reported with code 33418?
READ THE ANSWER

LABORATORY​

​

Question:
May we bill separately for duplicative testing on the same bone marrow biopsy and bone marrow aspirate specimens?
READ THE ANSWER

PHARMACY​

​

Question:
What are DMARDs?
READ THE ANSWER

RADIOLOGY​

​

Question:
Can we use 0031T for myocardial infarct avid imaging?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can we bill separately for the pulse oximetry procedures when trying to determine oxygen saturation levels?
READ THE ANSWER

GENERAL​

​

Question:
The physician documented six follow-up angiograms during an embolization. How many may we report?
READ THE ANSWER
 

FOR THE WEEK OF OCTOBER 12, 2020​


CARDIOLOGY​

​

Question:
I just have a quick question on which charge is sent for a pediatric transthoracic echocardiogram complete. This would be on a newborn of 21 days. Some articles say the first echo is 93306, then if dx with a congenital anomaly, then follow-ups are 93303. What is your guidance?
READ THE ANSWER

LABORATORY​

​

Question:
How many components of a complete blood count should be ordered if we want to report a comprehensive code?
READ THE ANSWER

PHARMACY​

​

Question:
When billing for infusion services, would we need to validate the NCD on a claim for the drug vial?
READ THE ANSWER

RADIOLOGY​

​

Question:
Can extremity angiography codes 75710 and 75716 be assigned for selective and non-selective imaging?
READ THE ANSWER

RESPIRATORY​

​

Question:
Is the preparation and documentation time included within code 95816?
READ THE ANSWER

GENERAL​

​

Question:
When we perform a nuclear medicine thyroid scan and uptake using I 123 capsules are we allowed to charge the patient for the standard capsules?
READ THE ANSWER
 

FOR THE WEEK OF OCTOBER 19, 2020​


CARDIOLOGY​

​

Question:
Can you report radiologic examination codes 71045 and 71046 with 93503?
READ THE ANSWER

LABORATORY​

​

Question:
I’ve heard there are updates on coverage for NGS and germline cancer, is this true?
READ THE ANSWER

PHARMACY​

​

Question:
When we are revising a treatment plan for services related to infusion, how should we support the inclusion of new drugs?
READ THE ANSWER

RADIOLOGY​

​

Question:
An exam is ordered for CT study of the sacroiliac (SI) joints, with and without contrast, with an indication of SI joint pain. SI joints are studied, and findings documented for both joints. Should this be coded with 76380, as we are only studying a limited portion of the pelvis?
READ THE ANSWER

RESPIRATORY​

​

Question:
Do “routine” EEGs codes include hyperventilation?
READ THE ANSWER

GENERAL​

​

Question:
If we are billing only with the TC modifier for 77014 and the 76498 what are the documentation requirements?
READ THE ANSWER
 

FOR THE WEEK OF OCTOBER 26, 2020​


CARDIOLOGY​

​

Question:
The patient presents for a diagnostic left heart catheterization (LHC), left ventriculogram, and selective coronary angiography. The physician determines that hemodynamic assessment should be performed before and after exercise to assist in the clinical diagnosis. The patient is given a pair of 2.5-pound dumbbell weights then asked to exercise by extending
the arms and bringing the arms with the weights to their chest. The patient exercises for three to five minutes. Does this type of exercise meet the criteria for billing code 93464?
READ THE ANSWER

LABORATORY​

​

Question:
What criteria must be met for NGS for germline cancer coverage to be considered reasonable and necessary?
READ THE ANSWER

PHARMACY​

​

Question:
We are administering Kytril by injecting it into the bag of hydrating fluid, what codes would we use to bill?
READ THE ANSWER

RADIOLOGY​

​

Question:
What are the “additional artery” codes for revascularization in the femoral/popliteal territory?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can we use 94799 to report the reassessment of cardio/respiratory response of infants, and if so how must we support it?
READ THE ANSWER

GENERAL​

​

Question:
We have a referring physician that insists on ordering a unilateral screening mammogram on the same script as a unilateral diagnostic mammogram. Can you please advise as to the correctness of this order?
READ THE ANSWER
 

FOR THE WEEK OF NOVEMBER 2, 2020​


CARDIOLOGY​

​

Question:
Can I report 33274 with 93453?
READ THE ANSWER

LABORATORY​

​

Question:
If we perform an additional single antibody stain procedure along with 88346, what code would we report?
READ THE ANSWER

PHARMACY​

​

Question:
What are the keys to differentiating hydration therapy from drug administration?
READ THE ANSWER

RADIOLOGY​

​

Question:
How many times can 76881 or 76882 be billed when multiple joints are scanned during the same patient encounter?
READ THE ANSWER

RESPIRATORY​

​

Question:
What is the purpose of an MWT?
READ THE ANSWER

GENERAL​

​

Question:
What are the documentation requirements when performing a microbubble ultrasound 76978/76979 and a diagnostic ultrasound 76705 during a liver biopsy? What verbiage is required to support performing/charging both in the report?
READ THE ANSWER
 

FOR THE WEEK OF NOVEMBER 9, 2020​


CARDIOLOGY​

​

Question:
Can we report 93461 with 0408T?
READ THE ANSWER

LABORATORY​

​

Question:
Can you tell me more about the new MAAA codes added to the quarterly CLFS update?
READ THE ANSWER

PHARMACY​

​

Question:
How do we bill for drug administration when nursing documentation for intravenous infusion does not note the stop time?
READ THE ANSWER

RADIOLOGY​

​

Question:
If a film is obtained to verify the position of the clip placed during a needle
localization procedure, can we bill this with the unilateral mammogram
code 77065?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can we report 95782 if CPAP is applied during the PSG?
READ THE ANSWER

GENERAL​

​

Question:
May an abdominal duplex scan (93975) be billed more than once in the same day?
READ THE ANSWER
 

FOR THE WEEK OF NOVEMBER 16, 2020​


CARDIOLOGY​

​

Question:
Can we report 93454 if a physician performs road-mapping injections for guidance during a coronary intervention?
READ THE ANSWER

LABORATORY​

​

Question:
Do you have any tips for prostate saturation biopsy specimen collections defined by 55706?
READ THE ANSWER

PHARMACY​

​

Question:
Do you have any tips on how to bill complex drugs for chemotherapy administration?
READ THE ANSWER

RADIOLOGY​

​

Question:
If two cysts in the same breast are aspirated under ultrasound guidance, how do we code the procedure?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can we report an unattended sleep study along with a code for cardiac monitoring?
READ THE ANSWER

GENERAL​

​

Question:
We often report codes 76700 and 3975 together. Do we need a modifier?
READ THE ANSWER
 

FOR THE WEEK OF NOVEMBER 30, 2020​


CARDIOLOGY​

​

Question:
An interventional cardiologist places three drug-eluting stents, one in the left circumflex and another in the obtuse marginal branch. A third DES stent is deployed within the left anterior descending coronary artery. Do you have any recommendations for reporting?
READ THE ANSWER

LABORATORY​

​

Question:
What are the primary technologies involved in urinalysis?
READ THE ANSWER

PHARMACY​

​

Question:
Do we need to bill for monitoring services when further monitoring is required during drug administration?
READ THE ANSWER

RADIOLOGY​

​

Question:
Do you have any tips when reporting an injection/aspiration under ultrasound guidance?
READ THE ANSWER

RESPIRATORY​

​

Question:
Can 31632 be reported multiple times if multiple biopsies are performed?
READ THE ANSWER

GENERAL​

​

Question:
I am finding that payers will not cover 76805 if 76801 has already been billed. Do you know why that is?
READ THE ANSWER

​

​

 
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