DAVID STERN, MD (Practice Velocity) Q.Can nebulizer treatments and instructions for use of the nebulizer inhaler be billed together? Who can perform these services in an urgent care center? A. There are two codes associated with nebulizer treatment and instruction: 94640, “Pressurized or non-pressurized inhalation treat- ment for acute airway obstruction or for sputum induc- tion for diagnostic purposes (e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermit- tent positive pressure breathing [IPPB] device”; …
Read MoreJanuary 2013
Billing for Medications, Supplies, and X-rays
DAVID STERN, MD (Practice Velocity) Q. What is the CPT code for Tetracaine Ophthalmic used in an urgent care setting? A. If you are referring to the drops used as part of the treatment in the office, then you should not charge separately for them. They are part of the E/M service. If you are providing a bottle of the solution for a patient to use at home, there are a few practical issues to …
Read MoreDecember 2012
November 2012
Fracture Care, Laceration Kits, Reimbursement for Extended Hours
DAVID STERN, MD (Practice Velocity) Q. When is it appropriate to use fracture codes without manipulation? If a patient comes in with pain in a finger after a fall and an E/M is performed, x-rays are taken to confirm a fracture, the finger is splinted and the patient is referred to an orthopedist, would that treatment constitute billing for initial care? If not, what must we do to be able to bill these? A. CPT …
Read MoreOctober 2012
Tetanus Code Change, Coding Injections and Infusions, Facility and After Hours Codes
DAVID STERN, MD (Practice Velocity) Q. What codes should we use in place of the discontinued 90701 (tetanus vaccines, diphtheria, tetanus toxoids, and whole cell pertussis vaccine [DTP], for intramuscular use) and 90718 (tetanus and diphtheria toxoids [Td] absorbed when administered to individuals 7 years or older, for intramuscular use) that were discontinued effective July 1, 2012? A. You should use 90714 (Tetanus and diphtheria toxoids [Td] absorbed, preservative free, for use in individuals 7 …
Read MoreSeptember 2012
E/M Coding for Multiple Visits, Contracted Case-rate Billing, Comparing Payor Reimbursement Policies
DAVID STERN, MD (Practice Velocity) Q. We sometimes have patients who require two visits to clear impacted cerumen in their ears. In some cases, this procedure requires a 24-hour regimen to soften the cerumen prior to flushing the ear. How do we bill for the second visit and does it change how we bill if we find a second diagnosis after we clear the cerumen? A. For the second visit, you may code for all …
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