Help Coding

I need help with a big homework assignment. I need icd9 /cpt codes for the following:

A patient presents to the orthopedic office with his index fingers curling of his right hand. The provider diangnosed him with trigger fingers and scheduled him for trigger finger release. He presents to the OR for the trigger finger release of both fingers.

My take is 727.03/26055 ??

2. Patient has severe bilateral wrists pain as well as left elbow pain. He was discovered to have carpal tunnel syndrome and cubital tunnel syndrome. The provider scheduled him for release. He presents to the or where a bilateral endoscopic release was performed and a left cubital tunnel release.

Not sure

3. A patient accidentaly cut the insode of her hand, while cutting food. The laceration measured 5 cm in length. It required a simple laceration repair. While she was there she also had a TDAP injection.

Diagnosis: ? CPT ?

4. Mr. Smith is an 89 year old resident of local nursing home. While eating steak she began to choke at which tshe felt as if she had something stuck in her throat. She currently has breast cancer which she is being treated with chemotherapy which has also spread to her bones, diabetic retinopathy, legal blindness, and AKA of her right leg. She was brought to the ER at which time an EGDY was performed and the foreign body for white residue. The pathology report reported candidal Esophagitis

Diagnosis? CPT ??

Any and all help is greatly appreciated, Thank you in Advance.

Help Coding

How to figure out the correct charges for injections

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I am needing some guidance on figuring the correct amount to charge on injectable drugs. The previous biller never billed for any injections that were given at the office I am currently working in. I am trying to bill for an injection of toradol and in my software the code was never added along with the amounts. I have looked at the fee schedule on my MAC website (cahaba) and the CMS web-site but am very confused on how to figure the amount that can be billed. Any advice or guidance would be greatly appreciated. (The patient has BCBS actually so do I need to look there for pricing?)

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Sheri Meadows

How to figure out the correct charges for injections

Nerve Conduction Studies/NCS

Debate in my office on counting Nerve Conduction Studies. I know they are "per study" and not "per nerve", but I'm looking for some advice on how to code (count) the following. How many studies do you see here?

Motor Nerve Conduction Study

Median Left

Median Right

Ulnar Left

Ulnar Right

Sensory Nerve Conduction Study

Median Left

Median Right

Ulnar Left

Ulnar Right

Radial Left

Radial Right

Palmar Left- Median Palm and Ulnar Palm

Palmar Right- Median Palm and Ulnar Palm

Any help would be greatly appreciated!

Nerve Conduction Studies/NCS

Billing for Lab Out of State

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Can you tell me if you we do lab tests in another state by licensed professionals from another state can we client bill the lab in that state for the technicians work done for that specimen? Example we are in Texas and the lab is in California. The lab there sends us the specimen we do the work up and send results to California and they bill the insurance or patient. We bill them directly for our services. Anyone know if we can do this?

Billing for Lab Out of State

Venogram (IVC) help please

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Procedures

Right heart catheterization, left heart catheterization, coronary angiography, left ventriculography and central venography.

Indication

Dyspnea, abnormal nuclear stress imaging with inferoapical ischemia

Clinical

Mr. Smith is a 70-year-old male with 3 months of increasing shortness of breath on exertion, tis was fairly sudden onset. He has been diagnosed via CT with honeycombing suggesting pulmonary fibrosis, moderate-to-severe pulmonary hypertension on echo estimation, preserved LV function with abnormal nuclear stress imaging as above. Right and left heart catheterization was recommended by his cardiologist in Greenwood. Subsequently, he sought a second opinion and saw Dr.Nawabi. Dr.Nawabi recommended the same. He does have a history of recurrent DVT and pulmonary emboli and is on chronic Coumadin. I was asked to perform the procedure.

Procedure In Detail

After informed consent was obtained, the patient was brought to the cath lab, prepped and draped in the usual sterile fashion. Lidocaine was used for local anesthesia and Versed for sedation. Seldinger technique was used to cannulate the right femoral vein and place a 7-French venous sheath. With some difficulty due to some mild-to-moderate stenosis in the right iliac vein and with the use of a Swan wire, the Swan-Ganz catheter was gently inserted to the region of the IVC filter. It was deiced previously given the patients pulmonary fibrosis and chronic coughing that attempted internal jugular or subclavian venous cannulation without general anesthesia would be difficult and potentially dangerous. Subsequently, we attempted to pass the probe and the Swan-Ganz catheter beyond the IVC filter. Unfortunately, the IVC was completely occluded with collateral flow around the IVC Filter. Venography was performed in this region. Subsequently, attempts were abandoned, the central venous pressure was obtained and subsequently, the Swan-Ganz catheter was removed. Seldinger technique was then used to cannulate the right femoral artery and place a 5-French arterial sheath. JL4 and 3D RC catheters were used for selective coronary angiography. A pigtail catheter was then advanced to the left ventricle for hemodynamic monitoring and left ventriculography. Following the procedure, catheters and sheaths were removed and hemostasis was obtained using manual compression.

the rest of the dictation completes a LHC

how would you code this?

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Last edited by kashyatt@aol.com; Today at 03:56 PM.


Reason: not finished









Venogram (IVC) help please

NCS/Nerve Conduction Studies

Debate in my office on counting Nerve Conduction Studies. I know they are "per study" and not "per nerve", but I'm looking for some advice on how to code (count) the following. How many studies do you see here?

Motor Nerve Conduction Study

Median Left

Median Right

Ulnar Left

Ulnar Right

Sensory Nerve Conduction Study

Median Left

Median Right

Ulnar Left

Ulnar Right

Radial Left

Radial Right

Palmar Left- Median Palm and Ulnar Palm

Palmar Right- Median Palm and Ulnar Palm

Any help would be greatly appreciated!

NCS/Nerve Conduction Studies

Gallbladder surgery

I have a physician that was removing gallbladder, there were so many adhesions that he had to revert to open, he accidently knicked the colon. My understanding is that if he causes it then he can not bill for it, is this correct? Also, if another Dr. was called in and the first Dr. assisted can the other Dr. bill?

Thanks,

Kim

Gallbladder surgery