Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 A patient wants a CPK drawn because she's been reading it's a indicator of heart attack risk. I'm not sure how to code it. I try to find the page that copied for cholesterol and stumble into NCCI Policy for Medicare Service Version 15.3. Low and behold it says if a patient comes in with a head injury and he sutures it with checking for immunizations etc. there is no E/M code billable. BUT if the doctor does a neurological exam then there is a seperate E/M code as the neurological exam is not inherent to the procedure of suturing. Go figure! Anyways I'm still trying to find a site that will just list the lab test and the approved diagnosis for the most commonly used tests. I also found a copy of the 283 page manual Pratt was talking about and will wade my way through that. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Myria, Don’t order a test you don’t know how to interpret. I have never heard of CPK as a heart attack risk but it does tell you if you are having a heart attack and patient is probably just wrong on this one and misunderstood. CRP is a separate risk for heart disease but even that one is hard to get covered as there is no treatment for the results. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypractice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: [mailto: ] On Behalf Of Myria Sent: Wednesday, March 03, 2010 9:59 AM To: practiceimprovement1 Subject: Coding Nightmares A patient wants a CPK drawn because she's been reading it's a indicator of heart attack risk. I'm not sure how to code it. I try to find the page that copied for cholesterol and stumble into NCCI Policy for Medicare Service Version 15.3. Low and behold it says if a patient comes in with a head injury and he sutures it with checking for immunizations etc. there is no E/M code billable. BUT if the doctor does a neurological exam then there is a seperate E/M code as the neurological exam is not inherent to the procedure of suturing. Go figure! Anyways I'm still trying to find a site that will just list the lab test and the approved diagnosis for the most commonly used tests. I also found a copy of the 283 page manual Pratt was talking about and will wade my way through that. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Yep, I didn't. I couldn't find anything either. Don't know what she was reading. Thanks Kathy. To: Sent: Wed, March 3, 2010 10:38:47 AMSubject: RE: Coding Nightmares Myria, Don’t order a test you don’t know how to interpret. I have never heard of CPK as a heart attack risk but it does tell you if you are having a heart attack and patient is probably just wrong on this one and misunderstood. CRP is a separate risk for heart disease but even that one is hard to get covered as there is no treatment for the results. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypr actice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of MyriaSent: Wednesday, March 03, 2010 9:59 AMTo: practiceimprovement 1yahoogroups (DOT) comSubject: [Practiceimprovemen t1] Coding Nightmares A patient wants a CPK drawn because she's been reading it's a indicator of heart attack risk. I'm not sure how to code it. I try to find the page that copied for cholesterol and stumble into NCCI Policy for Medicare Service Version 15.3. Low and behold it says if a patient comes in with a head injury and he sutures it with checking for immunizations etc. there is no E/M code billable. BUT if the doctor does a neurological exam then there is a seperate E/M code as the neurological exam is not inherent to the procedure of suturing. Go figure! Anyways I'm still trying to find a site that will just list the lab test and the approved diagnosis for the most commonly used tests. I also found a copy of the 283 page manual Pratt was talking about and will wade my way through that. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Knowing a high CRP helps you counsel the pt about the importance of lifestyle changes, needs to take bp meds, Dm meds, statins etc. Many pts are in denial and CRP is a wake up call Myria, Don’t order a test you don’t know how to interpret. I have never heard of CPK as a heart attack risk but it does tell you if you are having a heart attack and patient is probably just wrong on this one and misunderstood. CRP is a separate risk for heart disease but even that one is hard to get covered as there is no treatment for the results. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypractice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: [mailto: ] On Behalf Of Myria Sent: Wednesday, March 03, 2010 9:59 AMTo: practiceimprovement1 Subject: Coding Nightmares A patient wants a CPK drawn because she's been reading it's a indicator of heart attack risk. I'm not sure how to code it. I try to find the page that copied for cholesterol and stumble into NCCI Policy for Medicare Service Version 15.3. Low and behold it says if a patient comes in with a head injury and he sutures it with checking for immunizations etc. there is no E/M code billable. BUT if the doctor does a neurological exam then there is a seperate E/M code as the neurological exam is not inherent to the procedure of suturing. Go figure! Anyways I'm still trying to find a site that will just list the lab test and the approved diagnosis for the most commonly used tests. I also found a copy of the 283 page manual Pratt was talking about and will wade my way through that. -- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined. This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Can you direct me to some reading to learn more? Thanks. To: Sent: Wed, March 3, 2010 4:01:46 PMSubject: Re: Coding Nightmares Knowing a high CRP helps you counsel the pt about the importance of lifestyle changes, needs to take bp meds, Dm meds, statins etc. Many pts are in denial and CRP is a wake up call On Wed, Mar 3, 2010 at 7:38 AM, Kathy Saradarian <qualityfphughes (DOT) net> wrote: Myria, Don’t order a test you don’t know how to interpret. I have never heard of CPK as a heart attack risk but it does tell you if you are having a heart attack and patient is probably just wrong on this one and misunderstood. CRP is a separate risk for heart disease but even that one is hard to get covered as there is no treatment for the results. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypr actice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimprovement 1yahoogroups (DOT) com] On Behalf Of MyriaSent: Wednesday, March 03, 2010 9:59 AMTo: practiceimprovement 1yahoogroups (DOT) comSubject: [Practiceimprovemen t1] Coding Nightmares A patient wants a CPK drawn because she's been reading it's a indicator of heart attack risk. I'm not sure how to code it. I try to find the page that copied for cholesterol and stumble into NCCI Policy for Medicare Service Version 15.3. Low and behold it says if a patient comes in with a head injury and he sutures it with checking for immunizations etc. there is no E/M code billable. BUT if the doctor does a neurological exam then there is a seperate E/M code as the neurological exam is not inherent to the procedure of suturing. Go figure! Anyways I'm still trying to find a site that will just list the lab test and the approved diagnosis for the most commonly used tests. I also found a copy of the 283 page manual Pratt was talking about and will wade my way through that. -- M.D.www.elainemd. comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 4, 2010 Report Share Posted March 4, 2010 In FPM Anthologies on coding it explains this. If you do a proceedure and a separate evaluation involving more work than proe proceedure work you can do both proceedure code and E & M cod with modifyer since in the same day. Makes sence to payers and coders, but docs would do both and think it is one. More lost money. A patient wants a CPK drawn because she's been reading it's a indicator of heart attack risk. I'm not sure how to code it. I try to find the page that copied for cholesterol and stumble into NCCI Policy for Medicare Service Version 15.3. Low and behold it says if a patient comes in with a head injury and he sutures it with checking for immunizations etc. there is no E/M code billable. BUT if the doctor does a neurological exam then there is a seperate E/M code as the neurological exam is not inherent to the procedure of suturing. Go figure! Anyways I'm still trying to find a site that will just list the lab test and the approved diagnosis for the most commonly used tests. I also found a copy of the 283 page manual Pratt was talking about and will wade my way through that. Quote Link to comment Share on other sites More sharing options...
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