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re: immunosuppressive therapy

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  • Bob Sanders
    I have a question. I am still a student for medical billing and coding but there seems to be something wrong with the codes. Would it be better to use V58.62
    Message 1 of 9 , Aug 9 7:08 PM
      Message
         I have a question. I am still a student for medical billing and coding but there seems to be something wrong with the codes. Would it be better to use V58.62 instead of V58.83? Like I said, I am still a student but I seriously want to learn as much as I can, as soon as I can. Given the fact that I am 59 years old and changing professions.
         Second question is with he modifier. Shouldn't modifier -21 be used instead of -24? In effect what she is telling Medicare is that the procedure they are doing has nothing to do with the transplant. Or am I reading this wrong?
         Third question. Why is 279.19 being used?
         Hope I am not making a pain of myself. I don't want to do that.
      Thank you,
      Bob Sanders
       
       
       
       
      Primary code is V58.83, second is 279.19, and third is V42.0

      --- In MedicalBillers@yahoogroups.com, Michelle Uhl
      <muhl4groups@y...> wrote:
      > just curious.. what DX are you using
      with these charges?
      >
      > mandybcoder <mandybcoder@y...>
      wrote:I am the coder for a small
      pancreatic and kidney transplant specialist
      > clinic.  Medicare recently has been denying follow-up visits
      within
      > the 90-day window of a transplant for immunosuppressive
      therapy.  I
      > use a modifier -24.  Any suggestions on getting
      those follow-ups
      paid?
      > Thanks,
      > Mandy Buck,
      RHIA

    • Helen L. Avery, CPC
      v07.2 and the v-code for the transplant are what is payable with a -24 for immunosupressive therapy; this is why they are being denied. Helen Bob Sanders
      Message 2 of 9 , Aug 10 6:14 AM
        v07.2 and the v-code for the transplant are what is payable with a -24 for immunosupressive therapy; this is why they are being denied.
        Helen

        Bob Sanders <daretobe@...> wrote:
           I have a question. I am still a student for medical billing and coding but there seems to be something wrong with the codes. Would it be better to use V58.62 instead of V58.83? Like I said, I am still a student but I seriously want to learn as much as I can, as soon as I can. Given the fact that I am 59 years old and changing professions.
           Second question is with he modifier. Shouldn't modifier -21 be used instead of -24? In effect what she is telling Medicare is that the procedure they are doing has nothing to do with the transplant. Or am I reading this wrong?
           Third question. Why is 279.19 being used?
           Hope I am not making a pain of myself. I don't want to do that.
        Thank you,
        Bob Sanders
         
         
         
         
        Primary code is V58.83, second is 279.19, and third is V42.0

        --- In MedicalBillers@yahoogroups.com, Michelle Uhl
        <muhl4groups@y...> wrote:
        > just curious.. what DX are you using with these charges?
        >
        > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
        pancreatic and kidney transplant specialist
        > clinic.  Medicare recently has been denying follow-up visits within
        > the 90-day window of a transplant for immunosuppressive therapy.  I
        > use a modifier -24.  Any suggestions on getting those follow-ups
        paid?
        > Thanks,
        > Mandy Buck, RHIA


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      • Jillian Borders
        Hi, I am sorry, but I am not sure. I only do coding for Chiropractors and Dentists. Again I am sorry, Jillian Borders BORDERS MEDICAL BILLING ... Helen L.
        Message 3 of 9 , Aug 10 9:48 AM
          Hi,
          I am sorry, but I am not sure. I only do coding for Chiropractors and Dentists.
           
          Again I am sorry,
          Jillian Borders
          BORDERS MEDICAL BILLING
          --------------------------------------------------------------------------------------------------------

          "Helen L. Avery, CPC" <helenaverycpc@...> wrote:
          v07.2 and the v-code for the transplant are what is payable with a -24 for immunosupressive therapy; this is why they are being denied.
          Helen

          Bob Sanders <daretobe@...> wrote:
             I have a question. I am still a student for medical billing and coding but there seems to be something wrong with the codes. Would it be better to use V58.62 instead of V58.83? Like I said, I am still a student but I seriously want to learn as much as I can, as soon as I can. Given the fact that I am 59 years old and changing professions.
             Second question is with he modifier. Shouldn't modifier -21 be used instead of -24? In effect what she is telling Medicare is that the procedure they are doing has nothing to do with the transplant. Or am I reading this wrong?
             Third question. Why is 279.19 being used?
             Hope I am not making a pain of myself. I don't want to do that.
          Thank you,
          Bob Sanders
           
           
           
           
          Primary code is V58.83, second is 279.19, and third is V42.0

          --- In MedicalBillers@yahoogroups.com, Michelle Uhl
          <muhl4groups@y...> wrote:
          > just curious.. what DX are you using with these charges?
          >
          > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
          pancreatic and kidney transplant specialist
          > clinic.  Medicare recently has been denying follow-up visits within
          > the 90-day window of a transplant for immunosuppressive therapy.  I
          > use a modifier -24.  Any suggestions on getting those follow-ups
          paid?
          > Thanks,
          > Mandy Buck, RHIA


          Yahoo! Mail
          Stay connected, organized, and protected. Take the tour


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        • mandybcoder
          No, V58.62 would not be better. The description for V58.83 is Encounter for immunosuppressive therapy , which is actually what the patient is being seen for.
          Message 4 of 9 , Aug 16 1:39 PM
            No, V58.62 would not be better. The description for V58.83
            is "Encounter for immunosuppressive therapy", which is actually what
            the patient is being seen for. It is completely separate from the
            transplant services. Modifier 21 is prolonged E/M, and that does not
            apply here either. Modifier 24 is Unrelated E/M service by the same
            physician during a post-op period. That one just lets the insurance
            company (or medicare) know that this service is completely separate
            form the procedure.

            --- In MedicalBillers@yahoogroups.com, "Bob Sanders" <daretobe@c...>
            wrote:
            > I have a question. I am still a student for medical billing and
            > coding but there seems to be something wrong with the codes. Would
            it be
            > better to use V58.62 instead of V58.83? Like I said, I am still a
            > student but I seriously want to learn as much as I can, as soon as I
            > can. Given the fact that I am 59 years old and changing professions.
            > Second question is with he modifier. Shouldn't modifier -21 be
            used
            > instead of -24? In effect what she is telling Medicare is that the
            > procedure they are doing has nothing to do with the transplant. Or
            am I
            > reading this wrong?
            > Third question. Why is 279.19 being used?
            > Hope I am not making a pain of myself. I don't want to do that.
            > Thank you,
            > Bob Sanders
            >
            >
            >
            >
            > Primary code is V58.83, second is 279.19, and third is V42.0
            >
            > --- In MedicalBillers@yahoogroups.com, Michelle Uhl
            > <muhl4groups@y...> wrote:
            > > just curious.. what DX are you using with these charges?
            > >
            > > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
            > pancreatic and kidney transplant specialist
            > > clinic. Medicare recently has been denying follow-up visits
            within
            > > the 90-day window of a transplant for immunosuppressive therapy.
            I
            > > use a modifier -24. Any suggestions on getting those follow-ups
            > paid?
            > > Thanks,
            > > Mandy Buck, RHIA
          • mandybcoder
            Helen, Thanks for the input, but I don t believe that applies here either. V70.2 is the code used when the patient has meds administered at that office visit.
            Message 5 of 9 , Aug 16 1:42 PM
              Helen,
              Thanks for the input, but I don't believe that applies here either.
              V70.2 is the code used when the patient has meds administered at that
              office visit. That is not what my physicians are doing. They are
              just running labs and checking medication levels to determine whether
              they need to change dosages. I think Medicare is just wanting to see
              the records and that's why they deny. Transplantation is really
              a "hot button" with them, and they like to make sure they are paying
              correctly.

              --- In MedicalBillers@yahoogroups.com, "Helen L. Avery, CPC"
              <helenaverycpc@y...> wrote:
              > v07.2 and the v-code for the transplant are what is payable with a -
              24 for immunosupressive therapy; this is why they are being denied.
              > Helen
              >
              > Bob Sanders <daretobe@c...> wrote:
              > I have a question. I am still a student for medical billing and
              coding but there seems to be something wrong with the codes. Would it
              be better to use V58.62 instead of V58.83? Like I said, I am still a
              student but I seriously want to learn as much as I can, as soon as I
              can. Given the fact that I am 59 years old and changing professions.
              > Second question is with he modifier. Shouldn't modifier -21 be
              used instead of -24? In effect what she is telling Medicare is that
              the procedure they are doing has nothing to do with the transplant.
              Or am I reading this wrong?
              > Third question. Why is 279.19 being used?
              > Hope I am not making a pain of myself. I don't want to do that.
              > Thank you,
              > Bob Sanders
              >
              >
              >
              >
              > Primary code is V58.83, second is 279.19, and third is V42.0
              >
              > --- In MedicalBillers@yahoogroups.com, Michelle Uhl
              > <muhl4groups@y...> wrote:
              > > just curious.. what DX are you using with these charges?
              > >
              > > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
              > pancreatic and kidney transplant specialist
              > > clinic. Medicare recently has been denying follow-up visits
              within
              > > the 90-day window of a transplant for immunosuppressive therapy.
              I
              > > use a modifier -24. Any suggestions on getting those follow-ups
              > paid?
              > > Thanks,
              > > Mandy Buck, RHIA
              >
              >
              >
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            • Bob Sanders
              Thank you very much. As I said, I am still a student. I will get the hang of this, I promise. ... From: MedicalBillers@yahoogroups.com
              Message 6 of 9 , Aug 16 5:27 PM
                Message
                Thank you very much. As I said, I am still a student. I will get the hang of this, I promise.
                -----Original Message-----
                From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com] On Behalf Of mandybcoder
                Sent: Tuesday, August 16, 2005 4:40 PM
                To: MedicalBillers@yahoogroups.com
                Subject: [MedicalBillers] Re: immunosuppressive therapy

                No, V58.62 would not be better.  The description for V58.83
                is "Encounter for immunosuppressive therapy", which is actually what
                the patient is being seen for.  It is completely separate from the
                transplant services.  Modifier 21 is prolonged E/M, and that does not
                apply here either.  Modifier 24 is Unrelated E/M service by the same
                physician during a post-op period.  That one just lets the insurance
                company (or medicare) know that this service is completely separate
                form the procedure.

                --- In MedicalBillers@yahoogroups.com, "Bob Sanders" <daretobe@c...>
                wrote:
                >    I have a question. I am still a student for medical billing and
                > coding but there seems to be something wrong with the codes. Would
                it be
                > better to use V58.62 instead of V58.83? Like I said, I am still a
                > student but I seriously want to learn as much as I can, as soon as I
                > can. Given the fact that I am 59 years old and changing professions.
                >    Second question is with he modifier. Shouldn't modifier -21 be
                used
                > instead of -24? In effect what she is telling Medicare is that the
                > procedure they are doing has nothing to do with the transplant. Or
                am I
                > reading this wrong?
                >    Third question. Why is 279.19 being used?
                >    Hope I am not making a pain of myself. I don't want to do that.
                > Thank you,
                > Bob Sanders




                > Primary code is V58.83, second is 279.19, and third is V42.0
                >
                > --- In MedicalBillers@yahoogroups.com, Michelle Uhl
                > <muhl4groups@y...> wrote:
                > > just curious.. what DX are you using with these charges?
                > >
                > > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
                > pancreatic and kidney transplant specialist
                > > clinic.  Medicare recently has been denying follow-up visits
                within
                > > the 90-day window of a transplant for immunosuppressive therapy. 
                I
                > > use a modifier -24.  Any suggestions on getting those follow-ups
                > paid?
                > > Thanks,
                > > Mandy Buck, RHIA


              • Michelle Uhl
                your off to a good start bob.. the best thing you can do is ask questions if you don t understand something.. that is how we all learn!! plus you seem to have
                Message 7 of 9 , Aug 16 6:36 PM
                  your off to a good start bob.. the best thing you can do is ask questions if you don't understand something.. that is how we all learn!! plus you seem to have the detective instinct that is also a very good sign for a coder/biller!! you'll do fine!

                  Bob Sanders <daretobe@...> wrote:
                  Thank you very much. As I said, I am still a student. I will get the hang of this, I promise.
                  -----Original Message-----
                  From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com] On Behalf Of mandybcoder
                  Sent: Tuesday, August 16, 2005 4:40 PM
                  To: MedicalBillers@yahoogroups.com
                  Subject: [MedicalBillers] Re: immunosuppressive therapy

                  No, V58.62 would not be better.  The description for V58.83
                  is "Encounter for immunosuppressive therapy", which is actually what
                  the patient is being seen for.  It is completely separate from the
                  transplant services.  Modifier 21 is prolonged E/M, and that does not
                  apply here either.  Modifier 24 is Unrelated E/M service by the same
                  physician during a post-op period.  That one just lets the insurance
                  company (or medicare) know that this service is completely separate
                  form the procedure.

                  --- In MedicalBillers@yahoogroups.com, "Bob Sanders" <daretobe@c...>
                  wrote:
                  >    I have a question. I am still a student for medical billing and
                  > coding but there seems to be something wrong with the codes. Would
                  it be
                  > better to use V58.62 instead of V58.83? Like I said, I am still a
                  > student but I seriously want to learn as much as I can, as soon as I
                  > can. Given the fact that I am 59 years old and changing professions.
                  >    Second question is with he modifier. Shouldn't modifier -21 be
                  used
                  > instead of -24? In effect what she is telling Medicare is that the
                  > procedure they are doing has nothing to do with the transplant. Or
                  am I
                  > reading this wrong?
                  >    Third question. Why is 279.19 being used?
                  >    Hope I am not making a pain of myself. I don't want to do that.
                  > Thank you,
                  > Bob Sanders




                  > Primary code is V58.83, second is 279.19, and third is V42.0
                  >
                  > --- In MedicalBillers@yahoogroups.com, Michelle Uhl
                  > <muhl4groups@y...> wrote:
                  > > just curious.. what DX are you using with these charges?
                  > >
                  > > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
                  > pancreatic and kidney transplant specialist
                  > > clinic.  Medicare recently has been denying follow-up visits
                  within
                  > > the 90-day window of a transplant for immunosuppressive therapy. 
                  I
                  > > use a modifier -24.  Any suggestions on getting those follow-ups
                  > paid?
                  > > Thanks,
                  > > Mandy Buck, RHIA



                  Start your day with Yahoo! - make it your home page
                • Bob Sanders
                  I have been an auto mechanic for 35 years. The CPT and ICD-9 parallel greatly with parts manuals. The medical part will be the hardest for me to get the hang
                  Message 8 of 9 , Aug 16 9:15 PM
                    Message
                    I have been an auto mechanic for 35 years. The CPT and ICD-9 parallel greatly with parts manuals. The medical part will be the hardest for me to get the hang of. Thank you all for being patient with me.
                    -----Original Message-----
                    From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com] On Behalf Of Michelle Uhl
                    Sent: Tuesday, August 16, 2005 9:37 PM
                    To: MedicalBillers@yahoogroups.com
                    Subject: RE: [MedicalBillers] Re: immunosuppressive therapy

                    your off to a good start bob.. the best thing you can do is ask questions if you don't understand something.. that is how we all learn!! plus you seem to have the detective instinct that is also a very good sign for a coder/biller!! you'll do fine!

                    Bob Sanders <daretobe@...> wrote:
                    Thank you very much. As I said, I am still a student. I will get the hang of this, I promise.
                    -----Original Message-----
                    From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com] On Behalf Of mandybcoder
                    Sent: Tuesday, August 16, 2005 4:40 PM
                    To: MedicalBillers@yahoogroups.com
                    Subject: [MedicalBillers] Re: immunosuppressive therapy

                    No, V58.62 would not be better.  The description for V58.83
                    is "Encounter for immunosuppressive therapy", which is actually what
                    the patient is being seen for.  It is completely separate from the
                    transplant services.  Modifier 21 is prolonged E/M, and that does not
                    apply here either.  Modifier 24 is Unrelated E/M service by the same
                    physician during a post-op period.  That one just lets the insurance
                    company (or medicare) know that this service is completely separate
                    form the procedure.

                    --- In MedicalBillers@yahoogroups.com, "Bob Sanders" <daretobe@c...>
                    wrote:
                    >    I have a question. I am still a student for medical billing and
                    > coding but there seems to be something wrong with the codes. Would
                    it be
                    > better to use V58.62 instead of V58.83? Like I said, I am still a
                    > student but I seriously want to learn as much as I can, as soon as I
                    > can. Given the fact that I am 59 years old and changing professions.
                    >    Second question is with he modifier. Shouldn't modifier -21 be
                    used
                    > instead of -24? In effect what she is telling Medicare is that the
                    > procedure they are doing has nothing to do with the transplant. Or
                    am I
                    > reading this wrong?
                    >    Third question. Why is 279.19 being used?
                    >    Hope I am not making a pain of myself. I don't want to do that.
                    > Thank you,
                    > Bob Sanders




                    > Primary code is V58.83, second is 279.19, and third is V42.0
                    >
                    > --- In MedicalBillers@yahoogroups.com, Michelle Uhl
                    > <muhl4groups@y...> wrote:
                    > > just curious.. what DX are you using with these charges?
                    > >
                    > > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
                    > pancreatic and kidney transplant specialist
                    > > clinic.  Medicare recently has been denying follow-up visits
                    within
                    > > the 90-day window of a transplant for immunosuppressive therapy. 
                    I
                    > > use a modifier -24.  Any suggestions on getting those follow-ups
                    > paid?
                    > > Thanks,
                    > > Mandy Buck, RHIA



                    Start your day with Yahoo! - make it your home page

                  • B Burgess
                    Hats off to you Bob for being so brave and hang in there !!! I m relatively new to this as well. I came into this field about a year ago after almost 30 years
                    Message 9 of 9 , Aug 19 6:11 AM
                      Hats off to you Bob for being so brave and hang in there !!! I'm relatively new to this as well.     
                      I came into this field about a year ago after almost 30 years of nursing................. and it's been hard for me at times !!  SOOO much to learn and remember and then, about the time I figure it out, someone changes something.   Don't be afraid to ask questions -- sometimes that's the only way to learn !
                       
                      Regards,
                       
                      Barbara Burgess, RN
                          CPC Wannabe
                       


                      Bob Sanders <daretobe@...> wrote:
                      I have been an auto mechanic for 35 years. The CPT and ICD-9 parallel greatly with parts manuals. The medical part will be the hardest for me to get the hang of. Thank you all for being patient with me.
                      -----Original Message-----
                      From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com] On Behalf Of Michelle Uhl
                      Sent: Tuesday, August 16, 2005 9:37 PM
                      To: MedicalBillers@yahoogroups.com
                      Subject: RE: [MedicalBillers] Re: immunosuppressive therapy

                      your off to a good start bob.. the best thing you can do is ask questions if you don't understand something.. that is how we all learn!! plus you seem to have the detective instinct that is also a very good sign for a coder/biller!! you'll do fine!

                      Bob Sanders <daretobe@...> wrote:
                      Thank you very much. As I said, I am still a student. I will get the hang of this, I promise.
                      -----Original Message-----
                      From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com] On Behalf Of mandybcoder
                      Sent: Tuesday, August 16, 2005 4:40 PM
                      To: MedicalBillers@yahoogroups.com
                      Subject: [MedicalBillers] Re: immunosuppressive therapy

                      No, V58.62 would not be better.  The description for V58.83
                      is "Encounter for immunosuppressive therapy", which is actually what
                      the patient is being seen for.  It is completely separate from the
                      transplant services.  Modifier 21 is prolonged E/M, and that does not
                      apply here either.  Modifier 24 is Unrelated E/M service by the same
                      physician during a post-op period.  That one just lets the insurance
                      company (or medicare) know that this service is completely separate
                      form the procedure.

                      --- In MedicalBillers@yahoogroups.com, "Bob Sanders" <daretobe@c...>
                      wrote:
                      >    I have a question. I am still a student for medical billing and
                      > coding but there seems to be something wrong with the codes. Would
                      it be
                      > better to use V58.62 instead of V58.83? Like I said, I am still a
                      > student but I seriously want to learn as much as I can, as soon as I
                      > can. Given the fact that I am 59 years old and changing professions.
                      >    Second question is with he modifier. Shouldn't modifier -21 be
                      used
                      > instead of -24? In effect what she is telling Medicare is that the
                      > procedure they are doing has nothing to do with the transplant. Or
                      am I
                      > reading this wrong?
                      >    Third question. Why is 279.19 being used?
                      >    Hope I am not making a pain of myself. I don't want to do that.
                      > Thank you,
                      > Bob Sanders




                      > Primary code is V58.83, second is 279.19, and third is V42.0
                      >
                      > --- In MedicalBillers@yahoogroups.com, Michelle Uhl
                      > <muhl4groups@y...> wrote:
                      > > just curious.. what DX are you using with these charges?
                      > >
                      > > mandybcoder <mandybcoder@y...> wrote:I am the coder for a small
                      > pancreatic and kidney transplant specialist
                      > > clinic.  Medicare recently has been denying follow-up visits
                      within
                      > > the 90-day window of a transplant for immunosuppressive therapy. 
                      I
                      > > use a modifier -24.  Any suggestions on getting those follow-ups
                      > paid?
                      > > Thanks,
                      > > Mandy Buck, RHIA



                      Start your day with Yahoo! - make it your home page

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