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List of 2017 cpt codes with modifier 95:
Definition Field Listing
Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. Take a Deep Look Inside Surgical Procedures for Turbinates. Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including spehnoidotomy. Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed. There still seems to be much confusion regarding how to bill these new codes for removal of tissue in all 4 sinuses. If we bill one of the two examples above(FESS Question) 31288/31267 or 31259/31267 are we being reimbursed for the frontal as well? If tissue is removed, 31287 and/or 31256 would be replaced with 31288 and/or 31267 in the first coding combination or 31257 and/or 31256 would be replaced with 31259 and/or 31267. 31298 includes a BSD of the frontal and sphenoid. If all three sinuses were dilated via balloon, you would code it 31298, 31295. If all three sinuses were dilated via balloon bilaterally, you are correct, it would be coded 31298-50, 31295-50. Make sure you link the frontal and sphenoid sinusitis diagnoses to 31298 and the maxillary sinusisits linked to 31295. Tell your doctor to list the specific sinuses that are effected and to not just list "chronic sinusitis" and/or "acute sinusitis" in the pre/post op diagnosis on the op note which would force you to use "unspecified" codes. The coder needs specific diagnoses in order to support medical necessity for the multiple BSD procedures performed. 31259 and 31256 if tissue is only removed from the sphenoid sinus. 31259-RT 31276-50-59 (or XS if the patient is enrolled in Medicare Part B) 31254-59-LT (or XS if the patient is enrolled in Medicare Part B) 31267-50 31288-59-LT (or XS if the patient is enrolled in Medicare Part B). I have a Dr. who is wanting to bill 31255-Rt, 31254-LT,31267-50,31288-50 and 31276-50. How do you suggest I code this with new bundled codes? Please advise. The 59 or XS if the patient is enrolled in Medicare Part B is needed for the 31276, 31254 and 31288 because they are al. Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or canine fossa. Does 31298 just include the frontal and sphenoid? Or does it also include the maxillary? When doing bilateral BSD I would normally bill 31298-50 and 31295-50. Is this correct? The XS is in place of a 59 modifier and refers to separate structure.. This is saying that this frontal BSD is on a separate structure than the frontal BSD is reflected from 31298. 31259 and 31267 if tissue is removed from both the maxillary and sphenoid sinuses. Bilateral frontal, bilateral ethmoidectomy w/removal of tissue and LT sphenoidotomy w/removal of tissue were performed. How should this be billed to a commercial insurance? The -78 modifier would not be applicable. If the 79 modifier is not being accepted by your payer, the other alternative is the 58 modifier for staged procedure since the provider plans on doing the debridements post sinus and septum surgery. Note that 30140 has gone down to zero global days in 2018 from 90 days in 2017 or earlier. So, if your surgeon performed FESS surgery and a submucous resection of the turbinates, the surgery has zero global days in 2018. Unfortunately, if the lesser service, a coblation of the turbinates, 30802 is performed, the surgery has a 10 day global since the other turbinate codes' global periods were not changed to be consistent with 30140. Where to Find Free and Low Cost CEUs. Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior). We have contacted a few of our insurance companies and they do not have allowable for these codes new bundling codes for sinuses. .. They say they are not aware of code changes. Should all insurances be aware of these changes? Is their a grace period on using these codes? Barbara J. Cobuzzi, MBA, CPC, COC, CPC-P, CPC-I, CENTC, CPCO. Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified healthcare professional and a patient who is located at a distant site from the physician or other qualified healthcare professional. E/M frequency data for infectious disease, pulmonary medicine and cardiology. April 25th Webinar - Analysis of 2018 CERT report. Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti. In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com. Modifier 95 may only be appended to the services listed in Appendix P. Appendix P is the list of CPT codes for services that are typically performed face-to-face but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. (CPT 2017 Professional Edition, American Medical Association, Chicago p. 730). What does it mean when it says a code. . Modifier 95 Synchronous Telemedicine Service Rendered via Real-Time Interactive Audio and Video Telecommunications System. Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do. Are you a coder, biller, administrator, office manager or physician?. The American Medical Association added a new modifier, symbol and Appendix to CPT in 2017;. Use these findings to educate and audit high risk codes!. Become a member, or learn more about the benefits of membership by clicking on the link below. New modifier for telemedicine in 2017: modifier 95. The totality of the communication of information exchanged between the physician or other qualified healthcare professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via face-to-face interaction. Accurate at time of posting: January 11, 2017. Q: Is time spent waiting for test results or for potential changes in a patient's condition reported as prolonged services?. Q: Do Prolonged Services with Direct Patient Contact include patient time spent with office staff and/or patient time spent unaccompanied in the office?. Medical billing cpt modifiers and list of medicare modifiers. Q: Should a physician or other qualified health care professional report prolonged services with preventive medicine E/M codes (CPT codes 99381-99397)?. In accordance with The Centers for Medicare and Medicaid Services (CMS), Prolonged Services without Direct Patient Contact (CPT codes 99358-99359) will not be separately reimbursed when reported with CCM CPT codes 99487 and 99489 and TCM CPT codes 99495 and 99496. Prolonged Services and Standby Services (Codes 99354 - 99360). Code 99355 or 99357 is used to report each additional 30 minutes beyond the first hour, depending on the place of service. Either code may also be used to report the final 15-30 minutes of prolonged service on a given date. Prolonged service of less than 15 minutes beyond the first hour or less than 15 minutes beyond the final 30 minutes is not reported separately. * Report CPT code 99358 (office, outpatient, inpatient or observation place of service codes) for the first hour of prolonged physician or other qualified health care professional services. This code should be used only once per date, and prolonged services must exceed 30 minutes in order to report this service. Prolonged Physician Service with Direct (Face-to-Face) Patient Contact (99354-99357). 99356Prolonged physician service in the inpatient setting, requiring unit/floor time beyond the usual service; first hour (List separately in addition to code for inpatient Evaluation and Management service). 99357Prolonged physician service in the inpatient setting, requiring unit/floor time beyond the usual service;each additional 30 minutes (List separately in addition to code for prolonged physician service). Prolonged services codes 99354– 99357 are not paid unless they are accompanied by the companion codes as indicated. 75-104 (1 hr. 15 min. - 1 hr. 44 min.) - 99354 X 1 AND 99355 X 1. CPT modifiers 25 question - where and when to use. The following examples illustrate the correct reporting of prolonged physician service with direct patient contact in the office setting:. 99354Prolonged physician service in the office or other outpatient setting requiring direct (face-to-face) patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management service). Physicians may count only the duration of direct face-to-face contact between the physician and the patient (whether the service was continuous or not) beyond the typical/average time of the visit code billed to determine whether prolonged services can be billed and to determine the prolonged services codes that are allowable. In the case of prolonged office services, time spent by office staff with the patient, or time the patient remains unaccompanied in the office cannot be billed. In the case of prolonged hospital services, time spent reviewing charts or discussion of a patient with house medical staff and not with direct face-to-face contact with the patient, or waiting for test results, for changes in the patient's condition, for end of a therapy, or for use of facilities cannot be billed as prolonged services. If the total direct face-to-face time equals or exceeds the threshold time for code 99354, but is less than the threshold time for code 99355, the physician should bill the evaluation and management visit code and code 99354. No more than one unit of 99354 is acceptable. If the total direct face-to-face time equals or exceeds the threshold time for code 99355 by no more than 29 minutes, the physician should bill the visit co Prolonged physician services (CPT code 99354) in the office or other outpatient setting with direct face-to-face patient contact which require 1 hour beyond the usual service are payable when billed on the same day by the same physician or qualified nonphysician practitioner (NPP) as the companion evaluation and management codes. The time for usual service refers to the typical/average time units associated with the companion evaluation and management service as noted in the CPT code. Each additional 30 minutes of direct face-to-face patient contact following the first hour of prolonged services may be reported by CPT code 99355. Prolonged service of less than 30 minutes total duration on a given date is not separately reported because the work involved is included in the total work of the evaluation and management codes. 105 or more (1 hr. 45 min. or more) - 99354 X 1 AND 99355 X 2 or more for each additional 30 minutes. * Report CPT code 99359 (office, outpatient, inpatient or observation place of service codes) for each additional 30 minutes beyond the first 60 minutes of prolonged physician or other qualified health care professional services. Additional services must exceed 15 minutes in order to report this service. The companion evaluation and management codes for 99356 are the Initial Hospital Care codes and Subsequent Hospital Care codes (99221 - 99223, 99231– 99233); Nursing Facility Services codes (99304 -99318); or.