Medicare Urgent Care Patient

Jan 10, 2025 | Coding Quandry

Question: An established Medicare patient was seen in our primary care office for a follow-up from the Urgent Care to have sutures removed. Do we need to report modifier 25 on our E/M code with 15853 for the suture removal? The doctor also talked to the patient about...
The Night Before Auditing (A Medical Auditor’s Tale)

The Night Before Auditing (A Medical Auditor’s Tale)

Dec 19, 2024 | Article

‘Twas the night before auditing, and all through the floor, The auditors prepped, ready to explore. The charts were all stacked, each file in its place, While audit reports awaited their grace. The coders were dreaming of claims they’d submit, But the...

ICD-10 Diagnosis Codes

Apr 3, 2024 | Coding Quandry

Question: I am unsure what ICD-10 diagnosis codes should go on a claim for an encounter.  Here is an example: a patient is seen for a nagging cough/cold symptoms.  Since the patient has hypertension, the doctor told her there are certain over-the-counter medications...

Punch Biopsies

Mar 13, 2024 | Coding Quandry

Question: A patient came in for two punch biopsies due to dermatitis that wouldn’t clear after treatment for a few months.  The doctor thinks that he should be able to bill an E/M with the visit, but I say no.  Who is right?  Answer:  I don’t like giving this answer,...
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