Recent content by myrandom2003

The funding program is kinda shady. Read response from AHA to UHC "...Second, the terms and conditions of the agreement are shockingly onerous. Among other things, your form agreement: (1) requires repayment of loans within 5 days of receiving notice; (2) allows your bank, Optum Financial...

Per my understanding, you cannot bill and E/M code on the day of the procedure if the procedure is a planned procedure. Need 25 modifier. Many insurance no longer use 25 modifier. Also many procedures have a 0-day global period so anything done that day in relation to the procedure is included...

This algorithm is more because of insurance denials of ESI after Facets, or so I thought.

Can you explain this technique more? Possibly post the incremental pictures you took?

So now that medicare requires prior auth for HOPD procedures, is it easier to get that third level approved with documentation?

For now, just hopd needs prior auth. But they will all need it eventually. We already see the writing on the wall.

I’m private practice but do certain hmo and Medicare patients at an hopd.

I am 0 for 15 this week with Medicare. Each one cited not documenting a functional disability scale. The LCD said a pain scale counted. I document a VAS/Numeric pain scale. But it looks like it doesn’t count. I am in the WPS region of Medicare. What disability scale are all of you documenting?

start on unaccredited fellowship, pay $50,000.

You just read your note. Say nothing more or less. If it’s not in your note, say I don’t know or I do not recall. You don’t need to say another word about anything unless they pay you for your opinion. But since they are not, you only read from your note. “I have no opinion” on repeat works as...

Forget the actual diagnosis. If you want to get procedures Approved with minimalIssue, Use m47.812, m47.816 or m47.817 for facet procedures M51.16/m54.16/m54.12 for epidurals M48.062 for mild/Vertiflex/esi And m96.1 or g90.52x for stim in lumbar G89.4 and z79.891 for opioids plus any of...

Walgreens today said patient is on norco bid and tizanidine bid (prescribed by me) recently got a klonopin rx from pcp. Pharmacy said I needed to fax them a letter stating that I was aware of the risk of this medication combo before they would fill. Told my Ma it was state law that I had to...

How do you even get an authorization for Medicare?

So for acute inpatient rehab inside a hospital, Is the place of service for the professional claim considered 21- A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of...

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