Wow 20 min NP slots... even that seems like a crunch... no?
If you tell me neck/back/knees/hips/toes- you get to pick one. If you cannot , you are in the wrong place. Or we can knock down the worst pain and move on from there. It's why I get the most entertaining reviews.
so what code are you using to bill those NP slots 99204? You must not be billing many 99205's at all huh?
I bill a couple every day, but maybe Im just overbilling...
Once a year at most. Not that many do not qualify, but I do not want to take the time to figure it out and then go back and change one thing to make sure it is upcharged a level. Not my style.
Head shoulders knees and toes qualifies
lol go ask ortho
I’m in ortho, no one bills that in my parts
You’re ortho or you’re pain?
That's pretty efficient. Do you use a scribe or dictate or templates?
Pain working with ortho. All level 3 and 4
Does this mean procedures in the morning? How many days per week are you doing this?
How do you document? Dragon? Scribe?
yes.
ExpressDictate iPhone App. Secure HIPAA email to transcription.
Just doing a procedure does not change your e&m code per se.
No scribe, but I do dictate everything, and have templates set up for most things. Usually 8-10 minutes in the room, then another 4-5 putting in orders and dictating the note. I almost never move on to the next patient without first signing the previous note and closing the encounter. I could maybe get quicker if I had my nurse put in more orders, or used a scribe, but I think I would get too stressed.
what EHR is this?
of course,
Epic
Wow. They’ve got you trained. Meanwhile medicare is looking for any way they can to short you a buck or two.
If neurosurgeons booking for 3-level fusions, are booking a 99204 for their visits for true major surgeries....you should not (and cannot) be booking a level 5 visit for any of the above based on complexity. Only if you are billing based on time.
so doing trigger points and taking 3 sets of vitals 20 minutes apart is a level 5?
yes. the type of procedure does increase the medical complexity and you can code often higher levels appropriately so. in particular, the Risk decision making component.
Unnecessary attention
Our clinic employs a multimodal model of pain mgmt. we do a comprehensive review of all major pain generators and develop a multimodal plan. To include, PT, pharmacotherapy (both non narcotic and narcotic), adjuvant therapies (TENS, US, Regenerative therapies, Ketamine, Qutenza, etc etc), and of course interventional therapies galore. I think very plausible to bill 99205’s in pain medicine if the complexity and time warrants it, which it often does. In fact almost ALL our new med mgmt visits are 99205’s. Which is justified per above posted guidelines.
Many of our NP visits and almost all new opioid management visits are 99205’s. We have been audited before, twice in fact, since Ive been here, never had an issue with our visit codes.
