Compliance Question of the Week

For the Week of June 19, 2017

Cardiology

Cardiology Question for the Week of June 19, 2017

Question:

Can we bill for a temporary pacemaker (33210) and permanent pacemaker (33208) performed on the same day but at different sessions if modified appropriately?

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Laboratory

Laboratory Question for the Week of June 19, 2017

Question:

Does CMS permit a hospital to bill for lab services delivered to an ESRD patient?

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Pharmacy

Pharmacy Question for the Week of June 19, 2017

Question:

What is the outpatient PPS packaging threshold for this year?

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Radiology

Radiology Question for the Week of June 19, 2017

Question:

If lymphoscintigraphy is performed in both breasts, I report 78195 and A9520 x 1 each. Code 78195 has a medically unlikely edit (MUE) of 1. A9520 is per study dose, but bilateral breasts are considered one study, not two. However, if both breasts are injected but imaging is not performed, I report 38792 x 2 and A9520 x 1. I don’t understand why they aren’t reported the same number of times. Can you explain?

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Respiratory

Respiratory Question for the Week of June 19, 2017

Question:

What code is reported for aspiration/drainage procedures?

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General

General Question for the Week of June 19, 2017

Question:

My question is a follow-up to last week’s question and answer about Medicare’s definition of a new patient. Would a patient still be considered “new” if only a diagnostic test was performed?

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