Q: A patient presents to the emergency department with chest pain. The physician orders multiple services along with a subsequent infusion without a stop time. What CPT codes would be used to report these services?
Q: If a patient is immobile or comatose for an extended period of time in the hospital and develops a stage 3 or 4 pressure ulcer of the left upper back, would this be considered a hospital-acquired condition (HAC)?
Q: If a patient comes into an outpatient facility for a surgical procedure and the physician evaluates the patient before performing the procedure, can you append modifier -25 to the E/M service?
Q: A patient receives treatment for two ulcers, one on his foot and one on his hip. The physician performs a subcutaneous debridement to treat the foot ulcer and a muscle debridement to treat the hip ulcer. How would this be reported?
Q: If a patient is seen for a pressure ulcer on the foot related to diabetes, would you report a diabetes diagnosis code? If surgical debridement is performed and the patient receives treatment for their diabetes, can you charge for both an office visit and debridement?
Q: We have gotten conflicting advice regarding ICD-10-CM code categories B95-B97 (Bacterial and viral infectious agents) regarding CCs, MCCs, and severity of illness/risk of mortality. Could you clarify the impact of reporting causative organisms?
Q: We are having trouble determining what qualifies a patient as having an acute myocardial infarction (MI) and what documentation would support the diagnosis. Can you help our coding team clarify?
Q: When querying a physician to confirm the stage of a pressure ulcer, is it appropriate to ask questions that require the physician to mark “yes” or “no” responses to the query?
Q: If a patient is admitted with a high blood alcohol level and the provider documents the blood alcohol level in his or her note, does the provider also need to specifically write “patient with intoxication?”
