Coding and Billing Training - Kentucky School Nurse Association编码和计费培训-肯塔基学校护士协会.ppt

Example of when to use the 25 Modifier: 39 year old established pt comes in for Family Planning preventive visit, while doing this pt’s family planning preventive visit, the APRN finds vaginal warts, and with the permission of the pt, treats. Coding would consist of: 99395 9921325 * Another Example of when to use the 25 Modifier: 17 year old established pt comes in for family planning supplies and RN finds out she has not received the Gardasil vaccine. Pt wants to receive this vaccine and is counseled per component. Coding would consist of: 9921225 90460 1unit 90649 * * Multiple Visits for the Same Patient on the Same Day with Different or Same Problem (School) If a patient presents to the local health department satellite school site more than one time on the same day for a different or same problem, only one Office Visit (OV) can be billed – per Medicaid However, each visit must be documented in the patient’s medical record Clarification: If a patient is seen multiple times on the same day, following the last visit of the day; the nurse should review the documentation select the most complex level of visit for billing Clarification of the Only Example of when to use the 25 Modifier in a School Setting: 7 year old established pt comes in at 8:00am for daily therapeutic insulin administration. Same pt comes back before lunch to find out what to eat. Same pt returns for symptoms present; RN meets all the needed components for a problem visit and codes to the most complex for the day. Coding would consist of: W921325 96372 * * Only provide the level of care that is medically necessary. Always provide and document services in accordance with the Core Clinical Services Guidelines (CCSG) and with established best practices. Always code and document exactly what care was provided. Guiding Principles * References: Current Procedural Terminology 2012 International Classification of Dis