Infectious Disease speciality in General Medical Billing Questions Forum

0 Points

<< Previous Topic Next Topic >>

Infectious Disease speciality

Author	Comment
SRPP	Infectious Disease speciality	Lead	[-]
Posts: 200 Jun 23 09 4:59 AM Reply Quote More My Recent Posts	Tags : None Can anyone guide me to the information (link, web site) for ID billing guidelines please and the speciality Q/A link Thanks
sporty981		#1	[-]
Posts: 2161 Jun 23 09 11:32 AM Moderator Reply Quote More My Recent Posts	Can you narrow down your request a little? Can you narrow it down to a few codes, I'm searching CMS and it's too wide of a search. Your local carrier should have medical policy LCDs on this. Also check for infectious disease associations. The infectious disease providers I know can be general or just take care of a specialty like just the meds or the surgical end of it and others do it all. So I guess I'm asking for more specifics. Karen Habel, CDA, CMBSI, CDBSI Nothing I say shall be construed as legal advice; always check with your own financial or legal advisors for your specific situation.
SRPP		#2	[-]
Posts: 200 Jun 23 09 11:55 AM Reply Quote More My Recent Posts	Hi Sporty: Thanks for responding quickly as usual. I am preparing to meet with a potential new client - ID speciality and as such would like to read a bit on general CPT codes used (she does mostly hospital consults), look up the Medicare web site for any guidelines I need to, review the fee schedule etc etc. I tried to look for a site like the one I have for AAFP (Family Pratice) that often talks about coding guidelines for ID speciality. Id IDsocitey .cm the official site for ID? Also this provider is in CT so I needed to look into Medicare for CT Any guidance in that direction would be appreciated. Thanks much
sporty981		#3	[-]
Posts: 2161 Jun 25 09 5:07 AM Moderator Reply Quote More My Recent Posts	If she is doing mostly hospital consults then she will be billing consults with infectious disease dx codes. This is such a wide range, is there a way you can ask her if she focuses on med treatments, procedures or manages it all? If any specific body area? I can give you a huge list of I&D CPT codes, that might give you a start to look for medical policy but like I said it's huge and that's just for I&D. If she is managing infusion drugs etc then we're in another area. As for the ID Society they are the primary society for this. Another suggestion is to contact someone at the AAPC but you would need some specifics. I did look for billing guidelines on CMS for ID but again too broad. There may be some specialty coding books on ID but your CPT manual will help you with that. I wish I could help you out but I think you need to find out more of what she does. Karen Habel, CDA, CMBSI, CDBSI Nothing I say shall be construed as legal advice; always check with your own financial or legal advisors for your specific situation.
sporty981		#4	[-]
Posts: 2161 Jun 25 09 5:17 AM Moderator Reply Quote More My Recent Posts	Here's a list of some I&D codes ranging several coding series. It might be a place to start for you to look at medical policy but I would still try to narrow down exactly what she does. 10040 Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules) 10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single 10061 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple 10080 Incision and drainage of pilonidal cyst; simple 10081 Incision and drainage of pilonidal cyst; complicated 10120 Incision and removal of foreign body, subcutaneous tissues; simple 10121 Incision and removal of foreign body, subcutaneous tissues; complicated 10140 Incision and drainage of hematoma, seroma or fluid collection 1015F Chronic obstructive pulmonary disease (COPD) symptoms assessed (Includes assessment of at least 1 of the following: dyspnea, cough/sputum, wheezing), or respiratory symptom assessment tool completed (COPD) 10160 Puncture aspiration of abscess, hematoma, bulla, or cyst 10180 Incision and drainage, complex, postoperative wound infection 19000 Puncture aspiration of cyst of breast; 19001 Puncture aspiration of cyst of breast; each additional cyst (List separately in addition to code for primary procedure) 19020 Mastotomy with exploration or drainage of abscess, deep 21501 Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; 21502 Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy 21510 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax 22010 Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic 22015 Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral 23030 Incision and drainage, shoulder area; deep abscess or hematoma 23031 Incision and drainage, shoulder area; infected bursa 23040 Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body 23044 Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body 23930 Incision and drainage, upper arm or elbow area; deep abscess or hematoma 23931 Incision and drainage, upper arm or elbow area; bursa 23935 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow 24000 Arthrotomy, elbow, including exploration, drainage, or removal of foreign body 25028 Incision and drainage, forearm and/or wrist; deep abscess or hematoma 25031 Incision and drainage, forearm and/or wrist; bursa 25035 Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess) 25040 Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body 26010 Drainage of finger abscess; simple 26011 Drainage of finger abscess; complicated (eg, felon) 26020 Drainage of tendon sheath, digit and/or palm, each 26025 Drainage of palmar bursa; single, bursa 26030 Drainage of palmar bursa; multiple bursa 26034 Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess) 26990 Incision and drainage, pelvis or hip joint area; deep abscess or hematoma 26991 Incision and drainage, pelvis or hip joint area; infected bursa 26992 Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess) 27030 Arthrotomy, hip, with drainage (eg, infection) 27301 Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region 27303 Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess) 27310 Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection) 27603 Incision and drainage, leg or ankle; deep abscess or hematoma 27604 Incision and drainage, leg or ankle; infected bursa 27610 Arthrotomy, ankle, including exploration, drainage, or removal of foreign body 28001 Incision and drainage, bursa, foot 28002 Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space 28003 Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas 28020 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint 28022 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint 28024 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint 30000 Drainage abscess or hematoma, nasal, internal approach 30020 Drainage abscess or hematoma, nasal septum 32036 Thoracostomy; with open flap drainage for empyema 32200 Pneumonostomy; with open drainage of abscess or cyst 32201 Pneumonostomy; with percutaneous drainage of abscess or cyst 33025 Creation of pericardial window or partial resection for drainage 38300 Drainage of lymph node abscess or lymphadenitis; simple 38305 Drainage of lymph node abscess or lymphadenitis; extensive 39000 Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach 39010 Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy 40800 Drainage of abscess, cyst, hematoma, vestibule of mouth; simple 40801 Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated 41000 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual 41005 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial 41006 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid 41007 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space 41008 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space 41009 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space 41010 Incision of lingual frenum (frenotomy) 41015 Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual 41016 Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental 41017 Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular 41018 Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space 41800 Drainage of abscess, cyst, hematoma from dentoalveolar structures 42000 Drainage of abscess of palate, uvula 42300 Drainage of abscess; parotid, simple 42305 Drainage of abscess; parotid, complicated 4230F Anticonvulsant medication therapy for 6 months or more (MM) 42310 Drainage of abscess; submaxillary or sublingual, intraoral 42320 Drainage of abscess; submaxillary, external 42700 Incision and drainage abscess; peritonsillar 4270F Patient receiving potent antiretroviral therapy for 6 months or longer (HIV) 4271F Patient receiving potent antiretroviral therapy for less than 6 months or not receiving potent antiretroviral therapy (HIV) 42720 Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach 42725 Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach 44900 Incision and drainage of appendiceal abscess; open 44901 Incision and drainage of appendiceal abscess; percutaneous 45000 Transrectal drainage of pelvic abscess 45005 Incision and drainage of submucosal abscess, rectum 45020 Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess 46040 Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure) 46045 Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia 46050 Incision and drainage, perianal abscess, superficial 46060 Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton 47010 Hepatotomy; for open drainage of abscess or cyst, one or two stages 47011 Hepatotomy; for percutaneous drainage of abscess or cyst, one or two stages 47400 Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus 47420 Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty 47425 Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty 47480 Cholecystotomy or cholecystostomy with exploration, drainage, or removal of calculus (separate procedure) 48000 Placement of drains, peripancreatic, for acute pancreatitis; 49020 Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; open 49021 Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; percutaneous 49040 Drainage of subdiaphragmatic or subphrenic abscess; open 49041 Drainage of subdiaphragmatic or subphrenic abscess; percutaneous 49060 Drainage of retroperitoneal abscess; open 49061 Drainage of retroperitoneal abscess; percutaneous 49080 Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); initial 49081 Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); subsequent 50020 Drainage of perirenal or renal abscess; open 50021 Drainage of perirenal or renal abscess; percutaneous 50040 Nephrostomy, nephrotomy with drainage 50125 Pyelotomy; with drainage, pyelostomy 50600 Ureterotomy with exploration or drainage (separate procedure) 51040 Cystostomy, cystotomy with drainage 51080 Drainage of perivesical or prevesical space abscess 53040 Drainage of deep periurethral abscess 53060 Drainage of Skene's gland abscess or cyst 54015 Incision and drainage of penis, deep 54700 Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) 55100 Drainage of scrotal wall abscess 55720 Prostatotomy, external drainage of prostatic abscess, any approach; simple 55725 Prostatotomy, external drainage of prostatic abscess, any approach; complicated 56405 Incision and drainage of vulva or perineal abscess 56420 Incision and drainage of Bartholin's gland abscess 57010 Colpotomy; with drainage of pelvic abscess 57020 Colpocentesis (separate procedure) 57022 Incision and drainage of vaginal hematoma; obstetrical/postpartum 57023 Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) 58800 Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach 58805 Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach 58820 Drainage of ovarian abscess; vaginal approach, open 58822 Drainage of ovarian abscess; abdominal approach 60000 Incision and drainage of thyroglossal duct cyst, infected 61312 Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural 61313 Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral 61314 Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural 61315 Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar 61320 Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial 61321 Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial 63172 Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space 63173 Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space 67405 Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only 67440 Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage 67700 Blepharotomy, drainage of abscess, eyelid 68020 Incision of conjunctiva, drainage of cyst 68400 Incision, drainage of lacrimal gland 68420 Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) 69000 Drainage external ear, abscess or hematoma; simple 69005 Drainage external ear, abscess or hematoma; complicated 69020 Drainage external auditory canal, abscess D7510 INCISION AND DRAINAGE OF ABSCESS-INTRAORAL SOFT TISSUE (Not Valid for Medicare) D7511 INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE - COMPLICATED (INCLUDES DRAINAGE OF MULTIPLE FASCIAL SPACES) D7520 INCISION AND DRAINAGE OF ABSCESS-EXTRAORAL SOFT TISSUE (Not Valid for Medicare) D7521 INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE - COMPLICATED (INCLUDES DRAINAGE OF MULTIPLE FASCIAL SPACES) I hope this helps you a little. Karen Habel, CDA, CMBSI, CDBSI Nothing I say shall be construed as legal advice; always check with your own financial or legal advisors for your specific situation.
2amytag		#5	[-]
Posts: 158 Jun 30 09 12:36 PM Reply Quote More My Recent Posts	IDSOCIETY.ORG is the ID webiste. We only typically bill the hosp consult, FU, and office consult, FU. Occasionally there are cultures done. Occasionally we do travel consults. Unless the dr does IV therapy at the office you will have very little challenge.
SRPP		#6	[-]
Posts: 200 Jul 10 09 9:02 AM Reply Quote More My Recent Posts	Thank you Karen & 2Amytag I truly appreciate this. I got teh client btw and so have been just busy getting her on a good start. It always pays to do the homework on a speciality before meeting the provider even though one has billed for a range of specialities. That is the only reason I had asked for your help. And you so graciously gave it. Thanks Again
sporty981		#7	[-]
Posts: 2161 Jul 10 09 9:21 AM Moderator Reply Quote More My Recent Posts	Congratulations on getting your new client!!! Karen Habel, CDA, CMBSI, CDBSI Nothing I say shall be construed as legal advice; always check with your own financial or legal advisors for your specific situation.

<< Previous Topic Next Topic >>