Compliance Question of the Week – General

Do the new Appropriate Use Criteria (AUC) modifiers and G codes have to be added to hospital claims as well as interpreting physician claims?

For exams with and without contrast should a physician be present? How is that documented?

A physician ordered a CT of the pancreas without and with contrast, and a CT of the pelvis without and with contrast. Is this documentation sufficient to allow us to bill for 74178?

A physician ordered a CT of the pancreas without and with contrast, and a CT of the pelvis without and with contrast. Is this documentation sufficient to allow us to bill for 74178?

We have an office that is a provider-based entity owned by the hospital. Diagnostic exams are billed as hospital outpatient exams, but how do we bill the professional component? What place of service (POS) is used?

What does the report need to indicate to allow billing of abscess drainage codes 49405–49407?

We have an office that is a provider-based entity owned by the hospital. Diagnostic exams are billed as hospital outpatient exams, but how do we bill the professional component? What place of service (POS) is used?

If the start and stop times are not documented on an infusion, can I bill an IV push?

What are the documentation requirements to bill for hydration?

A physician ordered a CT of the pancreas without and with contrast, and a CT of the pelvis without and with contrast. Is this documentation sufficient to allow us to bill for 74178?

If hydration is ordered for four hours before and four hours after a CT scan with contrast is performed, can we charge for the hydration hours?

Could a doctor use template documentation like the following in their reports? “IVC, Aorta, Pancreas: Not well seen given a combination of bowel gas and patient body habitus.”This documentation is in all of his US abdomen reports.