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Welcome - Read for Site Information!


By ljohnson - Posted on 01 January 2009

Edited 10/12/2010

Welcome to AskLeslie.net!  This site is all about getting valuable healthcare guidelines, coding tips, forms & other information into the hands of those who need and use it the most. This site averages between 10,000 and 15,000 visitors per month and we're growing!!   Read on for a quick "how this site works."

Plans in the Works: 

·     Building a slide-show of AskLeslie.net friends & visitors to the site who wish to be included;

·     Creating interesting, more interactive services designed to make you think

·     Creating polls with content that interests the professional healthcare worker(Drunk

·     Building the blog to include news-worthy events that affect our industry.

·     Creating a showcase of works from individuals who will either charge a nominal fee or who will offer the information for free and host the links here.

Please feel free to visit any of the links, respond to our forums, leave comments to the articles that you read.  Your VOICE is welcomed and encouraged.

About Registration to this site:

·     You don't have to register to view a lot of the information here. The reason for the registration process is to keep spammers out.  It doesn't always work, but most of the time, we're pretty spam-free.

Those who don't register may not able to see some features (like the forums) and won't be able to create posts or leave comments. This is available only to registered users. This is a dynamic site that changes/updates all the time & we love to share.

·     When you register, a confirmation email will be sent to you before you can participate in the forums or polls, or to create or comment on any of the posts.

If you don't get an email from AskLeslie.net, please check your spam filters because something should be there. Yahoo & some others dump your registration confirmations somewhere. Without the confirmation email, you won't be a real "member" - although you can still enjoy & access much of the information here. If you have any problems, just EMAIL Leslie, with the details. 

·     General Registration is FREE but SPAM is not tolerated. Those who advertise without permission will be banned and their businesses IPs may be placed on a "Wall of Shame" banned list.

IPs caught spamming are banned immediately, the authors' registration deleted - NO QUESTIONS ASKED, NO EXCEPTIONS!.

·     If you think you're IP has been banned, EMAIL LJ,  please.

You should know that certain email accounts & IPs have been banned from registering & sadly, it may include yours. If you feel this may have happened to you (or to a friend) please send me an email & I'll be glad to look into it for you.

·     Our definition of SPAM includes unsolicited advertisements.

IPs caught spamming are banned immediately, the authors' registration deleted - NO QUESTIONS ASKED, NO EXCEPTIONS!. We share, we do not sell, except in certain areas, and for certain purposes, and admin will decide if/when this is allowed.

  •  About your information, IP, email address:

Any information gathered at this site is only used to determine what information is needed for building the site; no personal information about anyone is collected, shared, stored, sold nor bought. There are areas that may be open for membership public view (voluntary profiles, pictures). In general, this information isn't "public" except to others who register - any information divulged is voluntary.

Unless you write first, you won't find yourself receiving any emails or newsletters from us - we don't like SPAM, we don't send it.

Thanks for visiting; we hope you return & will share your Voice; we want to hear from YOU!

LJ & The AskLeslie.Network rev 10/12/2010

 

 

 

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I have a Coding question regarding Colonoscopy Screenings. When there is a commercial insurance, if a Colon screening is ordered and performed and during the procedure a polyp is found and removed, does this negate the screening diagnoses V76.51 or is it the V76.51 left as the original dx and then say a 211.3 or 211.4 added to reflect polyps or whatever the case may be? I have read the 2009 Coding Guidelines, but, our coder tells us that according to Medicare guidelines, the V76.51 code must be dropped and then the dx 211.3 would be the primary dx. Our patients that have preventative wellness benefits are then charged for deductibles and copays. We do call her and she will give us permission to include the screening code, but by then we have an angry patient and have to rebill and wait for payment. Is our coder correct? Any advise?

Your coder is misinformed.

When there is a screening colonocopy, it is always coded with V76.51. The surgeon does not know/expect anything, since the patient is without sign/symptom.

Any findings and/or histories are coded as secondary - regardless of whether or not a biopsy or polypectomy is done.

If it's a diagnostic procedure - say, to do a re-check on a past problem (history of colon polyp) or to treat a current problem (polyp/tumor, bleeding), then there is no screening code at all; you would code for the actual condition, either a history of past condition or polyp, etc.

See below and note the last paragraph I cut & pasted from MLM article found here: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0746.pdf

"The relevant section of the 2007 MPFS states, regarding screening colonoscopies, that:

``if during the course of such screening colonoscopy, a lesion or growth is detected which results in a biopsy or removal of the lesion or growth, payment under this part shall not be made for the screening colonoscopy but shall be made for the procedure classified as a colonoscopy with such biopsy or removal.'' Based on this statutory language, in such instances the test or procedure is no longer classified as a ``screening test.'' Thus, the deductible would not be waived in such situations.

The above scenario can be restated as follows:

• A patient presents for a screening colonoscopy (or flexible sigmoidoscopy), and the patient has no gastrointestinal symptoms.

• During the subsequent screening colonoscopy (or flexible sigmoidoscopy), an abnormality is identified (such as a polyp, etc.), and it is biopsied or removed.

CMS advises that, whether or not an abnormality is found, if a service to a Medicare beneficiary starts out as a screening examination (colonoscopy or sigmoidoscopy), then the primary diagnosis should be indicated on the form CMS-1500 (or its electronic equivalent) using the ICD-9 code for the screening examination."

Short Soapbox "rant":

Your coder is to be commended for stepping up to give feedback and initiate change, but your coder needs to be cautioned to produce written backup for why coding should be done a certain way if it's different than what is currently being done.

When it comes to coding/billing rules/regs, never take anyone's word for it unless something can produce something in writing. Sadly, there are still a lot of myths & misinformation floating around that get passed down "because I told you so" and "we've always done it that way" and "we get paid when we do it like this.".

When you have the backup in writing from an authoritative source, such as a CMS or payer policy, you can reasonably presume that is the safe course to follow. Also remember that commercial payers don't always follow CMS rules, so it's equally important to look at those policies as well.

OK, off my soapbox.

Kudos to both of you for looking beyond. L J

I was recently told by a friend about your website and how I could ask questions about medicines, healthcare and other medically related questions. I'm ready to try it since I recently received a prescription that will cost me $181.00 after insurance.
You can try. We might be able to to help you, but this site is dedicated to those working in the industry. What I would expect, though, is advice on what we SEE in the industry - but not much advice on what you should do as a customer of a particular insurance carrier. Some things we'd have to refer you back to the plan that you bought into because we wouldn't have any information on what or how someone might be covered for certain things. Sorry. L J
I been using your website for a year now, I did not knew you could register, so I did it today. Congrat it is fantastic! DEO
Leslie: The website looks fantastic !! Kim Dues
Kim
Thanks, Kim! It's a lot of work transferring over the info, so it's a work in progress. If you think I've missed something, would you let me know? New "toys" & goodies are on their way, though, we're working on it. So come back soon; you never know what you might see - like the jobs board we have that you can't view unless you're logged in! Glad you visited - thanks for the kudos! L J