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Orthopedic Coding Alert

Reimbursement Tips for Multiple Surgery at Same Session
Orthopedic surgeons often tackle two procedures in tandem. Intervention to correct one con... Read more
Avoid Bipolar Hip Conversion Coding Errors
The number of claims for hip replacement and bipolar hip conversion procedures is on the r... Read more
Getting Reimbursed for Applying Casts and Splints
Casts, splints and straps are immobilization devices applied to protect injured bones and ... Read more
Asking the Right Questions Helps with the Right Coding for Injuries
Asking the right questions when treating a child for injuries resulting from a fall will l... Read more
Reader Questions:
Initial Visit vs. Consult
Question: A Medicare patient came to the ER with a broken hip. The primary-care physician ... Read more
Reader Questions:
Closed Procedure and Open Procedure
Question: When a patient presents with a fracture and the physician spends thirty minutes ... Read more
CPT 2000 Spells Few Orthopedic Coding Changes
The updated Current Procedural Terminology (CPT) manual, CPT 2000, published by the Americ... Read more
Coding Analysis:
Spinal Surgery
This month, we will analyze a spinal surgery that includes arthrodesis (fusion), diskectom... Read more
Coding for ACL Repair and Microfracture Chondroplasty
"Orthopedic surgeons often perform anterior cruciate ligament (ACL) repair and chondroplas... Read more
Satisfying Medicare for Office Visit and Injection Coding
A Medicare patient visits an orthopedic surgeons office for preoperative care that requi... Read more
How to Code for Claviculectomy
Shoulder pain associated with adduction activitiese.g., golf swing, carrying a heavy tray ... Read more
Reader Questions:
Injection Codes 64440 and 64441
Question: 1. A patient was given an injection at C-7 cervial region, T-2 thoracic region, ... Read more
Reader Questions:
Removal of External Fixator
Question: We are having a problem receiving reimbursement for removal of external fixator ... Read more
Avoid SLAP and Bankart Repair Denials:
Don't Substitute Codes
A photographic record could be your answer to the nagging problem of receiving reimburse... Read more
Documentation is Key to Reimbursement with New Medicare Consultation Update
Documentation—by both the primary and specialist physician—is the key to get... Read more
Coder's Column:
Learn the Basics of Correct Coding for Spinal Surgeries
By Susan Callaway-Stradley, CPC, CCS-P   The coders in an orthopedic practice s... Read more
Background on the Spine
Spine surgeries can be performed for several reasons. There may be spinal deformity, suc... Read more
Reader Question:
Cast Change
Question: A patient comes in for an x-ray and cast change during the 90-day global perio... Read more
Reader Question:
Modifier -57
Question: I was called to see a 90-year-old man who had fallen and fractured his right h... Read more
Reader Question:
Billing for Fracture Care
Question: A diabetic patient is seen in the hospital for foot pain. Multiple tarsal and ... Read more
Reader Question:
Coding for Repeated Visits
Question: Office treatment of diabetic foot ulcerations required repeated (staged) debri... Read more
Reader Question:
Billing for Evaluations
Question: I am confused about billing for the orthopedic surgeon’s evaluation of a... Read more
Reader Question:
Bundling Options
Question: According to HCFA’s Correct Coding Initiative (CCI) guidelines, 29881 (a... Read more
Reader Question:
Emergency Department Billing
Question: Under teaching guidelines, what is the proper way to bill for fracture treatme... Read more
How to Correctly Bill When a Diskectomy and Arthrodesis are Performed at the Same Time
Laura Nuechterlein, MPA, senior policy analyst for the American Academy of Orthopedic Surg... Read more
Optimize Coding for Joint Injections by Knowing What to Bill with the Injection Code
"Arthrographies and anesthetic injections can cause confusion when it comes to coding beca... Read more
Reimbursement Issues over Bunionectomies Combined with Hammertoes
When bunionectomies and hammertoes are billed together, there can often be problems gettin... Read more
How to Properly Code for Post-emergency Fracture Care
Proper coding for post-emergency fracture care presents an array of reimbursement challeng... Read more
Reader Questions:
Epidural Steriod Injections
Question: We would like clarification on how to bill epidural steroid injections to Medica... Read more
Reader Questions:
Salter Type II
Question: A patient is placed on the operating table in the supine position. After adequat... Read more
Reader Questions:
Interpretation of X-rays
Question: One of our physicians bills for interpretations of previously taken x-rays broug... Read more
Reader Questions:
Attempted ORIF
Question: In your August 1999 issue of Orthopedic Coding Alert, there is a reader question... Read more
Reader Questions:
Second Opinion
Question: If a patient is in the global period for an arthroscope by a physician in our pr... Read more
Reader Questions:
H & P on All Surgeries
Question: The hospital requires an H&P on all surgeries, including staged procedures. Can ... Read more
Reader Questions:
Two Sets of X-rays?
Question: Can we charge for two sets of x-rays when a fracture is reduced in the office?De... Read more
Reader Questions:
Modifier -57
Question: Can using modifier -57 help us get reimbursed for performing a consult or an adm... Read more
Stave Off Auditors:
Benchmarking Coding Utilization Statistics Will Help Decrease Denials
Auditors stress that they want to see a bell curve when comparing statistics from an indiv... Read more
How to Code Consults within the Same Practice
If an orthopedic surgeon sees a patient for a consultation and then refers the patient to ... Read more
Reader Questions:
Is an ED Vistit Included in Post-op?
Question: A patient, who had a endoscopic knee repair presented at the emergency departmen... Read more
Reader Questions:
New Patient Qualifications
Question: When can we bill for a new patient in the group? This patient had been seen prev... Read more
Reader Questions:
Billing X-rays
Question: One of our physicians bills for the interpretation of x-rays brought in with the... Read more
Reader Questions:
Coding Counseling Time
Question: How can we bill for the time spent with the family discussing the patient? Anon... Read more
Reader Questions:
Using Modifier -57
Question: Is a modifier used when undertaking non-surgical as well as surgical treatment i... Read more
Reader Questions:
Defining Global Periods
Question: Who defines the accepted time for the global period? Medicare defines only 10 an... Read more
Reader Questions:
How to Code Elective Surgery
Question: 1. When patients are admitted for elective surgery, is it proper to code with th... Read more
Modifiers -52, -53, -76, and -78:
Optimize Failed Procedure Reimbursements
Some orthopedists are under the misconception that procedures shouldnt be billed for if ... Read more
Avoid Audits:
Orthopedic Practices Should Code Radiology Services Carefully
Case Description The patient is a 50-year-old female with symptomatic osteochondral defec... Read more
Reader Questions:
H & P During Global Periods
Question: Patients are seen three to four days in the office prior to ACL reconstruction. ... Read more
Flouroscopy Included in Percutaneous Pinning
Tyler Wesland, RN, of Sangemente, CA, is just one of several readers who wrote to ask how ... Read more
Be Careful When Coding for Consultations
Orthopedic coders are still confused about when its appropriate to bill for initial inpati... Read more
Case Study:
Coding Is Tricky for Rotator Cuff Repairs
A 54-year-old man, who suffers from rotator cuff impingement syndrome and acromioclavicula... Read more
Reader Questions:
Problems with Medicaid and X-ray Interpretations
Question: Our local community hospital has an x-ray facility located in our office and pro... Read more
Reader Questions:
Assistant Confusion: PA vs. OPA-C
Question: I appreciated the article on physician assistant coding and reimbursement in the... Read more
Plug Reimbursement Leaks by Coding Properly for Hip Conversions
With more than a quarter of a million total hip replacements performed each year, coding... Read more
Avoid Upcoding or Downcoding:
Read the Entire Operative Report
Although weve discussed coding for consults in the Emergency Department in previous issues... Read more
Case Study:
Coding for Patalla and Tibial Liner Replacement
Case DescriptionA patient previously had total knee replacement, including a metal-backed ... Read more
Reader Questions:
Fracture Care and E/M Services
Question: A patient comes into the office with wrist pain and the physician determines he ... Read more
Open vs. Closed Fractures:
Cut the Coding Confusion
"One of the first concepts orthopedic coders learn is the difference between open a... Read more
Avoid Audits:
Bill Cortisone Injections Carefully
Cortisone joint injections are a mainstay for orthopedic practices. Yet many are inappropr... Read more
Coding Case Study:
Coding for Shoulder Revision
Case Description A bipolar arthroplasty of the left shoulder has failed. A surgeon an... Read more
Reader Questions:
Billing for Assistant Surgeons
Question: Several orthopedic seminars have stated the proper coding for assistant surgeons... Read more
Reader Questions:
RVU for Thermal Shrinkage
Question: I saw your question regarding Thermal Shrinkage in the February issue (page 13) ... Read more
Reader Questions:
Clarification, Modifier -51 with Wrist and Finger Fractures
Question: You said on page 14 of the February 1999 issue, regarding wrist and finger fract... Read more
Reader Questions:
Hospital Admission and Modifier -57
Question: You said (February 1999 issue, page 14) to add modifier -57 to code 99221 in adm... Read more
Two Surgeons, One Difficult Procedure:
How to Meet the Co-surgery Coding Challenge
Coding for co-surgery is often as tricky as the complex procedure that triggers it. For ex... Read more
Coding Correctly for Transfer of Care vs. Consults Can Stave Off Auditors
Improperly billed consultations are high on the fraud and abuse list of the Health Care Fi... Read more
Avoid Fraud and Abuse Charges:
How to Bill for Orthodedic PA Services Correctly
Physician assistants (PAs) can be a valuable asset to orthopedic practices as they perform... Read more
Reader Questions:
Hylagan/SynVisc Correct HCPCS Code?
Editors Note: These questions refer to an article on the new HCPCS codes for Hyalgan, J731... Read more
Reader Questions:
Arthroscopy and Unbundling
Question: How do we code for a shoulder arthroscopy performed with a rotator cuff repair? ... Read more
Reader Questions:
Coding for Multiple Physician Fracture Care
In the following situations, how should we be coding for our physicians fracture care:Judi... Read more
Maximize Reimbursement for IMEs
Orthopedic practices are often requested to perform independent medical evaluations (IME),... Read more
Correct Coding for Osteochondral Transplant
In the last several years, a number of expensive new treatments for injury or degeneration... Read more
Coding Case Study:
When a Hemiarthroplasty Becomes Dislocated
Editors Note: Experts in orthopedic coding agree that successful coding in this specialty ... Read more
Self Audits:
Good Insurance for Avoiding Provider Audits
The increasing scrutiny from third-party payers of coding in general, particularly with Ev... Read more
Reader Questions:
Pain Control Catheter
Question: At the conclusion of a rotator cuff repair, one of our physicians placed an indw... Read more
Reader Questions:
Thermal Shrinkage of Shoulder Capsule
Question: What code would you use for a shoulder arthroscopy with thermal shrinkage of the... Read more
Reader Questions:
Core Decompression
Question: I need help finding a code for core decompression for the femoral head, performe... Read more
Reader Questions:
Repair of Hand Fractures
Question: If a patient has two finger fractures, and a wrist fracture of the same hand, h... Read more
Reader Questions:
Bone Spur Codes
Question: What are the best codes to use for excision of spurs (other than calcaneal)?Orth... Read more
Reader Questions:
Manipulation of PIP Joints
Question: What is the correct CPT code for manipulation of the PIP joints under anesthesia... Read more
Reader Questions:
Patient Seen in ER with Later Surgery
Question: After examining a patient in our emergency room, the orthopedist decided the pat... Read more
Get Paid for Multiple Arthroscopic Procedures During the Same Surgery
Receiving fair payment for multiple surgical procedures is a frustrating dilemma for ortho... Read more
Code to Collect When You Treat Patients in the ED
Because of the nature of orthopedic care, the hospital emergency department is a common se... Read more
Getting Paid for Hyalgan and SynVisc Injections
As of Jan. 1, 1999, there are finally specific level II HCPCS codes for both Hyalgan and S... Read more
Reader Questions:
New Hip Fracture above Old
Question: A patient presents with a subcapital hip fracture above retained dynamic condyla... Read more
Reader Questions:
Shoulder Arthroscopy
Question: How should we code for a shoulder arthroscopy performed with partial claviculec... Read more
Reader Questions:
Underlying Disease Diagnosis Codes
Question: We have been getting denials when using a diagnosis code for underlying disease... Read more
Reader Questions:
Getting Paid for Nail Trims
Question: I bill for an orthopedic surgeon who specializes in the foot and ankle. How do y... Read more
Reader Questions:
Fracture Care vs. Cast Application
Question: What are the guidelines for coding fracture care, as opposed to cast application... Read more
Available Years:  1999