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Orthopedic Coding Alert

CPT 2001:
Understand Significant 2001 Orthopedic Coding Changes for Proper Reimbursement
The American Medical Association (AMA) released CPT changes for 2001 in November 2000.... Read more
Get Paid for Arthroscopic-to- Open Shoulder Surgeries
As more and more orthopedic surgeons embrace arthroscopy as the most effective tool for d... Read more
Reader Question:
Billing Time
Question: If a physician spends 45 minutes reviewing a patients current situation and answ... Read more
Reader Question:
External Fixator
Question: How should I code for the application of a uniplanar external fixator for a comm... Read more
Reader Question:
Discharge Statement
Question: Is the discharge statement dictated by an orthopedic surgeon for a Medicare pati... Read more
Reader Question:
Injection and X-ray
Question: Ive been told that if an injection and x-ray are performed during the same visit... Read more
Reader Question:
Failed Back Syndrome
Question: How should I code failed back syndrome?Texas Subscriber Answer: Its always a ... Read more
Reader Question:
Hardware Removal
"Question: How should I code the removal of hardware in the ankle? I am removing a ... Read more
You Be the Coder:
Irrigation and Debridement
Question: My surgeon performed a 28008 (fasciotomy, foot and/or toe) and three days later ... Read more
Documentation is Key to Receive Optimal Reimbursement for Orthopedic Consultations
Requests for consultations are not unusual in orthopedics, nor are problems getting paid f... Read more
Use Modifiers for Discontinued or Reduced Procedures
Some orthopedic surgery coders have difficulty distinguishing between modifiers -52 (reduc... Read more
Reader Question:
Open Medial Plication
"Question: How do I code an open medial plication for dislocation of patella? Also done d... Read more
Reader Question:
Open and Closed Reductions
Question: A closed reduction with manipulation is performed on an outpatient basis, and th... Read more
Reader Question:
Phalangeal Shaft Fracture
Question: How do I code for an open reduction internal fixation of base proximal phalanx f... Read more
Reader Question:
Unlisted Procedures
Question: How do I code the following situation? Postoperative diagnosis: 1. Small tear of... Read more
Reader Question:
Pubic Ramus and Sacrum Fracture
Question: How do I bill for both a pubic ramus fracture and a sacrum fracture? Florida Sub... Read more
Reader Question:
Removal of Pin
Question: When is it appropriate to bill 20670 or 20680? Both refer to removal of a pin, b... Read more
Reader Question:
Billing for PA Service
Question: Our orthopedic surgeons are thinking of hiring a physicians assistant (PA). Can ... Read more
You Be the Coder:
Shoulder Scope
Question: How do I code a shoulder scope with debridement and capsular shrinkage? Do I use... Read more
Overcome Reimbursement Challenges With Bilateral TKRs
Increasingly common bilateral total knee replacement (TKR) surgeries 27447 (arthroplasty,... Read more
Billing Solutions for Failed Closed Procedures
CPT and carrier rules will not let orthopedists bill for an open procedure that is the res... Read more
Keys to Coding for Therapeutic Injections
Coding and reimbursement for therapeutic injections generate as many questions as answers ... Read more
Correction
The insert Billing for Casting Supplies: A State-by-State Guide that accompanied the Aug... Read more
Reader Question:
Removal of Implant
Question: When you remove hardware from a patient, can you charge for each piece you remov... Read more
Reader Question:
Ankle Fracture
Question: The orthopedist sees a patient in the emergency department as a consultant for a... Read more
Reader Question:
Arthroplasty
Question: We have a patient who is having a total ankle arthroplasty (27702, arthroplasty,... Read more
You Be the Coder:
Fulkerson Procedure
Question: Please advise on the use of codes 27418 and 27425. How should I bill for the Ful... Read more
Receive Reimbursement for Physician Assistants in the Surgical Setting
A certified physician assistant (PA) is a healthcare professional licensed to practice m... Read more
A Procedural Coding Primer:
Improve Pay Up for Surgery Of the Bones of the Hand
In the multifaceted arena of hand surgery, the range of available codes and the number ... Read more
Case Study:
Get Paid for Amputation and Debridement of Toes
An amputation surgery means that bone is being cut through and removed from the body of th... Read more
Reader Question:
Posterior Tibial Tendon Dysfunction
Question: Please explain what posterior tibial tendon dysfunction is. What ICD-9 code be... Read more
Reader Question:
Follow-up Visit
Question: During the global period for 99024 (postoperative follow-up visit, included in g... Read more
Reader Question:
Consultation
Question: Is a consult fee an opinion only in either the hospital or office situation? If ... Read more
Reader Question:
Judet View X-ray
Question: My physician ordered a Judet view of a patients hip it is not a common view. My... Read more
Reader Question:
THR With Adductor Tenotomy
Question: When coding a total hip replacement and adductor tenotomy through a separate inc... Read more
Reader Question:
Office Visit vs. Global Fracture
Question: Is it legal to charge office visits rather than a global fracture charge for sim... Read more
You Be the Coder:
Ligament Repair
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Receive Reimbursement for Post-Emergency Department Orthopedic Care
If someone is injured and needs immediate care, as in the case of a broken bone, he or she... Read more
Coding Case Study:
Meet the Challenge of Multicode Shoulder Surgeries
"Complicated arthroscopic shoulder surgeries often result in multiple surgical procedures ... Read more
It Pays to Code Correctly for Multiple Procedures
Modifier -51 (multiple procedures) has been used widely in orthopedic settings, where surg... Read more
Correction
In the July 2000 Orthopedic Coding Alert article Use 1995 or 1997 Guidelines to Get Paym... Read more
Reader Question:
Weaver-Dunn Procedure
Question: One of our physicians performed a coracoclavicular ligamentous reconstruction ... Read more
Reader Question:
Closed Reduction of Humerus Fracture
Question: Is there a procedure code other than 23929 (unlisted procedure, shoulder) to use... Read more
You Be the Coder:
Arthrodesis
Question: How can we get code 22630 (arthrodesis, posterior interbody technique, including... Read more
Optimize Payment for Orthopedic Surgery
Orthopedic surgeons and their staff who work with residents in a teaching hospital or a te... Read more
Use 1995 or 1997 Guidelines to Get Payment for E/M Services
In orthopedic care, as in other disciplines, two schools of thought exist when it comes to... Read more
Correction:
Mini Open Rotator Cuff Repair
Several readers pointed out that the answer to the You Be the Coder question on page 46 of... Read more
Reader Question:
Revision
Question: When a traumatic fingertip amputation occurs and the physician performs a revisi... Read more
Reader Question:
External Fixation
Question: We have always billed for the removal of external fixation with 20694 (removal, ... Read more
Reader Question:
Open Excision of Un-united Ossicle
Question: How do you code open excision of un-united ossicle in a patient with Osgood-Schl... Read more
Reader Question:
Assistant Surgeon Fees
Question: How do I find the rules regarding assistant surgeons' fees? I have the Med... Read more
Reader Question:
Arthroplasty
Question: When doing a revision of a total joint arthroplasty, what code is used if: Onl... Read more
You Be the Coder:
Modifier -58
Question: When is the proper time to use modifier -58? CPT states that it cannot be used i... Read more
Maximize Payment of Workers' Compensation
Each of the 50 states and the District of Columbia has its own Workers Compensation progra... Read more
A Procedural Coding Primer:
Increase Pay-Up for Soft Tissue Surgery of the Hand
Most orthopedic surgery coders are familiar with the 26XXX series of CPT Codes for hand su... Read more
Reader Question:
History and Physical During Global Period
Question: Where do your coding experts find the information on H&P (history and physical) ... Read more
Reader Question:
Removal of Pins
Question: During post-op surgery for insertion of pins in finger, can we charge for remova... Read more
Reader Question:
X-Rays
Question: Can we bill for reviewing x-rays? If a patient comes in with x-rays and the repo... Read more
Reader Question:
Consultation
Question: In a recent discussion on the Orthopedic Coding Discussion list serve [accesse... Read more
You Be the Coder:
Rotator Cuff Repair
Question: When a mini open rotator cuff repair is performed at the same time as an arthros... Read more
Avoid Denials for Total Knee Replacement Procedures
"Total knee replacement presents a double challenge for codersmodifiers must be used corre... Read more
Shoulder Decompression:
How to Optimize Pay Up When Multiple Procedures are Done
When an arthroscopic procedure and an open procedure (arthrotomy) are done during the same... Read more
Optimize Payment for Neck and Torso Orthotics/Supplies
A lack of documentation for devices, such as corsets, provided to Medicare patients in an ... Read more
Maximize Reimbursement for ACI Procedures
Is an unlisted code always the best one for a new procedure? Expert coders say yes. But a ... Read more
Look for Corrections to CCI Version 6.1 Errors
Due to a large number of errors, the implementation of the national Correct Coding Initiat... Read more
Reader Question:
Obtaining Coding Certification
Question: I would like to know about state testing for coding certification. Are there are... Read more
Reader Question:
Removal of Multiple Hardware, One Site
Question: When coding for hardware removal (20680), can you charge for multiple pieces of ... Read more
Reader Question:
Casting Confusion
Question: I am confused about billing for materials used for casting. Can you please clari... Read more
You Be the Coder:
Thermal Capsulorrhaphy Reviewed
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Receive Optimum Reimbursement for Treatment Of Pediatric Femoral Shaft Fractures
There are a variety of treatment options for pediatric femoral shaft fractures, and the pa... Read more
Correctly Coding Counseling and Coordination of Care Maximizes Reimbursement
Billing for additional time spent in counseling and the coordination of care presents a ch... Read more
Using V Codes for Related Conditions Improves Pay Up
Talking with a patient (or his or her surrogate) with undiagnosed, early-stage Alzheimers ... Read more
Correct Coding Maximizes Payment for Supplies/Orthotics
Note: Part two of a three-part series reviews the essentials of billing for selected suppl... Read more
Standards of Ethical Coding Released
On March 16, the American Health Information Management Association (AHIMA) for Ethical Co... Read more
Reader Question:
Incomplete Documentation
Question: My doctor [regularly] leaves part of the procedure out of the heading. For examp... Read more
Reader Question:
Antibiotic Cement Not Billable
Question: How do I bill for insertion of an antibiotic cement block during surgery for a l... Read more
You Be the Coder:
Multiple Procedure Rule Clarified
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Correctly Coding Bone Metastases to Maximize Reimbursement
In most cases when an orthopedic surgeon assists in the treatment of a cancer patient, the... Read more
Accurate Billing Will Optimize Supplies/Orthotics Payment
Editors Note: Part one of this three-part series reviews strategies to simplify billing fo... Read more
Where An Orthopedic PA Works Is Crucial to Reimbursement
Because the orthopedic physician assistant (PA) takes on roles in the office, hospital and... Read more
Reader Question:
Using the -22 Modifier to Relate Unusual Circumstances
Question: Prior to our patients undergoing a total knee replacement, the doctors like to t... Read more
Reader Question:
Removal of an Intramedullary Rod
Question: I am having difficulty coding for removal of an intramedullary rod from a patien... Read more
Reader Question:
Treatment During the Global Period
Question: A patient who recently underwent back surgery and within the global follow-up pe... Read more
Reader Question:
Injection with Evaluation and Management Service
Question: When billing for an evaluation and management service (E/M) along with an inject... Read more
You Be the Coder:
Adjustment of Cervical Halo
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Use Multiple Modifiers to Correctly Code for Multiple Trauma
Understanding when to use modifiers -50, -51, -59, -79 and -99 is vital to correctly code ... Read more
Endoscopic Thermal Capsulorrhaphy:
Correctly Code For New Unlisted Procedure
Receive proper reimbursement for unlisted procedures by providing solid documentation an... Read more
Reader Question:
Codes that Promise More than they Deliver
Question: When can code 99050 be used? Can that be added to all services (e.g., emergency ... Read more
Reader Question:
List Each Diagnosis Code That Applies
Question: What is the correct diagnosis code for the following (exploratory) operative fin... Read more
Reader Question:
Consultation Converted to Management
Question: We are getting conflicting or impossible directions. We have been told that we c... Read more
Reader Question:
Endoscopic Carpal Tunnel Release
Question: Is there anything that might trip us up when coding for endoscopic carpal tunnel... Read more
You Be the Coder:
Failed Cortisone Injection
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Overcoming Problems Coding Multiple Knee Ligament Repairs
"Multiple ligament repairs can be a real challenge for a coder unless he or she has a thor... Read more
Correctly Coding Excision of a Heel Spur
"When the excision of a heel spur is complicated by associated conditions, comprehensive d... Read more
Billing for General Anesthesia for Arthrofibrosis Manipulation
Occasionally a physician must turn to a procedure that lies outside the normthe one most... Read more
Reader Question:
Percutaneous Pinning
Question: How do you code a percutaneous pinning of a proximal humeral fracture? I have be... Read more
Reader Question:
Epidural Injections
Question: Please indicate the proper codes for epidural injections (e.g., right L4-5 selec... Read more
Reader Question:
Commonly Encountered Problems
Question: I am writing to ask questions about commonly encountered problems in my practice... Read more
You Be the Coder:
Consultation Charges
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Available Years:  2000  1999