Orthopedic Coding Alert
Are You Missing Out on PLIF Reimbursement?
Here's how to break down fusions to improve your billing and coding accuracy If yo... Read more
Here's how to break down fusions to improve your billing and coding accuracy If yo... Read more
Stop Giving Away Your CPO Services for Free
Documentation is key for care plan oversight reimbursement Don't let carriers undervalue... Read more
Documentation is key for care plan oversight reimbursement Don't let carriers undervalue... Read more
Create a Foolproof System for Tracking CPO Services
Like other time-based codes, you must document CPO services carefully, and each physician ... Read more
Like other time-based codes, you must document CPO services carefully, and each physician ... Read more
2 OIG Hot Spots and How to Steer Clear of Them
Want to avoid OIG scrutiny in 2004? Check consults and modifiers Do you append modifier ... Read more
Want to avoid OIG scrutiny in 2004? Check consults and modifiers Do you append modifier ... Read more
News You Can Use:
CMS Makes It Easier (and Cheaper) to Get NCCI
Tired of shelling out hundreds of dollars a year to stay current on changes to the Nationa... Read more
CMS Makes It Easier (and Cheaper) to Get NCCI
Tired of shelling out hundreds of dollars a year to stay current on changes to the Nationa... Read more
Reader Question:
Surgical Wound Re-Opening Is 'Related'
Question: Our patient underwent a hemi-arthroplasty for a fractured hip. He returned to th... Read more
Surgical Wound Re-Opening Is 'Related'
Question: Our patient underwent a hemi-arthroplasty for a fractured hip. He returned to th... Read more
Reader Question:
27829 Describes Maisonneuve Fracture
Question: My surgeon documented a Maisonneuve fracture, but I can't find this termin... Read more
27829 Describes Maisonneuve Fracture
Question: My surgeon documented a Maisonneuve fracture, but I can't find this termin... Read more
Reader Question:
No Anesthesia, No 15852
Question: One of our patients had bilateral pilon fractures with compartment syndrome requ... Read more
No Anesthesia, No 15852
Question: One of our patients had bilateral pilon fractures with compartment syndrome requ... Read more
Reader Question:
Report Initial Hospital Care for Admits Only
Question: I was recently called into the hospital to take over the care of a patient who... Read more
Report Initial Hospital Care for Admits Only
Question: I was recently called into the hospital to take over the care of a patient who... Read more
Reader Question:
401.0 Is Rare for Most Hyptertension
Question: When should I use a diagnosis of malignant hypertension? One of our hip-replacem... Read more
401.0 Is Rare for Most Hyptertension
Question: When should I use a diagnosis of malignant hypertension? One of our hip-replacem... Read more
Reader Question:
Report 28730 Once for 3 Joints
Question: Our orthopedist performed fusions to the first, second and third tarsometatarsal... Read more
Report 28730 Once for 3 Joints
Question: Our orthopedist performed fusions to the first, second and third tarsometatarsal... Read more
You Be the Coder:
Multiple Screws, 1 Incision
Question: Our orthopedist extracted multiple pieces of hardware (one plate and three screw... Read more
Multiple Screws, 1 Incision
Question: Our orthopedist extracted multiple pieces of hardware (one plate and three screw... Read more
Survive NCCI 9.3:
Bundle Fluoroscopy Into Spinal Surgeries
The latest version of the National Correct Coding Initiative (NCCI) perpetuates the trend ... Read more
Bundle Fluoroscopy Into Spinal Surgeries
The latest version of the National Correct Coding Initiative (NCCI) perpetuates the trend ... Read more
3 Surefire Tips for Laminoplasty Payment
Laminoplasty may still be considered an unlisted procedure, but you can recoup reimburseme... Read more
Laminoplasty may still be considered an unlisted procedure, but you can recoup reimburseme... Read more
Stave Off Laminoplasty Denials With a Detailed Letter
You can avoid laminoplasty denials if you submit a detailed letter with your claim. Includ... Read more
You can avoid laminoplasty denials if you submit a detailed letter with your claim. Includ... Read more
Want to Report 99205? Read This First
Many orthopedic practices are stuck reporting low-level new patient E/M codes even though ... Read more
Many orthopedic practices are stuck reporting low-level new patient E/M codes even though ... Read more
Find Your Place in History
Don't report another E/M service without using this chart (based on Medicare's 1997 Docume... Read more
Don't report another E/M service without using this chart (based on Medicare's 1997 Docume... Read more
News Brief:
Append -GN, -GO and -GP to Therapy Claims
Modifier requirement returns Medicare carriers and many private insurers will now require... Read more
Append -GN, -GO and -GP to Therapy Claims
Modifier requirement returns Medicare carriers and many private insurers will now require... Read more
Reader Question:
Multiple Diagnoses Are Often Required
Question: I performed a finger examination and manipulation under anesthesia for a mentall... Read more
Multiple Diagnoses Are Often Required
Question: I performed a finger examination and manipulation under anesthesia for a mentall... Read more
Reader Question:
Extra Coccyx View Is Included
Question: Our orthopedist ordered a coccyx x-ray, but our radiology technologist took two ... Read more
Extra Coccyx View Is Included
Question: Our orthopedist ordered a coccyx x-ray, but our radiology technologist took two ... Read more
Reader Question:
Select 23405 or 29999 for Tenotomy
Question: Our surgeon documented a biceps tenotomy. How should I report this?Wisconsin Sub... Read more
Select 23405 or 29999 for Tenotomy
Question: Our surgeon documented a biceps tenotomy. How should I report this?Wisconsin Sub... Read more
Reader Question:
Team Conferences May Be Reportable
Question: Our orthopedist treated a pregnant patient for an open femoral fracture (820.10)... Read more
Team Conferences May Be Reportable
Question: Our orthopedist treated a pregnant patient for an open femoral fracture (820.10)... Read more
Reader Question:
Report 72110 for Four-View Spine X-Ray
Question: We performed a four-view x-ray of the spine including flexion and extension view... Read more
Report 72110 for Four-View Spine X-Ray
Question: We performed a four-view x-ray of the spine including flexion and extension view... Read more
Reader Question:
Report 732.x Series for Juveniles
Question: Does the term "juvenile" in juvenile osteochondrosis (732.x) refer to the age of... Read more
Report 732.x Series for Juveniles
Question: Does the term "juvenile" in juvenile osteochondrosis (732.x) refer to the age of... Read more
You Be the Coder:
Is There a Quad Muscle Repair Code?
Question: Our surgeon repaired a quadriceps tendon rupture. Is there a code to describe ... Read more
Is There a Quad Muscle Repair Code?
Question: Our surgeon repaired a quadriceps tendon rupture. Is there a code to describe ... Read more
Secure Nucleoplasty Reimbursement With These Expert Tips
Physicians have performed nucleoplasty on more than 20,000 patients since the procedure ma... Read more
Physicians have performed nucleoplasty on more than 20,000 patients since the procedure ma... Read more
5 Steps to Fluoroscopy Reimbursement
According to CMS, orthopedic surgeons reported the fluoroscopic guidance code 76005 nearly... Read more
According to CMS, orthopedic surgeons reported the fluoroscopic guidance code 76005 nearly... Read more
Fluoroscopy Clip-and-Save Chart:
Get Paid for Fluoroscopic Guidance Every Time
Reporting fluoroscopic guidance with epidural injections is a challenge for even the most-... Read more
Get Paid for Fluoroscopic Guidance Every Time
Reporting fluoroscopic guidance with epidural injections is a challenge for even the most-... Read more
Private Payers May Pay for After-Hours Visits
After-hours codes are supposed to boost your reimbursement, but payment is not always auto... Read more
After-hours codes are supposed to boost your reimbursement, but payment is not always auto... Read more
Reader Questions:
Report 99255 Just Once Daily
Question: If I report 99255 more than once for the same patient (but on different days), M... Read more
Report 99255 Just Once Daily
Question: If I report 99255 more than once for the same patient (but on different days), M... Read more
Reader Questions:
Apply Phone Call to E/M
Question: A primary-care physician (PCP) called our orthopedist for consulting services re... Read more
Apply Phone Call to E/M
Question: A primary-care physician (PCP) called our orthopedist for consulting services re... Read more
Reader Questions:
Report Medication For Halted Injection
Question: One of our patients presented for a sacroiliac joint injection. The orthopedist ... Read more
Report Medication For Halted Injection
Question: One of our patients presented for a sacroiliac joint injection. The orthopedist ... Read more
Reader Questions:
NOS, NEC: Note These Differences
Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I choose between them?F... Read more
NOS, NEC: Note These Differences
Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I choose between them?F... Read more
Reader Question:
Ask Private Payers for a -59 Alternative
Question: In your July reader question "Signify Separate Interspaces With -59," you recomm... Read more
Ask Private Payers for a -59 Alternative
Question: In your July reader question "Signify Separate Interspaces With -59," you recomm... Read more
You Be the Coder:
Crush Injury Amputation Code?
Question: Is there an ICD-9 code that describes a transmetatarsal amputation due to a crus... Read more
Crush Injury Amputation Code?
Question: Is there an ICD-9 code that describes a transmetatarsal amputation due to a crus... Read more
Coding Case Study:
Billing Five or More Orthotics Codes? You May Have to Cut a Few
When it comes to fitting and dispensing orthotics, you should live by the "less is more" c... Read more
Billing Five or More Orthotics Codes? You May Have to Cut a Few
When it comes to fitting and dispensing orthotics, you should live by the "less is more" c... Read more
TPs Documenting E/M Exams? Read This First
Teaching physicians, take note: Don't rely on residents to complete your documentation for... Read more
Teaching physicians, take note: Don't rely on residents to complete your documentation for... Read more
Know Your Teaching Physician Requirements
The following excerpt from Medicare Transmittal 1780 (Nov. 22, 2002) can help you determin... Read more
The following excerpt from Medicare Transmittal 1780 (Nov. 22, 2002) can help you determin... Read more
News Brief:
$1,590 Therapy Cap Takes Effect This Month
Effective Sept. 1, CMS will implement a $1,590 annual cap on Medicare Part B outpatient oc... Read more
$1,590 Therapy Cap Takes Effect This Month
Effective Sept. 1, CMS will implement a $1,590 annual cap on Medicare Part B outpatient oc... Read more
Reader Question:
Prosthesis Insertion Is Not Unlisted
Question: I performed a patellofemoral joint arthroplasty during which I inserted a prosth... Read more
Prosthesis Insertion Is Not Unlisted
Question: I performed a patellofemoral joint arthroplasty during which I inserted a prosth... Read more
Reader Question:
Medicare May Bundle Hardware Removal
Question: Our surgeon repaired a nonunion of a left intertrochanteric femur fracture (2747... Read more
Medicare May Bundle Hardware Removal
Question: Our surgeon repaired a nonunion of a left intertrochanteric femur fracture (2747... Read more
Reader Question:
MD Must See Patient First for Incident-To
Question: Our nurse practitioner (NP) often sees patients and, if the orthopedist is in th... Read more
MD Must See Patient First for Incident-To
Question: Our nurse practitioner (NP) often sees patients and, if the orthopedist is in th... Read more
Reader Question:
Diskography RS&I per Level
Question: If our orthopedist performs diskography injections at multiple levels (such as L... Read more
Diskography RS&I per Level
Question: If our orthopedist performs diskography injections at multiple levels (such as L... Read more
Reader Question:
Z Joint Is Facet Joint
Question: Our orthopedist documented a "z-joint injection," but we couldn't find a code fo... Read more
Z Joint Is Facet Joint
Question: Our orthopedist documented a "z-joint injection," but we couldn't find a code fo... Read more
You Be the Coder:
No Incision, No Modifier -53?
Question: Prior to meniscectomy, we established general anesthesia, but the patient began ... Read more
No Incision, No Modifier -53?
Question: Prior to meniscectomy, we established general anesthesia, but the patient began ... Read more
New NCCI Edits Make Their Debut:
Know When You Can Collect for Casting
It's official: You should report either casting or fracture... Read more
Know When You Can Collect for Casting
It's official: You should report either casting or fracture... Read more
Multiple-Endoscopy Rules Apply to Arthroscopy
Do you know how to handle coding for more than one arthroscopic service performed at a s... Read more
Do you know how to handle coding for more than one arthroscopic service performed at a s... Read more
Take 3 Steps to Fewer Modifier -25 Denials
If you can demonstrate that your E/M encounter and your other procedures are separately ... Read more
If you can demonstrate that your E/M encounter and your other procedures are separately ... Read more
News Brief:
Carriers Wont Request Planned Refunds
Due to the late implementation of the 2003 Medicare Physician Fee Schedule, Medicare carri... Read more
Carriers Wont Request Planned Refunds
Due to the late implementation of the 2003 Medicare Physician Fee Schedule, Medicare carri... Read more
Reader Question:
Report Symptom Codes in Absence of Dx
Question: When we see a patient for a new pain-related problem, I usually report ... Read more
Report Symptom Codes in Absence of Dx
Question: When we see a patient for a new pain-related problem, I usually report ... Read more
Reader Question:
Report Hip Arthrograms Bilaterally
Question: Our orthopedist performed bilateral hip arthrograms under anesthesia. Should... Read more
Report Hip Arthrograms Bilaterally
Question: Our orthopedist performed bilateral hip arthrograms under anesthesia. Should... Read more
Reader Question:
Update Your TPI Coding
Question: Our orthopedist performed four trigger point injections in different muscle gr... Read more
Update Your TPI Coding
Question: Our orthopedist performed four trigger point injections in different muscle gr... Read more
Reader Question:
OK to Bill NPs Debridement Incident-To
Question: Our orthopedic surgeon and nurse practitioner (NP) worked together in our offi... Read more
OK to Bill NPs Debridement Incident-To
Question: Our orthopedic surgeon and nurse practitioner (NP) worked together in our offi... Read more
Reader Question:
Append -51 if NCCI Doesnt Bundle
Question: Our orthopedist performed a carpal tunnel release (64721) followed by a trig... Read more
Append -51 if NCCI Doesnt Bundle
Question: Our orthopedist performed a carpal tunnel release (64721) followed by a trig... Read more
You Be the Coder:
Report Joint Injection Once or Twice?
Question: If I remove fluid from a patients knee joint and then inject Depomedrol into tha... Read more
Report Joint Injection Once or Twice?
Question: If I remove fluid from a patients knee joint and then inject Depomedrol into tha... Read more
New Crop of ICD-9 Codes Makes Debut:
Muscle Weakness, Difficulty Walking Diagnoses Redefined
"Orthopedic practices will finally be able to specify muscle weakness diagnoses, thanks to... Read more
Muscle Weakness, Difficulty Walking Diagnoses Redefined
"Orthopedic practices will finally be able to specify muscle weakness diagnoses, thanks to... Read more
Same-Practice Orthopedists:
Same Surgeon
When different orthopedists in your practice treat a patient during her global surgical ... Read more
Same Surgeon
When different orthopedists in your practice treat a patient during her global surgical ... Read more
Global Periods XXX and 000 Are Not Synonymous
When dealing with global surgical packages, remember to differentiate between the XXX and ... Read more
When dealing with global surgical packages, remember to differentiate between the XXX and ... Read more
Reader Questions:
Pulley Reconstruction? See the 26500 Series
Question: Which code should I use for reconstruction of the A1 and A2 pulleys of the right... Read more
Pulley Reconstruction? See the 26500 Series
Question: Which code should I use for reconstruction of the A1 and A2 pulleys of the right... Read more
Reader Questions:
Follow Five Rules for Dermabond Repairs
Question: Can I report G0168 when I use Dermabond for a simple laceration repair? Can I re... Read more
Follow Five Rules for Dermabond Repairs
Question: Can I report G0168 when I use Dermabond for a simple laceration repair? Can I re... Read more
Reader Questions:
Apply 29807 to SLAP Lesions Only
Question: Our surgeons operative report states, Repair of posterior labral tear. Should I ... Read more
Apply 29807 to SLAP Lesions Only
Question: Our surgeons operative report states, Repair of posterior labral tear. Should I ... Read more
Reader Questions:
Signify Separate Interspaces With -59
Question: Our surgeon performed a single-level bilateral revision decompression (63042-5... Read more
Signify Separate Interspaces With -59
Question: Our surgeon performed a single-level bilateral revision decompression (63042-5... Read more
Reader Questions:
Append -59 for Two Fluoros
Question: Our physician performed fluoroscopy for a transforaminal lumbar epidural stero... Read more
Append -59 for Two Fluoros
Question: Our physician performed fluoroscopy for a transforaminal lumbar epidural stero... Read more
Reader Questions:
Even Observation Patients Require H&P
Question: Our orthopedist admitted a patient as observation status. He handwrote a history... Read more
Even Observation Patients Require H&P
Question: Our orthopedist admitted a patient as observation status. He handwrote a history... Read more
Reader Questions:
76066 Signals Joint Survey
Question: How should I report a long leg x-ray that included films of the hip, knee, ankle... Read more
76066 Signals Joint Survey
Question: How should I report a long leg x-ray that included films of the hip, knee, ankle... Read more
You Be the Coder:
Which Modifier Describes Assisted Surgery?
Question: I assisted another surgeon during part of a patients total hip replacement, but ... Read more
Which Modifier Describes Assisted Surgery?
Question: I assisted another surgeon during part of a patients total hip replacement, but ... Read more
Fluoroscopy Claims Denied? Try Adding -26
Although the fluoroscopy codes 76000 and 76001 specifically refer to "physician ti... Read more
Although the fluoroscopy codes 76000 and 76001 specifically refer to "physician ti... Read more
Benchmark Your Fluoroscopy Code Use
According to CMS'physician utilization data, orthopedic surgeons reported the fluorosc... Read more
According to CMS'physician utilization data, orthopedic surgeons reported the fluorosc... Read more
Avoid IME Codes for Patient-Requested Evaluations
Orthopedists who evaluate workers'compensation patients should report the 99455-99456 ... Read more
Orthopedists who evaluate workers'compensation patients should report the 99455-99456 ... Read more
Reader Question :
Use 64470 Range for Medial Branch Blocks
Question: Which code should we report for a medial branch block? New Jersey Subscribe... Read more
Use 64470 Range for Medial Branch Blocks
Question: Which code should we report for a medial branch block? New Jersey Subscribe... Read more
Reader Question :
Modifier -78 or -58?
Question: I surgically repaired a patient's intertrochanteric hip fracture (27244). Th... Read more
Modifier -78 or -58?
Question: I surgically repaired a patient's intertrochanteric hip fracture (27244). Th... Read more
Reader Question :
Report 76040 for Bone Length Studies
Question: We performed a "long cassette whole leg study" on an 11-year-old patient. Th... Read more
Report 76040 for Bone Length Studies
Question: We performed a "long cassette whole leg study" on an 11-year-old patient. Th... Read more
Reader Question :
Medicare Bundles DVT Evaluations
Question: Five days after I performed a total hip replacement, I evaluated the pa... Read more
Medicare Bundles DVT Evaluations
Question: Five days after I performed a total hip replacement, I evaluated the pa... Read more
Reader Question :
See LMRP for Mortons Neuroma Injection
Question: The article in the May 2003 Orthopedic Coding Alert about differentiating be... Read more
See LMRP for Mortons Neuroma Injection
Question: The article in the May 2003 Orthopedic Coding Alert about differentiating be... Read more
Reader Question :
Elbow Debridement Not Bundled Like Knee
Question: There is a new HCPCS code that allows orthopedists reimbursement for chondro... Read more
Elbow Debridement Not Bundled Like Knee
Question: There is a new HCPCS code that allows orthopedists reimbursement for chondro... Read more
Reader Question :
Modifier -79 Signals Unrelated Procedures
Question: While our orthopedist was performing an arthroscopic partial meniscectomy (2... Read more
Modifier -79 Signals Unrelated Procedures
Question: While our orthopedist was performing an arthroscopic partial meniscectomy (2... Read more
Reader Question :
Rest Home Versus Home Services
Question: Our orthopedist often visits homebound elderly patients who live in a retire... Read more
Rest Home Versus Home Services
Question: Our orthopedist often visits homebound elderly patients who live in a retire... Read more
You Be the Coder:
Is Pre-Op EPO Reimbursable?
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Is Pre-Op EPO Reimbursable?
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Modifiers Can Make or Break Surgical X-Ray Claims
If you perform medically necessary x-rays before and after surgery for insta... Read more
If you perform medically necessary x-rays before and after surgery for insta... Read more
Coding Case Study:
Report Only One E/M Code on Hospital Admit Date
Outpatient E/M visits sometimes uncover problems so severe that the orthopedist orders... Read more
Report Only One E/M Code on Hospital Admit Date
Outpatient E/M visits sometimes uncover problems so severe that the orthopedist orders... Read more
Modifier -57 At a Glance
For elective cases, orthopedists normally make surgical decisions days or weeks before... Read more
For elective cases, orthopedists normally make surgical decisions days or weeks before... Read more
NCCI Scopes New Knee Surgery Edits
Version 9.1 of the National Correct Coding Initiative (NCCI), which took effect A... Read more
Version 9.1 of the National Correct Coding Initiative (NCCI), which took effect A... Read more
Correction:
Graft Harvest/Insertion With 25447
The February 2003 Orthopedic Coding Alert article "Rule of Thumb: 25447 Includes... Read more
Graft Harvest/Insertion With 25447
The February 2003 Orthopedic Coding Alert article "Rule of Thumb: 25447 Includes... Read more
Reader Question:
Dont Report E/M for Warfarin Visit
Question: Our orthopedists often give patients warfarin following hip and knee replace... Read more
Dont Report E/M for Warfarin Visit
Question: Our orthopedists often give patients warfarin following hip and knee replace... Read more
Reader Question:
Append -53 Only With Anesthesia
Question: We were about to start anesthesia on a total knee replacement (27447) patien... Read more
Append -53 Only With Anesthesia
Question: We were about to start anesthesia on a total knee replacement (27447) patien... Read more
Reader Question:
Tendon Injections Differ From TPIs
Question: What is the difference between the codes in the 20550-20553 series? I know t... Read more
Tendon Injections Differ From TPIs
Question: What is the difference between the codes in the 20550-20553 series? I know t... Read more
Reader Question:
Use -47 If Surgeon Performs Anesthesia
Question: I administered anesthesia to a patient before performing a bunionectomy an... Read more
Use -47 If Surgeon Performs Anesthesia
Question: I administered anesthesia to a patient before performing a bunionectomy an... Read more
Reader Question:
Report 62310-62311 for Single Epidurals
Question: Should we report 62318 or 62319 when the orthopedist percutaneously inserts ... Read more
Report 62310-62311 for Single Epidurals
Question: Should we report 62318 or 62319 when the orthopedist percutaneously inserts ... Read more
Reader Question:
Append -22 for TKA Conversion
Question: How should we report conversion of a total knee arthroplasty (TKA) for a p... Read more
Append -22 for TKA Conversion
Question: How should we report conversion of a total knee arthroplasty (TKA) for a p... Read more
Reader Question:
Report 99141 for Conscious Sedation
Question: We recently treated a dislocated shoulder while we had the patient under con... Read more
Report 99141 for Conscious Sedation
Question: We recently treated a dislocated shoulder while we had the patient under con... Read more
You Be the Coder:
Weaver-Dunn Procedure
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Weaver-Dunn Procedure
Test your coding knowledge. Determine how you would code this situation before lo... Read more
Specialty Spotlight:
Sports Medicine Dont Strike Out When Reporting Elbow Ligament Repairs
Baseball season has arrived, which means orthopedists should expect to... Read more
Sports Medicine Dont Strike Out When Reporting Elbow Ligament Repairs
Baseball season has arrived, which means orthopedists should expect to... Read more
Avoid Undercoding Subsequent Hospital Care
If your practice repeatedly reports 99231 for all of your subsequent hospital care ser... Read more
If your practice repeatedly reports 99231 for all of your subsequent hospital care ser... Read more
Subsequent Hospital Care:
Documentation Is Key to Selecting Accurate Codes
Once your practice learns CMS'requirements for documenting subsequent hospital care, y... Read more
Documentation Is Key to Selecting Accurate Codes
Once your practice learns CMS'requirements for documenting subsequent hospital care, y... Read more
News Brief:
2003 Conversion Factor Increased by 1.6 Percent
Thanks to a last-minute congressional move, CMS raised the 2003 conversion factor ab... Read more
2003 Conversion Factor Increased by 1.6 Percent
Thanks to a last-minute congressional move, CMS raised the 2003 conversion factor ab... Read more
Clarification:
Shoulder Manipulation
The December 2002 Orthopedic Coding Alert reader question "Shoulder Manipulation" advise... Read more
Shoulder Manipulation
The December 2002 Orthopedic Coding Alert reader question "Shoulder Manipulation" advise... Read more
Reader Question:
Dont Report Both Injection and 99211
Question: When our nurses administer injections, we usually report the codes for injec... Read more
Dont Report Both Injection and 99211
Question: When our nurses administer injections, we usually report the codes for injec... Read more
Reader Question:
Report 24341 for Pectoralis Major Repair
Question: What is the appropriate code to report for pectoralis major muscle repair? I... Read more
Report 24341 for Pectoralis Major Repair
Question: What is the appropriate code to report for pectoralis major muscle repair? I... Read more
Reader Question:
Posterolateral Corner Repair Codes Vary
Question: Our surgeon performed an arthroscopic ACL reconstruction (29888) with an open p... Read more
Posterolateral Corner Repair Codes Vary
Question: Our surgeon performed an arthroscopic ACL reconstruction (29888) with an open p... Read more
Reader Question:
Report 26546 or 26565 for Open Osteoclasis
Question: Our surgeon performed open osteoclasis to treat a right proximal fifth metac... Read more
Report 26546 or 26565 for Open Osteoclasis
Question: Our surgeon performed open osteoclasis to treat a right proximal fifth metac... Read more
Reader Question:
Know the Three Knee Compartments
Question: We were pleased to read in the February Orthopedic Coding Alert that we can ... Read more
Know the Three Knee Compartments
Question: We were pleased to read in the February Orthopedic Coding Alert that we can ... Read more
Reader Question:
Report E/M For Oxygen Administration
Question: One of our patients suffered syncope and collapsed in the office. We adminis... Read more
Report E/M For Oxygen Administration
Question: One of our patients suffered syncope and collapsed in the office. We adminis... Read more
Reader Question:
Rib,Vertebrae Fractures:Use Two Codes
Question: Our orthopedist performed closed treatments on two vertebral compression fra... Read more
Rib,Vertebrae Fractures:Use Two Codes
Question: Our orthopedist performed closed treatments on two vertebral compression fra... Read more
You Be the Coder:
Report Separate-Compartment Multiple Chondroplasties
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Report Separate-Compartment Multiple Chondroplasties
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Coding Ankle Procedures Doesnt Have to Be Your Achilles Heel
" Because orthopedists use many different terms to describe ank... Read more
" Because orthopedists use many different terms to describe ank... Read more
Every Minute Counts When Reporting Therapy Codes
If you overhear your practice's physical therapist asking a patient ho... Read more
If you overhear your practice's physical therapist asking a patient ho... Read more
Specialty of the Month:
Avoid the Generation Gap When Coding for Pediatric Patients
Because pediatric patients usually don't boast "comprehensive" medical histories, prac... Read more
Avoid the Generation Gap When Coding for Pediatric Patients
Because pediatric patients usually don't boast "comprehensive" medical histories, prac... Read more
Follow Learning Curve to Code Scoliosis Treatment
Pediatric orthopedists who perform vertebral body stapling on scoliosis (737.x) pa... Read more
Pediatric orthopedists who perform vertebral body stapling on scoliosis (737.x) pa... Read more
Reader Question:
Use 64622 for Nerve Destruction
Question: Our orthopedist performed a radiofrequen-cy thermal coagulation (RFTC) t... Read more
Use 64622 for Nerve Destruction
Question: Our orthopedist performed a radiofrequen-cy thermal coagulation (RFTC) t... Read more
Reader Question:
Report 27418 for Elmslie-Trillat
Question: Our orthopedist documented an "Elmslie-Trillat procedure" for patellar insta... Read more
Report 27418 for Elmslie-Trillat
Question: Our orthopedist documented an "Elmslie-Trillat procedure" for patellar insta... Read more
Reader Question:
Tarsal Excision Is Ostectomy
Question: Our surgeon performed an excision of calcaneal navicular, tarsal coalition. ... Read more
Tarsal Excision Is Ostectomy
Question: Our surgeon performed an excision of calcaneal navicular, tarsal coalition. ... Read more
Reader Question:
Medicare May Deny Procaine Injections
Question: We have been reporting J2690 (Injection, procainamide HCl, up to 1... Read more
Medicare May Deny Procaine Injections
Question: We have been reporting J2690 (Injection, procainamide HCl, up to 1... Read more
Reader Question:
Split Codes When Billing WC,Medicare
Question: After the orthopedist evaluated a workers' compensation patient who had low-... Read more
Split Codes When Billing WC,Medicare
Question: After the orthopedist evaluated a workers' compensation patient who had low-... Read more
Reader Question:
Level II Modifiers Pinpoint Anatomic Site
Question: After reading the December 2002 article regarding the Level II site modifier... Read more
Level II Modifiers Pinpoint Anatomic Site
Question: After reading the December 2002 article regarding the Level II site modifier... Read more
You Be the Coder:
Append -62 When Surgeons Work Together
Test your coding knowledge.Determine how you would code this situation before looking ... Read more
Append -62 When Surgeons Work Together
Test your coding knowledge.Determine how you would code this situation before looking ... Read more
New G Code Allows Chondroplasty Payment with Meniscectomy
Orthopedists who perform chondroplasty (29877) and meniscectomies (29880-29881) i... Read more
Orthopedists who perform chondroplasty (29877) and meniscectomies (29880-29881) i... Read more
Rule of Thumb:
25447 Includes Trapezium Excision
" Hand surgeons who document thumb carpometa-carpal stabilization&quo... Read more
25447 Includes Trapezium Excision
" Hand surgeons who document thumb carpometa-carpal stabilization&quo... Read more
Split Codes When Billing WorkersComp with Medicare
If your workers'compensation examination (99201-99215) turns up a separate problem, ... Read more
If your workers'compensation examination (99201-99215) turns up a separate problem, ... Read more
2003 Fee Schedule Update:
Arthroscopic Lateral Release Pays More Than Open
To many orthopedists, CMS'2003 Physician Fee Schedule conta... Read more
Arthroscopic Lateral Release Pays More Than Open
To many orthopedists, CMS'2003 Physician Fee Schedule conta... Read more
New CCI Edition Bundles 64416 into Most Orthopedic Codes
Version 9.0 of the Correct Coding Initiative (CCI), which took effect on Jan. 1, bundl... Read more
Version 9.0 of the Correct Coding Initiative (CCI), which took effect on Jan. 1, bundl... Read more
Reader Question:
Use Unlisted-Procedure Code for Thermal Shrinkage
Question: Is there a CPT code for thermal shrinkage of the knee or shoulder? Minnesot... Read more
Use Unlisted-Procedure Code for Thermal Shrinkage
Question: Is there a CPT code for thermal shrinkage of the knee or shoulder? Minnesot... Read more
Reader Question:
Laminectomy Includes Dural Leak Repair
Question: Our surgeon performed a lumbar laminec-tomy, facetectomy and foraminotomy, d... Read more
Laminectomy Includes Dural Leak Repair
Question: Our surgeon performed a lumbar laminec-tomy, facetectomy and foraminotomy, d... Read more
Reader Question:
Use In-Office Physicians ID for Incident-To
Question: One of our physicians treated a patient for a sprained ankle, and a week l... Read more
Use In-Office Physicians ID for Incident-To
Question: One of our physicians treated a patient for a sprained ankle, and a week l... Read more
Reader Question:
Assign 13100 Series to Complex Repairs
Question: Our orthopedist removed hardware from a patient's injury site, during which ... Read more
Assign 13100 Series to Complex Repairs
Question: Our orthopedist removed hardware from a patient's injury site, during which ... Read more
Reader Question:
Report 25420 for Nonunion Repair
Question: I performed ulnar and radial nonunion repair with autograft through two sepa... Read more
Report 25420 for Nonunion Repair
Question: I performed ulnar and radial nonunion repair with autograft through two sepa... Read more
Reader Question:
Report 99271 Series for Second Opinions
Question: One of my former patients, whom I haven't seen in more than a year, came to ... Read more
Report 99271 Series for Second Opinions
Question: One of my former patients, whom I haven't seen in more than a year, came to ... Read more
Reader Question:
Use 20605 for Medial Epicondyle Injection
Question: Should we report 64450* (Injection, anesthetic agent; other peripheral nerve... Read more
Use 20605 for Medial Epicondyle Injection
Question: Should we report 64450* (Injection, anesthetic agent; other peripheral nerve... Read more
Reader Question:
Append -26 for Fluoroscopy with 20600
Question: When I administer a finger joint injection (20600) with fluoroscopy, should ... Read more
Append -26 for Fluoroscopy with 20600
Question: When I administer a finger joint injection (20600) with fluoroscopy, should ... Read more
You Be the Coder:
Use V67.09 for Annual Visit
Test your coding knowledge. Determine how you would code this situation before looking... Read more
Use V67.09 for Annual Visit
Test your coding knowledge. Determine how you would code this situation before looking... Read more
CPTs New Nerve Block Codes Alter Pain Management Infusion Coding
CPT 2003 introduces four new somatic nerve block codes, eliminating the need to bill a... Read more
CPT 2003 introduces four new somatic nerve block codes, eliminating the need to bill a... Read more
Specialty of the Month:
Spine Surgery - Modifier -50 Is the Backbone to Bilateral Reimbursement
Spine surgeons who perform bilateral surgeries such as lumbar laminotomies (63030)... Read more
Spine Surgery - Modifier -50 Is the Backbone to Bilateral Reimbursement
Spine surgeons who perform bilateral surgeries such as lumbar laminotomies (63030)... Read more
Dont Confuse Vertebroplasty and Kyphoplasty Codes
Spine coders, take note: Vertebroplasty and kyphoplasty are not synonymous, so you sh... Read more
Spine coders, take note: Vertebroplasty and kyphoplasty are not synonymous, so you sh... Read more
Reader Question:
Note Complexity of Shoulder Debridement
Question: What criteria should I use to distinguish between a limited shoulder debrideme... Read more
Note Complexity of Shoulder Debridement
Question: What criteria should I use to distinguish between a limited shoulder debrideme... Read more
Reader Question:
Bill for Suture Removal With Anesthesia
Question: Can we bill for removing a patients cast and sutures? Maryland Subscriber An... Read more
Bill for Suture Removal With Anesthesia
Question: Can we bill for removing a patients cast and sutures? Maryland Subscriber An... Read more
Reader Question:
Occiput-Atlas Is Level C1
Question: Our orthopedist indicated that he performed an occiput-atlas joint injecti... Read more
Occiput-Atlas Is Level C1
Question: Our orthopedist indicated that he performed an occiput-atlas joint injecti... Read more
Reader Question:
Bill Consults With Caution
Question: A primary-care physician (PCP) referred a patient to our practice after he h... Read more
Bill Consults With Caution
Question: A primary-care physician (PCP) referred a patient to our practice after he h... Read more
Reader Question:
Submit Modifier -GA When You Use an ABN
Question: Do we have to report modifiers -GA and -GX for all claims that we know Medicar... Read more
Submit Modifier -GA When You Use an ABN
Question: Do we have to report modifiers -GA and -GX for all claims that we know Medicar... Read more
Reader Question:
Respond When Insurer Downcodes Claims
Question: Our insurer requested documentation when we billed 29876 (Arthroscopy, knee, s... Read more
Respond When Insurer Downcodes Claims
Question: Our insurer requested documentation when we billed 29876 (Arthroscopy, knee, s... Read more
Reader Question:
Uniplane Is Included in Skeletal Fixation
Question: One of our surgeons wants me to bill 20690 (Application of a uniplane [pins or... Read more
Uniplane Is Included in Skeletal Fixation
Question: One of our surgeons wants me to bill 20690 (Application of a uniplane [pins or... Read more
You Be the Coder:
Swanson Implant Affects Silastic Joint
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Swanson Implant Affects Silastic Joint
Test your coding knowledge. Determine how you would code this situation before looki... Read more