Orthopedic Coding Alert
Coding Case Study:
Scrutinize Op Report Before You Bill 29822 With 29826
Not every SLAP lesion debridement claim will warrant separately reporting 29822 If you be... Read more
Scrutinize Op Report Before You Bill 29822 With 29826
Not every SLAP lesion debridement claim will warrant separately reporting 29822 If you be... Read more
Arthroscopic SAD Edits Vary According to Source
Compare AAOS' code pairs with NCCI's before you bill 29826 Orthopedic coders know that yo... Read more
Compare AAOS' code pairs with NCCI's before you bill 29826 Orthopedic coders know that yo... Read more
Using Modifier -59 to Separate All the NCCI Edits? Think Again
The OIG plans to crack down on -59 usage in 2005, so be careful If you think of modifier ... Read more
The OIG plans to crack down on -59 usage in 2005, so be careful If you think of modifier ... Read more
Clip and Save:
This Tool Can Do the Modifier Work for You
Use a flowchart to determine when modifier -59 best suits the bill Suppose your physician... Read more
This Tool Can Do the Modifier Work for You
Use a flowchart to determine when modifier -59 best suits the bill Suppose your physician... Read more
Reader Questions:
Negative History May Mean No History
Question: When the orthopedist writes, "Past history is negative," would this satisfy the ... Read more
Negative History May Mean No History
Question: When the orthopedist writes, "Past history is negative," would this satisfy the ... Read more
Reader Questions:
Stick With Unlisted for Meniscus Trephination
Question: Which code should I report when the orthopedist documents "arthroscopic trephina... Read more
Stick With Unlisted for Meniscus Trephination
Question: Which code should I report when the orthopedist documents "arthroscopic trephina... Read more
Reader Questions:
Look to 99141 for Conscious Sedation
Question: Especially when dealing with young children, our surgeon will administer conscio... Read more
Look to 99141 for Conscious Sedation
Question: Especially when dealing with young children, our surgeon will administer conscio... Read more
Reader Questions:
Append -24 During Global With Private Payers
Question: If a patient has a postsurgical hematoma during the global period, can we bill a... Read more
Append -24 During Global With Private Payers
Question: If a patient has a postsurgical hematoma during the global period, can we bill a... Read more
Reader Questions:
New Decubitus Ulcer Codes Shouldn't Be Confusing
Question: I noticed that ICD-9 2005 added an "unspecified site" and "other specified" decu... Read more
New Decubitus Ulcer Codes Shouldn't Be Confusing
Question: I noticed that ICD-9 2005 added an "unspecified site" and "other specified" decu... Read more
Reader Questions:
Append -21 to Level-5 E/M Only
Question: Our orthopedist performed a level-three E/M service on a new patient last week. ... Read more
Append -21 to Level-5 E/M Only
Question: Our orthopedist performed a level-three E/M service on a new patient last week. ... Read more
You Be the Coder:
How Should We Report a Disk Bulge?
Question: My surgeon's operative report says,"Mild central disk bulge at L4-5 with facet a... Read more
How Should We Report a Disk Bulge?
Question: My surgeon's operative report says,"Mild central disk bulge at L4-5 with facet a... Read more
2005 Sneak Peak:
Say Goodbye to Ambiguity With New Mosaicplasty Codes
Check out our preview of the new CPT codes that should take effect on Jan. 1 If you've g... Read more
Say Goodbye to Ambiguity With New Mosaicplasty Codes
Check out our preview of the new CPT codes that should take effect on Jan. 1 If you've g... Read more
Using ESWT? You May Finally Be Able to Collect
But payer coverage varies, so check your carriers' policiesIf your orthopedist uses extrac... Read more
But payer coverage varies, so check your carriers' policiesIf your orthopedist uses extrac... Read more
Know What to Expect From State Medicare ESWT Policies
2 examples will save you a hassle in the long runWhen you report ESWT for patients with ep... Read more
2 examples will save you a hassle in the long runWhen you report ESWT for patients with ep... Read more
Want to Bill 22849-22850 With Spinal Surgery? Now You Can
NCCI 10.3 offers a rare but welcome edit deletionGood news! Starting in October, you can b... Read more
NCCI 10.3 offers a rare but welcome edit deletionGood news! Starting in October, you can b... Read more
Think You're 99211 Savvy? Take Our Quiz to Find Out
If you're billing 99211 for injections, you may be coding incorrectlyHow much do you reall... Read more
If you're billing 99211 for injections, you may be coding incorrectlyHow much do you reall... Read more
Reader Question:
Insurers May Require X-Rays to Justify Fracture Dx
Question: When a patient presents with a fracture, we usually get an x-ray confirmation be... Read more
Insurers May Require X-Rays to Justify Fracture Dx
Question: When a patient presents with a fracture, we usually get an x-ray confirmation be... Read more
Reader Question:
Assign a Single Date to Medicare Claims
Question: Our surgeon performed subsequent hospital care over the course of four days, so ... Read more
Assign a Single Date to Medicare Claims
Question: Our surgeon performed subsequent hospital care over the course of four days, so ... Read more
Reader Question:
Don't Separately Bill ACL Graft Harvest
Question: In your August reader question "Include Graft Harvest in ACL Repair," you said t... Read more
Don't Separately Bill ACL Graft Harvest
Question: In your August reader question "Include Graft Harvest in ACL Repair," you said t... Read more
Reader Question:
20550 Is Your Best Bet for Heel Spur Steroid Injection
Question: Which code should I report for a heel spur steroid injection?Kentucky Subscriber... Read more
20550 Is Your Best Bet for Heel Spur Steroid Injection
Question: Which code should I report for a heel spur steroid injection?Kentucky Subscriber... Read more
Reader Question:
Shoulder Decompression Code Includes Diagnostic Arthroscopy
Question: How should we report subacromial decompression of the shoulder with diagnostic a... Read more
Shoulder Decompression Code Includes Diagnostic Arthroscopy
Question: How should we report subacromial decompression of the shoulder with diagnostic a... Read more
You Be the Coder:
How Should We Code Knee Replacement Change?
Question: Our surgeon performed a unicondylar knee replacement several years ago, but it f... Read more
How Should We Code Knee Replacement Change?
Question: Our surgeon performed a unicondylar knee replacement several years ago, but it f... Read more
5 Answers to Your Most Pressing X-Ray Questions
You'll hit your claims on the mark every time with these expert tips If you can't g... Read more
You'll hit your claims on the mark every time with these expert tips If you can't g... Read more
E Codes Can Help You Unlock Workers' Comp Pay
Workers' comp insurers may not pay your claim without accident details Workers' compensat... Read more
Workers' comp insurers may not pay your claim without accident details Workers' compensat... Read more
News You Can Use:
CMS Won't Cover Arthroscopic Debridement for Knee OA
You can't report 29877 for osteoarthritis lavage alone, experts say If your orthopedic su... Read more
CMS Won't Cover Arthroscopic Debridement for Knee OA
You can't report 29877 for osteoarthritis lavage alone, experts say If your orthopedic su... Read more
Look to the Web for Medicare's Physician Fee Schedule
In the July Orthopedic Coding Alert article "PA Assists at Surgery? 4 Steps Ensure Reimbur... Read more
In the July Orthopedic Coding Alert article "PA Assists at Surgery? 4 Steps Ensure Reimbur... Read more
Correction:
Report 10180 for Complex Post-op Wound Infection I&D
In the August Orthopedic Coding Alert article "2 Questions Help You Report Postoperative I... Read more
Report 10180 for Complex Post-op Wound Infection I&D
In the August Orthopedic Coding Alert article "2 Questions Help You Report Postoperative I... Read more
Reader Questions:
Use 727.89 for Dislocated Peroneal Tendon Dx
Question: Our orthopedic surgeon recently repaired a patient's peroneal tendon, but we can... Read more
Use 727.89 for Dislocated Peroneal Tendon Dx
Question: Our orthopedic surgeon recently repaired a patient's peroneal tendon, but we can... Read more
Reader Questions:
Include Graft Harvest in ACL Repair
Question: Which code should I report when the surgeon performs a hamstring autograft with ... Read more
Include Graft Harvest in ACL Repair
Question: Which code should I report when the surgeon performs a hamstring autograft with ... Read more
Reader Questions:
Insurers Don't Subject Boot to Casting Guidelines
Question: Can we charge for closed treatment of an ankle fracture along with a walker boot... Read more
Insurers Don't Subject Boot to Casting Guidelines
Question: Can we charge for closed treatment of an ankle fracture along with a walker boot... Read more
Reader Questions:
Payers May Sway on DEXA Limits
Question: If we perform a DEXA scan on a patient, and then repeat the DEXA a year later to... Read more
Payers May Sway on DEXA Limits
Question: If we perform a DEXA scan on a patient, and then repeat the DEXA a year later to... Read more
Reader Questions:
Turn to Unlisted-Procedure Code for Core Decompression
Question: Does CPT include a code for core decompression of the right hip? I haven't been ... Read more
Turn to Unlisted-Procedure Code for Core Decompression
Question: Does CPT include a code for core decompression of the right hip? I haven't been ... Read more
You Be the Coder:
How Should We Report Olecranon Bone Spur?
Question: Which diagnosis code should we report for an olecranon bone spur? ICD-9 points t... Read more
How Should We Report Olecranon Bone Spur?
Question: Which diagnosis code should we report for an olecranon bone spur? ICD-9 points t... Read more
You've Got G0289 Questions? We've Got Answers
Our experts answer your top-4 knee chondroplasty questions If you've dreaded coding arthr... Read more
Our experts answer your top-4 knee chondroplasty questions If you've dreaded coding arthr... Read more
Fulfill This Requirement Before You Report 63075 With ACDF
Remember to bill multiple codes when surgeon performs ACDF If your surgeon performs an e... Read more
Remember to bill multiple codes when surgeon performs ACDF If your surgeon performs an e... Read more
Consult or Referral? Stop Flipping Coins With Expert Advice
Difficulty differentiating between consults and referrals could cause trouble When you c... Read more
Difficulty differentiating between consults and referrals could cause trouble When you c... Read more
Reader Questions:
Choose 99235 for Physician Who Examines Patient
Question: Dr. Smith was on call and admitted a patient to the hospital. On the same day, D... Read more
Choose 99235 for Physician Who Examines Patient
Question: Dr. Smith was on call and admitted a patient to the hospital. On the same day, D... Read more
Reader Questions:
Describe Bone Length Study With 76040
Question: How should I report a long leg x-ray that includes films of the hip, knee, ankle... Read more
Describe Bone Length Study With 76040
Question: How should I report a long leg x-ray that includes films of the hip, knee, ankle... Read more
Reader Questions:
Use -LT, -RT for Bilateral Arthroplasties
Question: Two orthopedic surgeons from our practice performed total knee arthroplasties on... Read more
Use -LT, -RT for Bilateral Arthroplasties
Question: Two orthopedic surgeons from our practice performed total knee arthroplasties on... Read more
Reader Questions:
Look to 726.4 for Intersection Syndrome
Question: Which diagnosis code should I use if the surgeon documents "intersection syndrom... Read more
Look to 726.4 for Intersection Syndrome
Question: Which diagnosis code should I use if the surgeon documents "intersection syndrom... Read more
Reader Questions:
Append -78 for Return to OR
Question: Our surgeon performed a right total hip arthroplasty. Postoperative films taken ... Read more
Append -78 for Return to OR
Question: Our surgeon performed a right total hip arthroplasty. Postoperative films taken ... Read more
Reader Questions:
Append -79 During Global
Question: Our surgeon performed arthroscopic surgery on a patient's left knee. During the ... Read more
Append -79 During Global
Question: Our surgeon performed arthroscopic surgery on a patient's left knee. During the ... Read more
Reader Question:
Include CO2 Laser in Diskectomy Charge
Question: Should we charge more if we use a CO2 laser during diskectomy? For instance, is ... Read more
Include CO2 Laser in Diskectomy Charge
Question: Should we charge more if we use a CO2 laser during diskectomy? For instance, is ... Read more
You Be the Coder:
Modifier -58 or -78: You Decide
Question: I surgically repaired a patient's intertrochanteric hip fracture (27244). The fo... Read more
Modifier -58 or -78: You Decide
Question: I surgically repaired a patient's intertrochanteric hip fracture (27244). The fo... Read more
NCCI 10.2 Bundles Lidocaine Into Hundreds of Procedures
If you've billed J2001 with your injections, the latest NCCI edits will get your attention... Read more
If you've billed J2001 with your injections, the latest NCCI edits will get your attention... Read more
Coding Case Study:
Can You Bill Flexor Tenotomy With Hammertoe Correction?
The answer may surprise you Your foot surgeon performs a hammertoe correction and fle... Read more
Can You Bill Flexor Tenotomy With Hammertoe Correction?
The answer may surprise you Your foot surgeon performs a hammertoe correction and fle... Read more
2 Questions Help You Report Postoperative Infections
Know when not to follow CMS guidelines If you include postsurgical infection care in the ... Read more
Know when not to follow CMS guidelines If you include postsurgical infection care in the ... Read more
Clarification:
Use 27824-27825 for Closed Posterior Malleolus Fracture
Our July 2004 Reader Question titled "Closed Posterior Malleolus Fracture Requires an Unli... Read more
Use 27824-27825 for Closed Posterior Malleolus Fracture
Our July 2004 Reader Question titled "Closed Posterior Malleolus Fracture Requires an Unli... Read more
Reader Question:
Treat a WC Patient, Use Office Visit Code
Question: Should I use work-related code 99455 each time my orthopedist sees a workers'c... Read more
Treat a WC Patient, Use Office Visit Code
Question: Should I use work-related code 99455 each time my orthopedist sees a workers'c... Read more
Reader Question:
Look to 28020 for I&D With Biopsy
Question: Our physician performed an incision and drainage (I&D) and a bone biopsy f... Read more
Look to 28020 for I&D With Biopsy
Question: Our physician performed an incision and drainage (I&D) and a bone biopsy f... Read more
Reader Question:
Code Barbotage as Joint Injection
Question: Our orthopedist documented "barbotage of a calcific density in the supraspinat... Read more
Code Barbotage as Joint Injection
Question: Our orthopedist documented "barbotage of a calcific density in the supraspinat... Read more
You Be the Coder:
Can We Separately Report Bleeding Control?
Question: During surgery, our orthopedist dictated that she performed "control of bleedi... Read more
Can We Separately Report Bleeding Control?
Question: During surgery, our orthopedist dictated that she performed "control of bleedi... Read more
New ICD-9 Codes Allow Site Specificity for Decubitus Ulcers
You have until Oct.1 to implement the new diagnosis code changes Coders, take notice: At... Read more
You have until Oct.1 to implement the new diagnosis code changes Coders, take notice: At... Read more
Don't Settle for Unilateral Pay With Bilateral Surgery
Realize $430 more for bilateral laminotomy with the correct modifier You're not alone if ... Read more
Realize $430 more for bilateral laminotomy with the correct modifier You're not alone if ... Read more
PA Assists at Surgery? 4 Steps Ensure Reimbursement
Think you know the correct modifier? It differs depending on the insurer Physician assist... Read more
Think you know the correct modifier? It differs depending on the insurer Physician assist... Read more
Reader Question:
V Codes Signal Aftercare
Question: Our orthopedist often asks patients to return to our office 90 days after a fr... Read more
V Codes Signal Aftercare
Question: Our orthopedist often asks patients to return to our office 90 days after a fr... Read more
Reader Question:
Include Wound VAC Charge in E/M
Question: Our surgeons have started using a "Wound VAC system" to expedite wound healing... Read more
Include Wound VAC Charge in E/M
Question: Our surgeons have started using a "Wound VAC system" to expedite wound healing... Read more
Reader Question:
11981 Is Correct for Nonabsorbent Antibiotic Beads
Question: Our orthopedist inserted a nonabsorbable antibiotic bead under the patient's s... Read more
11981 Is Correct for Nonabsorbent Antibiotic Beads
Question: Our orthopedist inserted a nonabsorbable antibiotic bead under the patient's s... Read more
Reader Question:
Report Only 25611 for Radius, Ulna Fractures
Question: Our surgeon wants to bill both 25611 and 25651 for a percutaneous distal radiu... Read more
Report Only 25611 for Radius, Ulna Fractures
Question: Our surgeon wants to bill both 25611 and 25651 for a percutaneous distal radiu... Read more
Reader Question:
Chrisman-Snook Warrants 27698
Question: Our orthopedist documented a "Chrisman-Snook Lateral Ankle Reconstruction." He... Read more
Chrisman-Snook Warrants 27698
Question: Our orthopedist documented a "Chrisman-Snook Lateral Ankle Reconstruction." He... Read more
Reader Question:
New or Established? 3 Years Is the Magic Timeline
Question: When a patient presents to the office for the first time after our surgeon dis... Read more
New or Established? 3 Years Is the Magic Timeline
Question: When a patient presents to the office for the first time after our surgeon dis... Read more
Reader Question:
Closed Posterior Malleolus Fracture Requires an Unlisted-Procedure Code
Question: Which CPT code should we report for closed treatment of a posterior malleolus ... Read more
Closed Posterior Malleolus Fracture Requires an Unlisted-Procedure Code
Question: Which CPT code should we report for closed treatment of a posterior malleolus ... Read more
You Be the Coder:
How Should I Report Post-Op Care After Assist?
Question: My orthopedic surgeon performed an assist at surgery in another town, and then... Read more
How Should I Report Post-Op Care After Assist?
Question: My orthopedic surgeon performed an assist at surgery in another town, and then... Read more
Can You Bill Plica Resection With Meniscectomy? The Answer Depends on Whom You Ask
If your insurer follows AAOS guidelines, you may not be able to report separate-compartm... Read more
If your insurer follows AAOS guidelines, you may not be able to report separate-compartm... Read more
Coding Spinal Adhesions? 1 Day Can Make a $250 Difference
Choose the correct lysis codes based on the number of procedural days If you're billing y... Read more
Choose the correct lysis codes based on the number of procedural days If you're billing y... Read more
Want to Collect for ED Work and Inpatient Admit? Here's How
You may be able to increase your E/M coding level Your orthopedic surgeon sees ... Read more
You may be able to increase your E/M coding level Your orthopedic surgeon sees ... Read more
Clarification:
27814 Applies to Bimalleolar Fractures Only
Our May reader question "Choose 27814 for Bimalleolar Fracture" advised coders to report 2... Read more
27814 Applies to Bimalleolar Fractures Only
Our May reader question "Choose 27814 for Bimalleolar Fracture" advised coders to report 2... Read more
Reader Question:
Is This a Consult?
Question: A cardiologist admitted one of my arthritis patients to the hospital. The card... Read more
Is This a Consult?
Question: A cardiologist admitted one of my arthritis patients to the hospital. The card... Read more
Reader Question:
Don't Write Off Intraoperative Consults
Question: A cardiac surgeon recently called our orthopedic surgeon into the operating room... Read more
Don't Write Off Intraoperative Consults
Question: A cardiac surgeon recently called our orthopedic surgeon into the operating room... Read more
Reader Question:
Maintenance Therapy May Not Be Payable
Question: Our physical therapist documented gait training for a motor-vehicle accident pat... Read more
Maintenance Therapy May Not Be Payable
Question: Our physical therapist documented gait training for a motor-vehicle accident pat... Read more
Reader Question:
Report Unlisted-Procedure Code for Topaz Procedure
Question: Our surgeons have started documenting "Topaz procedures" for elbow and knee surg... Read more
Report Unlisted-Procedure Code for Topaz Procedure
Question: Our surgeons have started documenting "Topaz procedures" for elbow and knee surg... Read more
Reader Question:
Look to 27385-27386 for Quad Tendon Repair
Reviewed on May 20, 2015 Question: How should we report a quadriceps tendon repair? Sh... Read more
Look to 27385-27386 for Quad Tendon Repair
Reviewed on May 20, 2015 Question: How should we report a quadriceps tendon repair? Sh... Read more
Reader Question:
Report 756.12 or 738.4 for Anterolisthesis Dx
Question: Would you direct us to the appropriate ICD-9 code for anterolisthesis? Miss... Read more
Report 756.12 or 738.4 for Anterolisthesis Dx
Question: Would you direct us to the appropriate ICD-9 code for anterolisthesis? Miss... Read more
Reader Question:
DBX Counts as Allograft
Question: Our surgeon used both demineralized bone matrix putty (DBX) and bone marrow from... Read more
DBX Counts as Allograft
Question: Our surgeon used both demineralized bone matrix putty (DBX) and bone marrow from... Read more
You Be The Coder:
Which Codes Apply to an Ineffective Cast?
Question: An established 11-year-old patient hit his short arm cast so often that the cast... Read more
Which Codes Apply to an Ineffective Cast?
Question: An established 11-year-old patient hit his short arm cast so often that the cast... Read more
NCCI 10.1 Edits Could Cost You More Than $100
16 testing codes bundled into scores of spine surgery codes If your orthopedic surgeon p... Read more
16 testing codes bundled into scores of spine surgery codes If your orthopedic surgeon p... Read more
Coding Quiz:
Know Your Knee Anatomy and Increase Your Coding Accuracy
Will a notchplasty with ACL reconstruction bring you extra money? If you don't know your ... Read more
Know Your Knee Anatomy and Increase Your Coding Accuracy
Will a notchplasty with ACL reconstruction bring you extra money? If you don't know your ... Read more
4 Pointers Make Orthopedic Add-On Codes a Snap
Spinal surgeries often require add-ons, which can bring you up to $450+ CPT is full of "a... Read more
Spinal surgeries often require add-ons, which can bring you up to $450+ CPT is full of "a... Read more
3 Tips Ensure $75-$100 per Hospital Discharge Claim
Don't let poor documentation sink your 99238-99239 claims Orthopedists report hospital di... Read more
Don't let poor documentation sink your 99238-99239 claims Orthopedists report hospital di... Read more
Correction:
Ingrown Nail Trims Warrant 11730
In our March Reader Question "Infected Ingrown Nails May Be Payable," we advised orthopedi... Read more
Ingrown Nail Trims Warrant 11730
In our March Reader Question "Infected Ingrown Nails May Be Payable," we advised orthopedi... Read more
Reader Question:
Choose 27814 for Bimalleolar Fracture
Question: Our patient had a fractured lateral malleolus and ruptured ligaments on the medi... Read more
Choose 27814 for Bimalleolar Fracture
Question: Our patient had a fractured lateral malleolus and ruptured ligaments on the medi... Read more
Reader Question:
Don't Report Reattachment Without Amputation
Question: Our surgeon removed a patient's toenail and repaired the patient's partially det... Read more
Don't Report Reattachment Without Amputation
Question: Our surgeon removed a patient's toenail and repaired the patient's partially det... Read more
Reader Quesiton:
Report Category III Codes for IDEA
Question: How should I report intradiscal electro-thermal annuloplasty (IDEA)? Nevada Subs... Read more
Report Category III Codes for IDEA
Question: How should I report intradiscal electro-thermal annuloplasty (IDEA)? Nevada Subs... Read more
Reader Question:
Choose 99341 Series for Home Visits
Question: One of our orthopedists visits patients at their homes occasionally to evaluate ... Read more
Choose 99341 Series for Home Visits
Question: One of our orthopedists visits patients at their homes occasionally to evaluate ... Read more
Reader Question:
Append -58 for Return to OR
Question: Our patient's lower leg was amputated three years ago, but he suffered a supraco... Read more
Append -58 for Return to OR
Question: Our patient's lower leg was amputated three years ago, but he suffered a supraco... Read more
You Be the Coder:
Do Consults Have Time Limits?
Question: If I perform an office consultation on a patient, how much time must elapse befo... Read more
Do Consults Have Time Limits?
Question: If I perform an office consultation on a patient, how much time must elapse befo... Read more
Separately Report Grafting During Arthrodesis And Collect $200 or More
NCCI doesn't bundle these bone graft codes into the spinal fusion codesAlthough CPT and th... Read more
NCCI doesn't bundle these bone graft codes into the spinal fusion codesAlthough CPT and th... Read more
4 Ways to Improve Your Spinal Instrumentation Claims
Master terminology and modifier use to ensure accurate reimbursementIf you're bewildered b... Read more
Master terminology and modifier use to ensure accurate reimbursementIf you're bewildered b... Read more
Every State Now Offers Preoperative EPO Injections
All Medicare carriers provide some erythropoetin coverage, but policies varyAlthough many ... Read more
All Medicare carriers provide some erythropoetin coverage, but policies varyAlthough many ... Read more
Debunk This 99211 Myth -- It's Not Just for Nurses
Learn 99211's requirements to decide whether your patient visits warrant itBecause orthope... Read more
Learn 99211's requirements to decide whether your patient visits warrant itBecause orthope... Read more
Reader Question:
Append Modifier -22 for Complex Uni-Arthroplasty
Question: Our physician performed a minimal-incision total knee uni-arthroplasty, but we c... Read more
Append Modifier -22 for Complex Uni-Arthroplasty
Question: Our physician performed a minimal-incision total knee uni-arthroplasty, but we c... Read more
Reader Question:
Consults Apply to New and Established Patients
Question: Should I report a consult for an established patient (whom we last saw two years... Read more
Consults Apply to New and Established Patients
Question: Should I report a consult for an established patient (whom we last saw two years... Read more
Reader Question:
Most Leg Amputations Warrant 27880
Question: How do leg amputation codes differ from each other?Minnesota Subscriber Answer:... Read more
Most Leg Amputations Warrant 27880
Question: How do leg amputation codes differ from each other?Minnesota Subscriber Answer:... Read more
Reader Question:
Count X-Ray Read Toward E/M Level
Question: If our orthopedist orders an x-ray and provides personal, independent visualizat... Read more
Count X-Ray Read Toward E/M Level
Question: If our orthopedist orders an x-ray and provides personal, independent visualizat... Read more
Reader Question:
Laminectomy With Dural Tear May Warrant -22
Question: If our orthopedist performs a laminectomy and repairs a dural tear at the same l... Read more
Laminectomy With Dural Tear May Warrant -22
Question: If our orthopedist performs a laminectomy and repairs a dural tear at the same l... Read more
You Be The Coder:
How Should We Code Stitches, Adhesive Strips?
Question: Recently, a payer rejected a wound repair claim (12005) when our surgeon used a ... Read more
How Should We Code Stitches, Adhesive Strips?
Question: Recently, a payer rejected a wound repair claim (12005) when our surgeon used a ... Read more
Preauthorize Your EPO Injections - or Risk Forfeiting $450 or More
Get your insurer's erythropoeitin policy in writing before you inject If you're administe... Read more
Get your insurer's erythropoeitin policy in writing before you inject If you're administe... Read more
NCCI 10.0 Bundles Fracture Treatment Into Vertebroplasty
Medicare also bundles operating microscope into more codes than before The latest version... Read more
Medicare also bundles operating microscope into more codes than before The latest version... Read more
Collect Maximum Fees for Co-Surgery With These 4 Rules
Co-surgery coding can be as tricky as the complex surgery that triggers it, but if you app... Read more
Co-surgery coding can be as tricky as the complex surgery that triggers it, but if you app... Read more
Two Surgeons Won't Always Warrant Modifier -62
Just because two surgeons operate on the same patient during the same operative session do... Read more
Just because two surgeons operate on the same patient during the same operative session do... Read more
News You Can Use:
Higher Conversion Factor Bolsters Orthopedists' Pay
CMS finally released the long-awaited 2004 conversion factor. According to CMS' Dec. 24 Tr... Read more
Higher Conversion Factor Bolsters Orthopedists' Pay
CMS finally released the long-awaited 2004 conversion factor. According to CMS' Dec. 24 Tr... Read more
Reader Question:
New Kyphoplasty Codes Don't Guarantee Payment
Question: I have heard that a new HCPCS code for kyphoplasty was coming this year. What is... Read more
New Kyphoplasty Codes Don't Guarantee Payment
Question: I have heard that a new HCPCS code for kyphoplasty was coming this year. What is... Read more
Reader Question:
Count Self-Referrals as Office Visits
Question: A back-pain patient asked our orthopedist whether he could alleviate her pain th... Read more
Count Self-Referrals as Office Visits
Question: A back-pain patient asked our orthopedist whether he could alleviate her pain th... Read more
Reader Question:
Use 99201-99205 if Patient Switches to Your Office
Question: When my orthopedist covers for another local private-practice physician, I code ... Read more
Use 99201-99205 if Patient Switches to Your Office
Question: When my orthopedist covers for another local private-practice physician, I code ... Read more
Reader Question:
Infected Ingrown Nails May Be Payable
Question: A Medicare patient presented with a painful ingrown toenail, and our foot surgeo... Read more
Infected Ingrown Nails May Be Payable
Question: A Medicare patient presented with a painful ingrown toenail, and our foot surgeo... Read more
You Be the Coder:
Do Open Fractures Always Require Open Care?
Question: Our orthopedic surgeon documented "fracture care for an open scapula fracture," ... Read more
Do Open Fractures Always Require Open Care?
Question: Our orthopedic surgeon documented "fracture care for an open scapula fracture," ... Read more
One Modifier Collects Reimbursement for Skiing Injuries - If You Know the Rules
When patients go on skiing vacations and return with new injuries, both the treating and p... Read more
When patients go on skiing vacations and return with new injuries, both the treating and p... Read more
Debunk 3 Common Diagnosis Coding Myths
When it comes to ICD-9 coding, you can't believe everything you hear You assigned the co... Read more
When it comes to ICD-9 coding, you can't believe everything you hear You assigned the co... Read more
Is Your Consult Coding Opening the Reimbursement Door?
Experts reveal the answers to the 3 most commonly asked consult questions You can get th... Read more
Experts reveal the answers to the 3 most commonly asked consult questions You can get th... Read more
Reader Question:
Include Halo Adjustment in Global
Question: Is there a code for adjusting a cervical halo without using anesthesia, or would... Read more
Include Halo Adjustment in Global
Question: Is there a code for adjusting a cervical halo without using anesthesia, or would... Read more
Reader Question:
NPs Can Usually Report Standard E/M Codes
Question: Which code should I report for a nurse practitioner (NP) visit when the orthoped... Read more
NPs Can Usually Report Standard E/M Codes
Question: Which code should I report for a nurse practitioner (NP) visit when the orthoped... Read more
Reader Question:
Osteoporosis Checkups Might Be Preventive
Question: When an osteoporosis patient comes in for a checkup, should I report a sick visi... Read more
Osteoporosis Checkups Might Be Preventive
Question: When an osteoporosis patient comes in for a checkup, should I report a sick visi... Read more
Reader Question:
Carriers Include Marcaine in Injection Fee
Question: I have recently read a lot of conflicting advice regarding when I can report J34... Read more
Carriers Include Marcaine in Injection Fee
Question: I have recently read a lot of conflicting advice regarding when I can report J34... Read more
Reader Question:
Initial Hospital Care Need Not Be on Admit Day
Question: A patient presented to our office after a heavy piece of furniture fell on him a... Read more
Initial Hospital Care Need Not Be on Admit Day
Question: A patient presented to our office after a heavy piece of furniture fell on him a... Read more
Reader Question:
Nurse's Instruction Warrants 99211
Question: A patient with a broken toe didn't think she was retaping the fracture properly ... Read more
Nurse's Instruction Warrants 99211
Question: A patient with a broken toe didn't think she was retaping the fracture properly ... Read more
Reader Question:
See Modifier -55, Think Postoperative Care
Question: Our orthopedic surgeon recently took over the postoperative care of another surg... Read more
See Modifier -55, Think Postoperative Care
Question: Our orthopedic surgeon recently took over the postoperative care of another surg... Read more
You Be the Coder:
Should We Append Modifier -76?
Question: Our surgeon removed two segments during a coccygectomy in July. Today he removed... Read more
Should We Append Modifier -76?
Question: Our surgeon removed two segments during a coccygectomy in July. Today he removed... Read more
Never Miscode Bankart Procedures Again - Thanks to CPT 2004
The new coding manual teaches coders how to boost reimbursement for this common arthroscop... Read more
The new coding manual teaches coders how to boost reimbursement for this common arthroscop... Read more
2004 Fee Schedule Update:
Physicians Escape 4.5 Percent Cut for 2004
Medicare legislation raises conversion factor by 1.5 percent CMS offered orthopedis... Read more
Physicians Escape 4.5 Percent Cut for 2004
Medicare legislation raises conversion factor by 1.5 percent CMS offered orthopedis... Read more
Determine the Effect of the 2004 Fee Schedule on These Common Procedures
Visit the CMS Web site at http://cms.hhs.gov/physicians/... Read more
Visit the CMS Web site at http://cms.hhs.gov/physicians/... Read more
CPT Clears Up Cloudy Starred Procedures
Don't let deleted 'stars' disrupt your private-payer claims The AMA has el... Read more
Don't let deleted 'stars' disrupt your private-payer claims The AMA has el... Read more
Reader Question:
Use 'History of Cancer' After Removal
Question: We assisted an oncologist in treating a patient with secondary cancer of the fem... Read more
Use 'History of Cancer' After Removal
Question: We assisted an oncologist in treating a patient with secondary cancer of the fem... Read more
Reader Question:
Choose 92950 for Resuscitation
Question: Our orthopedic surgeon was making rounds at the hospital today when he responded... Read more
Choose 92950 for Resuscitation
Question: Our orthopedic surgeon was making rounds at the hospital today when he responded... Read more
Reader Question:
Modifier -58 Signals 2 Reductions
Question: I attempted to reduce a dislocated hip in the emergency department, but the proc... Read more
Modifier -58 Signals 2 Reductions
Question: I attempted to reduce a dislocated hip in the emergency department, but the proc... Read more
Reader Question:
Acquire Preauthorization for 0012T
Question: I reported mosaicplasty with code 0012T (Arthroscopy, knee ...), but Cigna denie... Read more
Acquire Preauthorization for 0012T
Question: I reported mosaicplasty with code 0012T (Arthroscopy, knee ...), but Cigna denie... Read more
Reader Question:
20605 Describes Wrist Aspiration
Question: I performed an orthopedic consultation at the hospital, where I also aspirated t... Read more
20605 Describes Wrist Aspiration
Question: I performed an orthopedic consultation at the hospital, where I also aspirated t... Read more
Reader Question:
Use Outpatient Codes for ED Consults
Question: Our orthopedist was recently on-call for the emergency department (ED). The ED p... Read more
Use Outpatient Codes for ED Consults
Question: Our orthopedist was recently on-call for the emergency department (ED). The ED p... Read more
You Be the Coder:
Will Medicare Pay for Post-Op Shoe?
Question: Our insurer suddenly stopped reimbursing us for the post-op shoe (L3260). Does t... Read more
Will Medicare Pay for Post-Op Shoe?
Question: Our insurer suddenly stopped reimbursing us for the post-op shoe (L3260). Does t... Read more