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Orthopedic Coding Alert

2024 MPFS Final Rule:
New Fee Schedule, Same Old CF Issues
Conversion factor cut again; experts disappointed again. On Nov. 16, the Centers for Med... Read more
Surgery:
Use These Tips to Code Osteotomy Claims Confidently
Don't forget about post-osteotomy arthrodesis. If a patient reports to your practice nee... Read more
Surgery:
Get Details Before Coding Wrist/Forearm Repair
Know extensor/flexor differences or face miscoding. When a patient reports to your surgeo... Read more
Reader Question:
I.D. All Elements of Achilles Injury Before Coding
Question: When a patient suffers an injured Achilles tendon, what is the correct ICD-... Read more
Reader Question:
Alternate Term Knowledge Handy for Horner’s Syndrome
Question: Encounter notes indicate that the provider treated a patient whose final d... Read more
Reader Question:
Uncertain Dx Might Factor Into MDM
Question: Does an undiagnosed new problem with uncertain diagnosis automatically tran... Read more
You Be the Coder:
Coding Acromionectomy With Ligament Release
Question: Encounter notes indicate that the surgeon performed a level-four office eva... Read more
Surgery:
Break Into Details for Femoral Fx Fix Code
Femoral fix can be accompanied by grafting, fixator codes. Patients with broken femurs ar... Read more
CPT® 2024:
Here’s the Category III Codes Coming Next Year
Remember to check with payer to see if procedure's covered. If CPT® 2024 is any indicati... Read more
Modifier Madness:
Toe the Line for F/T Modifier Coding Success
Reserve these modifiers for fingers, toes. When you're coding, you always strive to make ... Read more
You Be The Coder:
Remember Code Combo for This Osseous Defect
Question: A patient with acute hematogenous osteomyelitis of the right shoulder devel... Read more
Reader Question:
Know X-Ray With Arthrography Codes
Question: Encounter notes indicate that the surgeon performed a 41-minute office eval... Read more
Reader Question:
Dig Into Notes for Patellar Dislocation Dx
Question: Encounter notes indicate that the orthopedist treated a patient's patellar ... Read more
Reader Question:
Note Type of Leg Amputation to Code Accurately
Question: Is 27880 the correct code choice when the orthopedist performs leg amputat... Read more
Reader Question:
Use Notes to Block Reiter’s Disease Coding Mix-ups
Question: Encounter notes indicate that the physician treated a patient with Reiter's... Read more
CPT® 2024:
Spinal Procedures Proliferate New Code Book
Also, there's a significant pair of revisions to note. The list of new, revised, and dele... Read more
CPT® 2024:
New Code Book Updates Office/Outpatient E/M Descriptors
CPT® changed descriptors to mirror other E/M codes. The new CPT® code book will feature... Read more
Surgery:
Spinal Fusion, Part 2: Get Approach, Technique Info Before Coding
Include evidence of presurgical treatment attempts on the claim. In September, we focused... Read more
Reader Questions:
Anyone for Tennis … Elbow?
Question: Encounter notes indicate that the provider met with a new patient complaining of... Read more
Reader Questions:
Remember 7th Character for This Fx Dx
Question: Encounter notes indicate that a patient suffered from an atypical femoral fractu... Read more
Reader Questions:
Avoid Double-Dipping on TPIs
Question: A patient with trigger finger in their left index finger reports for a trigger p... Read more
Reader Questions:
Bennett’s Fracture Surgery Involves These 3 Codes
Question: Encounter notes indicate that the provider treated a patient with a Bennett's fr... Read more
Reader Questions:
Know All PHE Types
Question: Are all public health emergencies (PHEs) the same? Do they carry the same flexib... Read more
You Be the Coder:
Coding Multiple Vertebroplasties
Question: Encounter notes indicate that the surgeon performed percutaneous vertebroplasty ... Read more
Medicare Physician Fee Schedule:
Check Out These 4 MPFS Proposals for 2024
Rules on SDoH, telehealth highlight proposal. Even though the COVID-19 public health emer... Read more
Surgery:
Scope Out These Knee Arthroscopy Tips for Optimal Coding
Do you know how the provider decided the patient needed arthroscopy? When a patient has a... Read more
Check Out This 3-Visit Arthroscopy Tx Course
To get a more complete picture of how a knee arthroscopy scenario might play out, take a l... Read more
Surgery:
Technique, Approach Smarts Vital to Coding Spinal Fusion Correctly
Do you know which approach your surgeon used during the fusion? Patients requiring spin... Read more
Reader Questions:
Report This Code for Myotonic Atrophica
Question: Encounter notes indicate that the provider treated a patient with myotonic... Read more
Reader Questions:
Zero In on Surgery’s Purpose for Code Choice
Question: When the surgeon performs a surgical arthroscopy of the subtalar joint, how... Read more
Reader Questions:
MRA and MRI Are Different; Here’s How
Question: Encounter notes indicate the provider ordered a magnetic resonance angiogra... Read more
Reader Questions:
Take a Closer Look Before Coding for Castings
Question: We have a physician who is a foot and ankle specialist. They have been sen... Read more
You Be the Coder:
Coding Elbow Arthroplasty Revision
Question: A patient who had a right elbow arthroplasty for displaced simple supracondylar... Read more
NCCI Edits:
Look Out: This 3rd Quarter Edit Will Cause Confusion
CMS made a mistake, but clarification won't happen right away. If your practice performs ... Read more
Surgery:
Level Up to Master Cervical Arthrodesis Coding
If it's below C2, arthrodesis coding gets complicated. In an orthopedic practice, patient... Read more
MIPS Reporting:
Smaller Practices Benefit From These MIPS Tips
Here's why you should bookmark CMS MIPS tools. When submitting measures for the Merit-Ba... Read more
Reader Questions:
Remember Drug Supply for These CT Injections
Question: After a level-three evaluation and management (E/M) service for an establis... Read more
Reader Questions:
Get Coding Straight for Closed/Open Rib Fx Coding
Question: When a patient reports to the office for treatment of broken ribs, is there... Read more
Reader Questions:
Flat Feet Dx Depends on Congenital/Acquired Question
Question: My provider is treating a dancer who has pes planovalgus. The surgeon state... Read more
You Be the Coder:
Arthrodesis for Scoliosis Patient
Question: A 14-year-old patient presents with well-compensated double curve pattern a... Read more
ICD-10 2024:
Update Adds to Osteoporosis Dx Options
Desmoid tumor? There's a code for that in 2024. Summertime is known for cookouts, pool pa... Read more
Shoulder Surgery:
Scope Reason for Procedure to Use These Codes Correctly
Some require debridement; others call for surgery past debridement. When a patient repo... Read more
Clip And Save:
Remember to Include These Services in Shoulder Scopes
The global surgical package for these surgeries is large. When the orthopedist performs a... Read more
AI Learning:
Use CPT® Appendix S to Aid AI Understanding
Appendix S sheds light on AI nuances. The CPT® code book always contains an overwhelmi... Read more
Reader Questions:
Modifier 52-Injection Claim Getting Denied? Try This Instead
Question: Our providers commonly perform lumbar sympathetic plexus blocks via single injec... Read more
Reader Questions:
Use Dx Code Trio for This Laminectomy Patient
Question: A new patient presents with cervical spinal stenosis at C5-C6 and degenerative d... Read more
Reader Questions:
I.D. Anatomical Site for Compression Syndrome
Question: Encounter notes indicate that a patient suffers from anterior spinal artery comp... Read more
You Be the Coder:
Multiple Finger Fractures
Question: Encounter notes indicate the orthopedist performed two surgeries: closed treatme... Read more
Surgical Coding:
Gear Up for ACL/PCL Repairs With Surgical Smarts
Do you know which injury is more common: ACL or PCL tear? Patients reporting to the ortho... Read more
Case Study Corner:
Connect This Lisfranc Dislocation Case
Do you know where Lisfranc joint resides? If a patient suffers from foot trauma as the f... Read more
ICD-10 Coding:
Get Back to Basics for Cervical Disc Disorder Dx
‘Other' cervical disc disorders call for M50.8-. Patients reporting to the practice w... Read more
Reader Questions:
Anatomy Matters With Palindromic Rheumatism Dx
Question: Encounter notes indicate that a patient suffered from ‘palindromic rheuma... Read more
Reader Questions:
Choose This Code Pair for Ankle/Toe Loose Bodies
Question: Notes indicate that the surgeon performed a level-four office evaluation an... Read more
Reader Questions:
Get Signature Post-Addendum
Question: If a healthcare practitioner makes an addendum to a patient's medical recor... Read more
Reader Questions:
Report All Breaches Big and Small
Question: We uncovered a small data breach in our practice that impacted about 225 pa... Read more
You Be the Coder:
Multiple Finger Fractures
Question: Encounter notes indicate the orthopedist performed two surgeries: closed tr... Read more
E/M Coding:
Experts Weigh Challenges of 2023 Inpatient/Hospital Codes
Revised E/M codes are making payers, coders adjust. As a coder, you have had to deal with... Read more
Compliance:
Reduce Denials With Thorough Documentation
Lack of documentation leading cause of claims headaches. Denials are a part of coding; b... Read more
Surgery:
Count Vertebrae, Code Vertebroplasty/Vertebral Augmentation Correctly
Here's why code choice is affected by vertebral count. When a patient needs percutaneous ... Read more
Reader Questions:
Look to Code Trio for This Ankle Repair
Question: The orthopedist performs repair of a disrupted ankle ligament. I'm seeing a few ... Read more
Reader Questions:
Use T Code for This Arthrodesis Type
Question: The provider performs minimally invasive percutaneous arthrodesis of the sacroil... Read more
Reader Questions:
Use Multi-Site Dx Code for Some Skeletal Fluoroses
Question: Encounter notes indicate that the provider treated a patient with “skeletal fl... Read more
Reader Questions:
Explore Arthrotomy Code for Ankle Debridement
Question: Our podiatrist performed an ankle gutter debridement along with peroneal and pos... Read more
You Be the Coder:
Multiple Foot X-Rays and Dx Codes
Question: An established patient presents to the office complaining of pain in their right... Read more
Condition Spotlight:
Know Hip Dislocation Types for ICD-10, CPT® Success
 Do you know how the surgeon typically diagnoses hip dislocations? When a patient di... Read more
Case Study Corner:
Try Your Hand at Coding This Spinal Deformity Surgery Scenario
Remember, there are anterior and posterior arthrodesis codes. In last month's issue of Or... Read more
Compliance:
Get Hip to Post-PHE HIPAA World Before it Arrives
Here's how to ready your practice for PHE end times. The COVID-19 public health emergency... Read more
Reader Questions:
Modifiers LT/RT not Always the Answer
Question: Encounter notes indicate that the orthopedist performed an office evaluatio... Read more
Reader Questions:
Separate Pre-Exam Shot, CT
Question: Encounter notes indicate that the provider performed injection for contrast... Read more
Reader Questions:
Head to These Codes for Specific Juvenile RA
Question: Encounter notes indicate that a patient suffers from pauciarticular juvenil... Read more
Reader Questions:
Look Around This Code’s Notes for Periarthritis Dx
Question: Encounter notes indicate that a patient suffers from “periarthritis NOS.â... Read more
You Be the Coder:
Multiple Ganglion Cyst Injections
Question: Encounter notes indicate that the physician performed a level-three evaluat... Read more
Condition Spotlight:
Connect Dislocated Elbow Coding Dots for Full Coding Picture
Here's how your surgeon could diagnose a dislocated elbow. Patients reporting to your pra... Read more
Case Study Corner:
Test Yourself With These Foot Repair Scenarios
Tenolysis/tendon surgeries can test your coding ability. When orthopedic surgeons perform... Read more
Surgery:
Code Spinal Deformity Arthrodesis With Specific Code Set
Proper coding depends on knowing how surgeon diagnosed deformity. There's typically a lot... Read more
You Be the Coder:
Multi-Level Hemilaminectomies
Question: Encounter notes indicate that the surgeon performed hemilaminectomy on spin... Read more
Reader Questions:
PHE to End in May
Question: I read that there's been another extension to the public health emergency (... Read more
Reader Questions:
Get More Info Before Coding Tenotomy
Question: Encounter notes indicate that the surgeon performed tenotomy of a patient's... Read more
Reader Questions:
Get Specific With Stress Fracture Dx
Question: Encounter notes indicate that the patient suffered from a “stress Fx RT a... Read more
Reader Questions:
Use This Guide to MDM Leveling With 1 Chronic Problem
Question: We have a patient with one chronic problem. It is not worsening, but it is ... Read more
Surgery:
Remember to Code for All Services Surrounding Radial/Ulnar Fx
Also, keep several modifiers handy to separate services. When a patient reports with an u... Read more
Modifier Madness:
Use This Guide to Answer Surgical Modifier Questions
Surgical care only? Use this modifier. When your surgeon provides fracture care, there a... Read more
Surgery:
Don’t Miss Out: Code Disc Removals Separately
Also, these procedures could include other codeable services. In last month's issue of ... Read more
Reader Questions:
Count Segments, Then Code Arthrodesis
Question: Encounter notes indicate that on Monday, the surgeon provided a level-four ... Read more
Reader Questions:
Bundle Biopsy Into Arthrotomy
Question: Encounter notes indicate that the orthopedic surgeon performed a right shou... Read more
Reader Questions:
Leave Incident-To to the Side for This Patient Type
Question: A new patient came in and the nurse practitioner (NP) took the initial hist... Read more
Reader Questions:
Final CF Doesn’t Change Much
Question: I remember that the Medicare Physician Fee Schedule (MPFS) final rule came ... Read more
Reader Questions:
Count Foot, Toe X-Rays Separately
Question: Encounter notes indicate that the provider performed a two-view foot X-ray ... Read more
Reader Questions:
Descriptor Exceptions Exist for Talus Removals
Question: Do I document craterization of the talus and of the medial cuneiform with 2... Read more
You Be the Coder:
Note Spinal Area on Schmorl’s Nodes Dx
Question: What are Schmorl's nodes, and how do I choose a diagnosis code for the cond... Read more
Surgery:
Toe the Coding Line With Foot Tendon Repair/Tenolysis
Journey to this surgery will likely begin with E/M, imaging. When a patient reports to th... Read more
Surgery:
Code Family Matters on Total Disc Arthroplasty
Here's when you'll need T codes to report these surgeries. Patients that report to your p... Read more
Condition Spotlight:
Let Documentation Reign With Os Trigonum Coding
Notes must paint a clear picture of the patient's condition. Os trigonum syndrome most of... Read more
Reader Question:
Connect Dislocation Coding to Graft Question
Question: The provider performed open treatment of a sternoclavicular dislocation. Ho... Read more
Reader Question:
Remember to Code Using New Observation Rules
Question: Encounter notes indicate that on Jan. 2, 2023, the provider performed initi... Read more
Reader Question:
Go Deeper Into Code Book for Fuller Spine X-rays
Question: The provider performs a single-view X-ray of the spine that includes the entire ... Read more
Reader Question:
Never Use 99211 As a Catch-All E/M
Question: Should I be reporting all services performed by a nurse, including those pr... Read more
Reader Question:
Rely on Combo Code for This Lumbago/Sciatica Dx
Question: Encounter notes indicate that a patient suffers from right-sided lumbago an... Read more
You Be the Coder:
Osteotomies in 2 Spinal Areas
Question: Encounter notes indicate that the orthopedist performed a spinal osteotomy ... Read more
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