Orthopedic Coding Alert
Surgery Spotlight:
Understand the Ins and Outs of UCL Repair
How well do you know the elbow anatomy? When the surgeon performs work on an ulnar collat... Read more
Understand the Ins and Outs of UCL Repair
How well do you know the elbow anatomy? When the surgeon performs work on an ulnar collat... Read more
Surgery Spotlight:
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cind... Read more
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cind... Read more
Modifier Madness:
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
You Be the Coder:
Repairing a Re-Ruptured Achilles
Question: Encounter notes indicate that a patient who had ruptured their right Achill... Read more
Repairing a Re-Ruptured Achilles
Question: Encounter notes indicate that a patient who had ruptured their right Achill... Read more
Reader Questions:
Detail Matters on Osteomyelitis Dx
Question: For coding purposes, what are the different types of osteomyelitis? Alas... Read more
Detail Matters on Osteomyelitis Dx
Question: For coding purposes, what are the different types of osteomyelitis? Alas... Read more
Reader Questions:
Remember Laterality Rules on Electrothermal Annuloplasty
Question: A patient with lumbar spondylolysis reports to the surgeon for percutaneous... Read more
Remember Laterality Rules on Electrothermal Annuloplasty
Question: A patient with lumbar spondylolysis reports to the surgeon for percutaneous... Read more
Reader Questions:
Distinguish NCD From LCD
Question: What's the difference between a national coverage determination (NCD) and a... Read more
Distinguish NCD From LCD
Question: What's the difference between a national coverage determination (NCD) and a... Read more
Reader Questions:
Phone In this E/M Encounter
Question: A patient presented to the office for a follow-up appointment. When the pat... Read more
Phone In this E/M Encounter
Question: A patient presented to the office for a follow-up appointment. When the pat... Read more
ICD-10 2025:
Codes for Synovitis, Disc Degeneration Highlight New Additions
Unspecified condition now has codes for specific body areas. ICD-10 just settled on its l... Read more
Codes for Synovitis, Disc Degeneration Highlight New Additions
Unspecified condition now has codes for specific body areas. ICD-10 just settled on its l... Read more
Medicare Physician Fee Schedule:
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Servic... Read more
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Servic... Read more
E/M Coding:
Know These 4 Things to Bill 99211 Correctly
And learn these three reasons for not reporting it. When one of your clinical staff memb... Read more
Know These 4 Things to Bill 99211 Correctly
And learn these three reasons for not reporting it. When one of your clinical staff memb... Read more
Reader Questions:
Do This to Get to Chronic Gout Dx
Question: Encounter notes indicate that a patient is suffering from chronic gout. Ho... Read more
Do This to Get to Chronic Gout Dx
Question: Encounter notes indicate that a patient is suffering from chronic gout. Ho... Read more
Reader Questions:
1 Code to Rule Them All for This Surgery
Question: The surgeon performs arthrodesis of the carpometacarpal joint in a patient'... Read more
1 Code to Rule Them All for This Surgery
Question: The surgeon performs arthrodesis of the carpometacarpal joint in a patient'... Read more
Reader Questions:
Find CERT Info via Hub
Question: Are there any resources available to help folks navigate the Center for Med... Read more
Find CERT Info via Hub
Question: Are there any resources available to help folks navigate the Center for Med... Read more
You Be the Coder:
Testing for Sciatica
Question: A patient with degenerative disc disease reports to the orthopedist complai... Read more
Testing for Sciatica
Question: A patient with degenerative disc disease reports to the orthopedist complai... Read more
Fracture Primer:
Break Fracture Care Down to Brush Up on Basics
Do you know what a greenstick fracture is? Fractured bones are an orthopedic practice's ... Read more
Break Fracture Care Down to Brush Up on Basics
Do you know what a greenstick fracture is? Fractured bones are an orthopedic practice's ... Read more
Compliance:
Address These Key Fields, Complete ABNs With Ease
Don't forget that every ABN form must be one single page. As every practice is aware, c... Read more
Address These Key Fields, Complete ABNs With Ease
Don't forget that every ABN form must be one single page. As every practice is aware, c... Read more
Documentation:
Study These Strategies for Setting Up a Solid CDI Process
Realize the benefits of regular self-audits. Comprehensive clinical documentation is the... Read more
Study These Strategies for Setting Up a Solid CDI Process
Realize the benefits of regular self-audits. Comprehensive clinical documentation is the... Read more
Reader Questions:
Rely on Anatomical Area for This Calf Injury Dx
Question: Encounter notes indicate a patient suffers from “crushing injury, L calf.... Read more
Rely on Anatomical Area for This Calf Injury Dx
Question: Encounter notes indicate a patient suffers from “crushing injury, L calf.... Read more
Reader Questions:
Find Flexibility in Delegating Prior Authorizations
Question: If a patient's prescribed medication needs a prior authorization from their... Read more
Find Flexibility in Delegating Prior Authorizations
Question: If a patient's prescribed medication needs a prior authorization from their... Read more
Reader Questions:
Give Patients Tools to Boost Staff Morale
Question: How can I boost employee morale and keep track of all the great things my t... Read more
Give Patients Tools to Boost Staff Morale
Question: How can I boost employee morale and keep track of all the great things my t... Read more
You Be the Coder:
Bruised Chest and Ribs
Question: A new patient presents to the orthopedist after falling from a hotel balcon... Read more
Bruised Chest and Ribs
Question: A new patient presents to the orthopedist after falling from a hotel balcon... Read more
Spinal Surgery:
Code Differently for Arthrodesis for Spinal Deformity
Knowledge of deformity types will help, too. When a patient reports to the orthopedist fo... Read more
Code Differently for Arthrodesis for Spinal Deformity
Knowledge of deformity types will help, too. When a patient reports to the orthopedist fo... Read more
Modifiers:
Avoid These 5 Modifier 59 Errors to Keep Pay Flowing
Plus: Find out the 2024 news that changes one modifier 59 rule. What would you do if 40 ... Read more
Avoid These 5 Modifier 59 Errors to Keep Pay Flowing
Plus: Find out the 2024 news that changes one modifier 59 rule. What would you do if 40 ... Read more
Compliance:
Fight for Your Right to Appeal and Win
Insurance companies aren't advocating for your office; that's your job. During her HEALTH... Read more
Fight for Your Right to Appeal and Win
Insurance companies aren't advocating for your office; that's your job. During her HEALTH... Read more
Reader Questions:
Get Specific With Bone Cyst Dx
Question: Encounter notes indicate that a patient has a solitary bone cyst on their s... Read more
Get Specific With Bone Cyst Dx
Question: Encounter notes indicate that a patient has a solitary bone cyst on their s... Read more
Reader Questions:
Understand These CMN Basics
Question: My billing supervisor erased data that the doctor wrote on a certificate of... Read more
Understand These CMN Basics
Question: My billing supervisor erased data that the doctor wrote on a certificate of... Read more
Reader Questions:
Go ‘High’ for This Disc Disorder Code
Question: Encounter notes indicate that a patient is suffering a high cervical disc d... Read more
Go ‘High’ for This Disc Disorder Code
Question: Encounter notes indicate that a patient is suffering a high cervical disc d... Read more
You Be the Coder:
Bunionectomy With Sesamoidectomy
Question: Encounter notes indicate that a patient reports to the surgeon with a bunio... Read more
Bunionectomy With Sesamoidectomy
Question: Encounter notes indicate that a patient reports to the surgeon with a bunio... Read more
Fracture Care:
Know Ankle Anatomy, Fracture Types for Optimal Coding
Do you know what a trimalleolar fracture involves? Patients reporting to the orthopedist ... Read more
Know Ankle Anatomy, Fracture Types for Optimal Coding
Do you know what a trimalleolar fracture involves? Patients reporting to the orthopedist ... Read more
Surgery:
Use These Tips for Successful Corpectomy Claims
Know that approach is vital to coding. Patients reporting to the surgeon for vertebral ... Read more
Use These Tips for Successful Corpectomy Claims
Know that approach is vital to coding. Patients reporting to the surgeon for vertebral ... Read more
Technology:
Evaluate Your Claims Before Submission by Adding AI to Your Revenue Cycle
Let AI handle simple coding cases to improve productivity. Healthcare has enjoyed a fron... Read more
Evaluate Your Claims Before Submission by Adding AI to Your Revenue Cycle
Let AI handle simple coding cases to improve productivity. Healthcare has enjoyed a fron... Read more
Reader Questions:
Size of This Defect Type Matters
Question: If a patient suffers an intervertebral annulus fibrosis defect in the lumba... Read more
Size of This Defect Type Matters
Question: If a patient suffers an intervertebral annulus fibrosis defect in the lumba... Read more
Reader Questions:
Be Sensitive When Gathering Demographic Information
Question: I work as a scheduler and recently heard a colleague on the phone with a pa... Read more
Be Sensitive When Gathering Demographic Information
Question: I work as a scheduler and recently heard a colleague on the phone with a pa... Read more
Reader Questions:
Use NOS Code for Backache Dx
Question: If a patient is diagnosed with “backache” and there is no other inform... Read more
Use NOS Code for Backache Dx
Question: If a patient is diagnosed with “backache” and there is no other inform... Read more
You Be the Coder:
Diagnostic Hip Arthroscopy Turns Surgical
Question: Encounter notes indicate that the orthopedist decided to perform a diagnost... Read more
Diagnostic Hip Arthroscopy Turns Surgical
Question: Encounter notes indicate that the orthopedist decided to perform a diagnost... Read more
Surgery:
Take These Tips to Tackle TKR Coding Head-On
A single surgical code doesn't mean TKR is easy to report. When a patient requires total ... Read more
Take These Tips to Tackle TKR Coding Head-On
A single surgical code doesn't mean TKR is easy to report. When a patient requires total ... Read more
E/M Coding:
Answer the How, What, When, and Why for Preoperative Evaluations
Don't forget to check for comorbid conditions. Knowing how to navigate and select all o... Read more
Answer the How, What, When, and Why for Preoperative Evaluations
Don't forget to check for comorbid conditions. Knowing how to navigate and select all o... Read more
Compliance:
Final Rule Aims to Improve Interoperability and Access to Care
Plus: Feds finalize new API requirements and a MIPS measure, too. After the pandemic re... Read more
Final Rule Aims to Improve Interoperability and Access to Care
Plus: Feds finalize new API requirements and a MIPS measure, too. After the pandemic re... Read more
Reader Questions:
Medicare Ups Conversion Factor … Slightly
Question: Has there been any change to the Medicare Physician Fee Schedule (MPFS) con... Read more
Medicare Ups Conversion Factor … Slightly
Question: Has there been any change to the Medicare Physician Fee Schedule (MPFS) con... Read more
Reader Questions:
Know US Differences
Question: What's the difference between a complete and limited joint ultrasound (US)?... Read more
Know US Differences
Question: What's the difference between a complete and limited joint ultrasound (US)?... Read more
Reader Questions:
Sidestep Contusion Confusion With These Codes
Question: Our foot specialist recently examined a patient presenting with a bruise o... Read more
Sidestep Contusion Confusion With These Codes
Question: Our foot specialist recently examined a patient presenting with a bruise o... Read more
Reader Questions:
Employ Protections for Patient Signatures
Question: In our recent risk evaluation, we discovered that the electronic signatures... Read more
Employ Protections for Patient Signatures
Question: In our recent risk evaluation, we discovered that the electronic signatures... Read more
Reader Questions:
Know Which Finger Is ‘Triggered’ for Correct Dx
Question: Encounter notes indicate that a patient suffers from “L trigger finger.... Read more
Know Which Finger Is ‘Triggered’ for Correct Dx
Question: Encounter notes indicate that a patient suffers from “L trigger finger.... Read more
You Be the Coder:
Golfer’s Elbow Diagnosis, Tx
Question: Encounter notes that a patient reports to the orthopedist with complaints o... Read more
Golfer’s Elbow Diagnosis, Tx
Question: Encounter notes that a patient reports to the orthopedist with complaints o... Read more
News You Can Use:
CPT® Presents Updated Unlisted Procedure Guidelines
Multiple unlisted procedures? You can report them all now. The latest issue of CPT® Assi... Read more
CPT® Presents Updated Unlisted Procedure Guidelines
Multiple unlisted procedures? You can report them all now. The latest issue of CPT® Assi... Read more
Condition Spotlight:
Head to Surgery Section for Some Scoliosis Treatments
Condition typically confirmed by imaging. When a patient has scoliosis, their treatment r... Read more
Head to Surgery Section for Some Scoliosis Treatments
Condition typically confirmed by imaging. When a patient has scoliosis, their treatment r... Read more
Injection Coding:
Joint Size Vital to Coding Arthrocentesis Shots
Use vague CPT® descriptors to approximate unlisted joints. Swollen or painful joints ar... Read more
Joint Size Vital to Coding Arthrocentesis Shots
Use vague CPT® descriptors to approximate unlisted joints. Swollen or painful joints ar... Read more
Reader Questions:
Use Descriptors to Decide Superficial, Deep Biopsies
Question: How should I report a bone biopsy, and how do I determine a superficial bon... Read more
Use Descriptors to Decide Superficial, Deep Biopsies
Question: How should I report a bone biopsy, and how do I determine a superficial bon... Read more
Reader Questions:
Exact Location a Necessity for Cystic Meniscus Dx
Question: Encounter notes indicate that the physician treated a patient with “cyst... Read more
Exact Location a Necessity for Cystic Meniscus Dx
Question: Encounter notes indicate that the physician treated a patient with “cyst... Read more
Reader Questions:
Levels Matter on Medicare Appeals
Question: I filed a claim for a Medicare Part B patient with my Medicare Administrati... Read more
Levels Matter on Medicare Appeals
Question: I filed a claim for a Medicare Part B patient with my Medicare Administrati... Read more
You Be the Coder:
Bilateral Rib Fractures
Question: After a level-four office evaluation and management (E/M) service for an es... Read more
Bilateral Rib Fractures
Question: After a level-four office evaluation and management (E/M) service for an es... Read more
Case Study Corner:
Put Pieces Together to Code These Vertebral Fx Scenarios
When a snowboarder falls, can you code the treatment? In last month's article “I.D. Ope... Read more
Put Pieces Together to Code These Vertebral Fx Scenarios
When a snowboarder falls, can you code the treatment? In last month's article “I.D. Ope... Read more
ICD-10 Coding:
Get Details Before Choosing Other Spondylopathy Dx
Particulars are vital on this ‘general' code set. With a pretty generic descriptor, ... Read more
Get Details Before Choosing Other Spondylopathy Dx
Particulars are vital on this ‘general' code set. With a pretty generic descriptor, ... Read more
E/M Coding:
Refresh Yourself on Recent Hospital Coding Rules Changes
Do you remember which inpatient services share codes now? The last few editions of the CP... Read more
Refresh Yourself on Recent Hospital Coding Rules Changes
Do you remember which inpatient services share codes now? The last few editions of the CP... Read more
Reader Questions:
Remember Code First Note on Arthropathy
Question: If a patient suffers from shoulder arthropathy as a result of sickle cell d... Read more
Remember Code First Note on Arthropathy
Question: If a patient suffers from shoulder arthropathy as a result of sickle cell d... Read more
Reader Questions:
Be Specific With Complication Dx
Question: If a patient suffers from an intra- or postoperative complication involving... Read more
Be Specific With Complication Dx
Question: If a patient suffers from an intra- or postoperative complication involving... Read more
Reader Questions:
2 Effusions Mean 1 Effusion Dx Code
Question: If a patient suffers from effusion of the same ankle and foot, should I su... Read more
2 Effusions Mean 1 Effusion Dx Code
Question: If a patient suffers from effusion of the same ankle and foot, should I su... Read more
You Be the Coder:
Capsulotomy and X-Ray Encounter
Question: An established patient suffering from rheumatoid myopathy with rheumatoid a... Read more
Capsulotomy and X-Ray Encounter
Question: An established patient suffering from rheumatoid myopathy with rheumatoid a... Read more
2024 MPFS:
CMS, CPT® Finally Agree on Split/Shared Visit Rules
Revision puts emphasis on substantive E/M portion. It's 2024, the year everything lined u... Read more
CMS, CPT® Finally Agree on Split/Shared Visit Rules
Revision puts emphasis on substantive E/M portion. It's 2024, the year everything lined u... Read more
CPT® 2024 Review:
Check Out This Last-Minute Code Check for 2024
New code book includes small helping of new spine codes and revisions. The 2024 CPT® cha... Read more
Check Out This Last-Minute Code Check for 2024
New code book includes small helping of new spine codes and revisions. The 2024 CPT® cha... Read more
Surgery:
I.D. Open/Closed Before Reporting Vertebral Fx Fix
Also, look for imaging studies to pinpoint fracture. When your surgeon evaluates a vert... Read more
I.D. Open/Closed Before Reporting Vertebral Fx Fix
Also, look for imaging studies to pinpoint fracture. When your surgeon evaluates a vert... Read more
Reader Questions:
Find Anatomical Location, Then Choose Neuroplasty Code
Question: Encounter notes indicate that the surgeon performed a neuroplasty. How shou... Read more
Find Anatomical Location, Then Choose Neuroplasty Code
Question: Encounter notes indicate that the surgeon performed a neuroplasty. How shou... Read more
Reader Questions:
You’ll Have to Use Unlisted Codes for This Facet Joint Destruction
Question: Encounter notes indicate that the surgeon performed destruction of a single... Read more
You’ll Have to Use Unlisted Codes for This Facet Joint Destruction
Question: Encounter notes indicate that the surgeon performed destruction of a single... Read more
Reader Questions:
Identify This Achilles Tendon Injection Situation
Question: The patient was brought to the table and laid in prone position. Their righ... Read more
Identify This Achilles Tendon Injection Situation
Question: The patient was brought to the table and laid in prone position. Their righ... Read more
Reader Questions:
Get to the Bottom of This Osteotomy Scenario
Question: I have this very barebones operative report from one of our surgeons. Here'... Read more
Get to the Bottom of This Osteotomy Scenario
Question: I have this very barebones operative report from one of our surgeons. Here'... Read more
You Be the Coder:
Guidance With Intervertebral Aspiration
Question: Encounter notes indicate that the surgeon performed percutaneous interverte... Read more
Guidance With Intervertebral Aspiration
Question: Encounter notes indicate that the surgeon performed percutaneous interverte... Read more
Orthopedic Coding:
Look to New Plane Block Code for 2025
Technique could improve post-op outcomes. CPT® has released its list of new, revised, an... Read more
Look to New Plane Block Code for 2025
Technique could improve post-op outcomes. CPT® has released its list of new, revised, an... Read more
Orthopedic Coding:
Radial and Ulnar Fracture Fix
Question: The orthopedic surgeon treats a patient with a right-sided radial and ulnar... Read more
Radial and Ulnar Fracture Fix
Question: The orthopedic surgeon treats a patient with a right-sided radial and ulnar... Read more
Orthopedic Coding:
Know Wrist Pain, CTS Dx Differences
Question: What is the difference between carpal tunnel syndrome (CTS) and wrist pain?... Read more
Know Wrist Pain, CTS Dx Differences
Question: What is the difference between carpal tunnel syndrome (CTS) and wrist pain?... Read more
Orthopedic Coding:
Hip Dysplasia and OA? There Are Codes for That
Question: If a patient suffers from osteoarthritis (OA) of the hip caused by hip dysplasia... Read more
Hip Dysplasia and OA? There Are Codes for That
Question: If a patient suffers from osteoarthritis (OA) of the hip caused by hip dysplasia... Read more
Orthopedic Coding:
Get Dx to the Proper Character for Reiter’s Block
Question: What is Reiter's disease, and how do I choose an ICD-10 code for the condition? ... Read more
Get Dx to the Proper Character for Reiter’s Block
Question: What is Reiter's disease, and how do I choose an ICD-10 code for the condition? ... Read more
Orthopedic Coding:
Make Sense of Arthroscopic Hip Labrum Surgery Coding
Note conservative Tx attempts before surgery option. The hip joint is a ball-and-socket j... Read more
Make Sense of Arthroscopic Hip Labrum Surgery Coding
Note conservative Tx attempts before surgery option. The hip joint is a ball-and-socket j... Read more