Orthopedic Coding Alert
Check Your Payers' 27215-27218 Policies
Rejoice: Pelvic fracture codes spared from CCI 15.0's wrath. Although CPT 2009 changed the descriptors to pelvic fracture codes (27215-27218) to reflect a "unilateral" procedure, CMS made no edits to these codes. Why: In the Physician Fee Schedule, CMS does not apply a relative value unit (RVU) value to the 27215-27218 codes because CMS will not reimburse these codes -- ever. Therefore, you won't have any CCI related issues with these codes, but your private payers could have their own guidelines you should follow. Make sure to check with their policies. Remember: CMS disagreed with the CPT revisions and added their own "bilateral" G codes (G0412-G0415). For more information about these G codes, see "CPT Update: Inclusion of -Unilateral- to Pelvic Fx Repair Codes Could Add $685 to Your Bottom Line" in the Orthopedic Coding Alert, Vol. 12, No. 2, issue.
Orthopedic Coding Alert
- CCI 15.0 Update:
Consider Nerve Blocks, Injections Inherent to Most New Ortho Codes -- Or Face Denials
Watch out: Not all these new edits allow you to unbundle them with a modifier. [...] - Toss Modifier 21 Out and Go to 99354-99359 Instead
See why 30 minutes more than usual is the magic requirement. If your orthopedist spends [...] - Check Your Payers' 27215-27218 Policies
Rejoice: Pelvic fracture codes spared from CCI 15.0's wrath. Although CPT 2009 changed the descriptors [...] - News You Can Use:
Wrong Spinal Level Can Mean No Reimbursement Whatsoever
Here's what to do if wrong location is due to extra vertebrae. If your orthopedic [...] - You Be the Coder:
Consults In-Group = Established Patients?
Question: Our orthopedists may refer to one another based on a provider's subspecialty, such as [...] - Fix Facet Joint Injection Coding in Wake of Startling OIG Report
Agency combed everything from injections to consulting agreements. The Office of the Inspector General (OIG), [...] - Reader Questions :
Leg Amputations Mean 27880
Question: How do leg amputation codes differ from each other? Minnesota Subscriber Answer: Technique differentiates [...] - Reader Questions:
Discover When You Should Apply Modifier 99
Question: I have been reporting the following code sequence: - 73562-26 - 73562-99 (in the [...] - Reader Questions:
Prove Separate Service Before Billing E/M in Global
Question: Our payer is denying a claim involving an E/M and a fine needle aspiration [...] - Reader Questions:
Look to This Shoulder Code for QSS
Question: What is Quadrilateral Space Syndrome, and what ICD-9 code should I use? Georgia Subscriber [...] - Ring in Better Rewards in '09 With These 3 Don't-Miss Tips-#1:
Save Hundreds With These A/R Best Practices
Tip: Assign each biller a list of payers to contact every month. Effective accounts receivable [...] - #2:
Keep in Mind That Medicare Lowers CF to $36.0666 for 2009
You won't feel as big a crunch, thanks to neutrality adjustment. CMS released the Medicare [...] - #3:
Let 2 Questions Guide You on Deductible Collection
Save time, effort by learning the downsides of up-front collection. Collecting deductibles from patients has [...]
