Orthopedic Coding Alert
Occiput-Atlas Is Level C1
Question: Our orthopedist indicated that he performed an occiput-atlas joint injection, but I can't find this in CPT. How should I code for it? Nevada Subscriber Answer: The occiput refers to the base of the skull, while the atlas is another name for the C1 vertebra. The occiput has convex facets, which roll on the joint surfaces of the cervical spine. Therefore, the orthopedist probably performed a cervical facet joint injection (64470, Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level). Confirm this with the physician before submitting your claim, because the operative report lacked specificity. If the orthopedist injected additional levels (e.g., C2), append the add-on code +64472 (... cervical or thoracic, each additional level [list separately in addition to code for primary procedure]) to 64470. Do not append modifier -59 (Distinct procedural service) or -51 (Multiple procedures) to the add-on code because it inherently describes an additional, separate procedure.
Orthopedic Coding Alert
- CPTs New Nerve Block Codes Alter Pain Management Infusion Coding
CPT 2003 introduces four new somatic nerve block codes, eliminating the need to bill an [...] - You Be the Coder:
Swanson Implant Affects Silastic Joint
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - 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) should append modifier -50 [...] - Dont Confuse Vertebroplasty and Kyphoplasty Codes
Spine coders, take note: Vertebroplasty and kyphoplasty are not synonymous, so you should not report [...] - Reader Question:
Note Complexity of Shoulder Debridement
Question: What criteria should I use to distinguish between a limited shoulder debridement (29822) and [...] - Reader Question:
Bill for Suture Removal With Anesthesia
Question: Can we bill for removing a patients cast and sutures? Maryland Subscriber Answer: If [...] - Reader Question:
Occiput-Atlas Is Level C1
Question: Our orthopedist indicated that he performed an occiput-atlas joint injection, but I can't find [...] - Reader Question:
Bill Consults With Caution
Question: A primary-care physician (PCP) referred a patient to our practice after he had performed [...] - 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 [...] - Reader Question:
Respond When Insurer Downcodes Claims
Question: Our insurer requested documentation when we billed 29876 (Arthroscopy, knee, surgical; synovecto-my, major, two [...] - Reader Question:
Uniplane Is Included in Skeletal Fixation
Question: One of our surgeons wants me to bill 20690 (Application of a uniplane [pins [...]
