Orthopedic Coding Alert
Strike Mod 26 When You Own Equipment
Question: The physician used our X-ray equipment in the office to place the needle prior to a hip injection. He did not use the C-arm or what I would consider fluoroscopy for additional guidance. Someone suggested we include modifier 26 on the claim, but I disagree. Who’s right?
New Hampshire Subscriber
Answer: You are correct: If your office owns the guidance equipment, you shouldn’t append modifier 26 (Professional component) to the guidance code. Report the service X-ray with 73500 (Radiologic examination, hip, unilateral; 1 view) or 73510 (... complete, minimum 2 views), depending on the number of views. Include 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) for the injection itself. Remember, the physician must document an interpretation report.
Orthopedic Coding Alert
- Knees:
Confront Medication, Diagnoses, and E/M Challenges for Hyaluronic Acid Injections
Here’s what you should do when your orthopedist treats both knees. Physicians administer hyaluronate or [...] - X-Rays:
How to Make Your X-Rays During the Global Period Claims Picture Perfect
Find out when to apply modifier 76. Myth: X-rays that you shoot or interpret during [...] - Modifiers:
Manage How You Append Modifier 25 for Claim Success
Review the basic rules to increase your effectiveness. Last month you learned three easy ways [...] - ICD-10:
10 FAQs Smooth Out Your Transition From ICD-9-CM to ICD-10
Let these tips from NGS guide you. Getting ready to submit your orthopedic claims using [...] - You Be the Coder:
Try Your Hand at This Arthrotomy Procedure
Question: My orthopedist performed the following procedures: 1. I&D paronychia with marsupialization.
2. I&D dorsal [...] - Reader Question:
Don't Let Your MDM Endanger Your Claim
Question: A fellow coder told me that for an established patient, I only need two [...] - Reader Question:
Determine Open/Closed and Acute/Chronic For This Suprascapularis Code
Question: What is the correct code for suprascapularis tendon repair? Minnesota Subscriber Answer: Report an [...] - Reader Question:
Strike Mod 26 When You Own Equipment
Question: The physician used our X-ray equipment in the office to place the needle prior to [...] - Reader Question:
For Debridement Level, You Need to Count Regions
Question: The physician’s notes state, “Bursal side rotator cuff showed fraying diffusely, was debrided to [...]
