Orthopedic Coding Alert
Hold Local Medicare to NCDs
Question: Michigan Subscriber Answer: Yes. According to a Medicare FAQ, NCDs are binding on the following: • all Medicare carriers • fiscal intermediaries • quality improvement organizations • health maintenance organizations • competitive medical plans • healthcare prepayment plans. Resource: Remember: Contractors can create their own coverage decisions for items not specifically covered or mentioned in NCDs. You can search NCDs at www.cms.hhs.gov/mcd/overview.asp or find them in the NCD manual at www.cms.hhs.gov/Manuals/ by clicking "Internet Only Manuals" and choosing publication 100-03.
Orthopedic Coding Alert
- Op Note Coding Corner:
Submit Your Hand Surgery Claims to Payers With Confidence Using This Strategy
Don't know what services a CPT code includes? You could be making bundling errors -- and [...] - Clip 'n' Save:
Handle Your Hand, Wrist Fracture Diagnoses With Care by Pinpointing Anatomic Site
Here's how to differentiate the tiquetrum from the trapezium. Orthopedic surgeons dealing with hand procedures [...] - 3 Questions Clear Up Your Modifier 24, 25, 57 Confusion
Applying the correct E/M modifier can boost your bottom line by $100. To avoid denials [...] - Modifier Cheat Sheet:
Banish Your E/M Modifier Phobias Forever
You'll never wonder which modifier applies to minor vs. major procedures. If you're often mixing [...] - You Be the Coder :
Untangle Hardware Removal, Reinsertion Coding
Question: My orthopedist removed posterior hardware at L5-S1 and then decided to do a fusion [...] - READER QUESTIONS:
Dodge G0289, Modifier 22 Mistakes
Question: Our orthopedist did a right knee arthroscopy with extensive tricompartmental synovectomy, partial medial menisectomy, [...] - READER QUESTIONS:
Find Your TFCC Code Here
Question: What ICD-9 code should we use for TFCC (triangular fibrocartilage complex) of the wrist? [...] - READER QUESTIONS:
Sort Out This ER, Then Assumed Care Scenario
Question: My orthopedist treated a patient who was first seen in the ER for an [...] - READER QUESTIONS:
Carrier Can Secure How You Use S-Codes
Question: We have been billing out 27299 for total hip resurfacing but then Regence requested [...] - READER QUESTIONS:
Hold Local Medicare to NCDs
Question: Are National Coverage Determinations (NCD) binding on contractors? Michigan Subscriber Answer: Yes. According to [...] - READER QUESTIONS:
Equate 'Weber B' With Lateral Malleolar Fx
Question: Which CPT and ICD-9 codes should we report when the surgeon dictates a Weber [...]
