Recent content by Orthocoderpgu

  1. O

    Wiki Carpal Tunnel Sx & Distal Fasciotomy

    In addition to everything previously mentioned, have you spoke to your provider about not having a diagnosis for 25020? As Dr. Raizman has pointed out 25020 is performed to treat compartment syndrome, which the patient does not have.
  2. O

    Wiki Adding insurance in EPIC

    I found out that EPIC has a "Learning Hub". If you go in there seach "Generic Insurance". It will show you how to add an insurance.
  3. O

    Wiki Adding insurance in EPIC

    If I get a work around I will let you know. But submitting a ticket for me will not do any good as they have already decided that we will not be submitting enough claims to have the insurance added yet.
  4. O

    Wiki Adding insurance in EPIC

    I have an insurance company that I need to add to an encounter in EPIC. This insurance is not billed often enough to have it added per our company. Someone says that there is a way it can be added each time we need to bill. Anyone know how to do this? Or have a tip sheet? Thanks.
  5. O

    Wiki Exploration finger flexor tendon

    This would not be 26145 since there is no documentation that the patient had synovitis. Look at the documented post op diagnosis: Intact FDP tendon. Nothing about synovitis. There was no repair, just exploratory with confirmation the FDP was intact.
  6. O

    Wiki Billing Incision and Drainage with 5th ray resection

    If the codes hit an edit, then you need to ask yourself does the procedure "qualify" for a modifier. I also see an issue with the dictation. Foot/Ankle dictation really needs to be specific. Did the provider "advance" the incision already made? Or was this a different incision. Dictation is not...
  7. O

    Wiki Provider is Billing both POS 72 and POS 11 on the same day and same member

    I code orthopedic surgeries, so this is a bit outside of my norm here. Are you thinking that this is a Stark violation? Initially it does not make sense to me. Is a FQHC allowed to process labs that would not be allowed in a normal doctor office (POS 11)?
  8. O

    Wiki E/M w 25 Mod denied on first visit

    The CMS general coding guidelines specifically states that just because a patient is new does not mean that an E/M is justified. The injection has a built in "E/M". Probably why it was denied.
  9. O

    Wiki How to code closure of Moh's procedure over the eyelid

    I am not coding this but trying to help the coder who is. Patient had a Mohs surgery on their eyelid, and the provider wants to bill for closure. Does the eyelid have subcutaneous tissue? During the closure the provider performed a canthotomy & cantholysis. How can you tell if this is a...
  10. O

    Wiki Modifier 51 and XS coded together

    I don't see billing -51 with -XU or -XS as an issue especially since modifier -51 is really being faded out. Assuming both codes are supported, I can see using modifier -XU since these procedures could be considered "over-lapping" especially since both correct nerve issues.
  11. O

    Wiki Fracture Care

    Can you clarify your question please? Your urgent care clinic is billing fracture, but who is doing the follow up? A doc in your clinic or another doc in a different practice?
  12. O

    Wiki Shoulder Scope I&D

    Reality check: Just because you bill it does not mean it's going to get paid. After any surgical procedure the joint is going to be flushed out with saline, normally one or two liters. In total your provider did six which is more than normal, but unless the extra time this took is actually...
  13. O

    Wiki What the difference between 11406 and 24075, 24076

    11406 the nodule is in the top portion of the skin. 24705 the nodule is within subcutaneous tissue. 24076 the nodule is in the muscle tissue.
  14. O

    Wiki Kenalog cc or mL?

    You are correct. Since the total amount injected is less than 1mL, you would bill with one unit. Your provider has documented this perfectly and does not need to correct or update the documentation.
  15. O

    Wiki Chronic stable illness-joint replacement

    Totally agree. Is there infection? Catching/locking? Any signs of infection? All hardware firm in place or starting to become loose? All that needs to be taken into consideration.
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