orthopaedic

  1. B

    Wiki 64450 Injection with ULS guidance

    Hello, I work in an orthopedic clinic and we have an MD who has recently started providing carpal / cubital / ulnar tunnel injections under ultrasound guidance. For billing we thought the best path for cubital tunnel specifically would be 64450 with 76942 with a diagnosis of G56.22. When we did...
    • Blyewskiconger
    • Thread
    • carpal cubital injection orthopaedic ulnar ultrasound guidance
    • Replies: 3
    • Forum: Orthopaedics
  2. J

    Wiki Coding soft tissue mass

    Hello! I am an outpatient anesthesia coder; we work with a lot of ortho centers, and I see a lot of 'soft tissue mass' diagnosis. Since we only code the anesthesia we don't often get the path report, but I do get the OP report. When the provider documents a 'mass' alone I use an R22 code, when...
  3. K

    Wiki HELP! anterior interosseous nerve to motor branch of ulnar nerve transfer

    I want to code 64718, 64719, and 69990, but my doc wants another CPT code for the anterior interosseous nerve transfer. Isn't it included or am I missing another code? 1.Right cubital tunnel release with anterior subcutaneous transposition of the ulnar nerve. 2. Decompression of ulnar nerve...
    • kmuth
    • Thread
    • hand coding help nerve transfer orthopaedic
    • Replies: 1
    • Forum: Orthopaedics
  4. H

    Wiki Total Joint Revisions

    I just read the CPT Assistant September 2021 Volume 31 Issue 9 total joint revision scenarios. Am I reading this correctly that they now want first stage hip or knee revisions that use an articulating spacer to be coded as a full-revision (27134 or 27487) instead of removal of implants with...
    • halll
    • Thread
    • orthopaedic total hip arthroplasty total knee arthroplasty
    • Replies: 0
    • Forum: Orthopaedics
  5. T

    Wiki Physician Assistants and Fluoroscopy-77002?

    Does anyone have any experience with billing for injections under fluoroscopy completed by a physician assistant? We use the normal injection codes such as 20610 and then bill 77002. I am struggling to find the restrictions for PA billing 77002 in Pennsylvania? Does anyone bill these services...
    • thoffert
    • Thread
    • 77002 fluoroscopic fluoroscopy orthopaedic physician assistant
    • Replies: 2
    • Forum: Orthopaedics
  6. C

    Wiki Assistants at surgery (non-MD: NP, PA, or CNS)

    Assistants at surgery (non-MD: NP, PA, or CNS) Our physicians are lack luster in their documentation of their assistants during surgery, which is causing denials and delays in payment. I am aware of the compliance standards that requires their active role to be documented in the body of the...
  7. K

    Wiki Fasciectomy/Contracture/ Partial Palmar

    Can someone please direct me with the coding. Would you code 26123 and 26125? F8 &F9? Insurance is saying the codes are not supported. Any help is appreciated. Preoperative diagnosis: Dupuytren's disease right hand with significant MP joint contractures of the ring finger small finger and a...
    • kmuth
    • Thread
    • dupuytren fasciectomy hand coding orthopaedic
    • Replies: 1
    • Forum: Orthopaedics
  8. K

    Wiki Cross-finger flap with split thickness skin graft

    Please help! I am not sure if I should code 15574 or 14350 for the cross finger flap and 15100 for the graft? Amputation of tip of right long finger with exposed distal phalanx. OPERATION PERFORMED: Cross-finger flap from right ring finger to right long finger and split-thickness skin graft...
    • kmuth
    • Thread
    • finger amputation hand coding orthopaedic skin flaps skin graft
    • Replies: 0
    • Forum: Orthopaedics
  9. R

    Wiki 29823, 29827 Clarification 2021

    Hello! I am reaching out to ask some questions regarding 29823. In an effort to explain to my providers the use of 29823, I want to make sure my understanding is accurate. 29823 (Arthroscopy, shoulder, surgical; debridement, extensive 3 or more discrete structures (eg, humeral bone, humeral...
  10. K

    Wiki Shoulder- Removal of failed hemi - to a total shoulder

    I am not sure which way to code this one. The patient had a hemi arthroplasty and it failed so they decided to remove the hemi and do a total shoulder. There are no conversion codes and even if there were I don't know if it would apply here because the humeral was a revision and the glenoid was...
    • kmuth
    • Thread
    • conversion hemiarthroplasty orthopaedic total shoulder
    • Replies: 0
    • Forum: Orthopaedics
  11. R

    Wiki BILATERAL X-RAY

    AZ Complete Health (Medicaid) recouped multiple claims we have billed as follows: 99203 (M17.12) - PAID 73562-LT (M25.562) - RECOUPED/DENIED 73562-RT(M25.561) - RECOUPED/DENIED We also have other claims that we billed different x-ray codes for bilateral areas with -LT and -RT that have...
    • raenayg
    • Thread
    • ahcccs bilateral billing orthopaedic xray
    • Replies: 3
    • Forum: Orthopaedics
  12. K

    Wiki External Neurolysis

    I need advice as I have never coded an external neurolysis. I know internal would be the primary cpt plus 64727, but would this be 64708? PREOPERATIVE DIAGNOSIS: Laceration to the left index finger dorsal aspect in the MP joint area. POSTOPERATIVE DIAGNOSIS: Laceration to the left index finger...
    • kmuth
    • Thread
    • external neurolysis hand coding orthopaedic
    • Replies: 2
    • Forum: Orthopaedics
  13. K

    Wiki Excision dupuytren's nodule & trigger finger release

    My doc wants me to bill for the trigger finger portion and the nodule excision, but I feel like the nodule was incidental? Am I incorrect? Preoperative diagnosis: Right long trigger finger Dupuytren's nodule Postoperative diagnosis: Right long trigger finger Dupuytren's nodule Operation...
    • kmuth
    • Thread
    • dupuytren's nodule hand coding orthopaedic trigger finger
    • Replies: 4
    • Forum: Orthopaedics
  14. K

    Wiki Excision of mass left small finger, left carpal tunnel release

    How would you code this? I am reading mucoid degeneration and he keeps extending the incision, but I don't think an actual cyst was removed. The carpal tunnel was not planned, can I bill it with the cyst excision 26160 or should I bill the arthrotomy with exploration 26070-26080? Preoperative...
    • kmuth
    • Thread
    • carpal tunnel hand coding ortho specialty coding orthopaedic
    • Replies: 1
    • Forum: Orthopaedics
  15. K

    Wiki Finger Capsulotomy/ Tenolysis

    I don't like hand coding and would love any webinar recommendations, or just general reading information to help me dive deeper. This doc tends to lack details/ dictation but when queried he doesn't respond or will say don't bill it. With this surgery I just don't think there is enough details...
    • kmuth
    • Thread
    • capsulotomy hand coding orthopaedic tenolysis
    • Replies: 1
    • Forum: Orthopaedics
  16. K

    Wiki Dupuytren partial palmar release left small & possibly left ring

    Here is my question I know I can code 26123-F5 but through out the op note he is also dissecting the left ring finger which he also says is involved but he did not state the left ring finger in the operation performed/ postop diagnosis. Can I bill 26123-F5 and 26125-F4 or just 26123...
    • kmuth
    • Thread
    • dupuytren's nodule fasciectomy hand specialist orthopaedic
    • Replies: 4
    • Forum: Orthopaedics
  17. K

    Wiki Repair extensor pollicis longus left hand

    I was just wondering if I can only code the repair 26418 or if I can also code the exploration. POSTOPERATIVE DIAGNOSIS(ES): Extensor pollicis laceration left hand PROCEDURE: Surgical exploration of the wound, repair of the extensor pollicis longus left hand INDICATIONS: Patient suffered a...
    • kmuth
    • Thread
    • extensor hand coding hand specialist orthopaedic
    • Replies: 3
    • Forum: Orthopaedics
  18. D

    Wiki Pilon vs Trimalleolar Fx

    Good morning! I need some help in deciding if this is a Pilon Fx-27828- and ankle dislocation with IF-27848- (per what the doctor is requesting) or if this should be coded as a trimalleolar ORIF. I've gone back and forth with this any help or advice will be appreciate....below is the OP note...
    • dcallaway
    • Thread
    • ankle foot and ankle orthopaedic orthopaedics orthopeadic podiatrist podiatry podiatry surgery surgery surgery coder
    • Replies: 1
    • Forum: Orthopaedics
  19. N

    Wiki In Urgent Care setting, Can a Physcian Assistant bill a new pt using his/her own NPI?

    Hi coder family:) I guess my question is can P.A's see new patients in Urgent Care? I am auditing our P.A.'s who see patients Monday-Sunday in Ortho Urgent Care. My question is, if a new patient comes in to be seen and a P.A. see's them for the first time. Would the P.A. be able to bill...
  20. B

    Wiki Ortho to Hosp Admit

    B][/B]I need some help with an e/m situation. I have a doctor here in our Ortho practice that saw a patient on one day (lets say Monday) and admitted her that day to the hospital. He is also the operating surgeon and saw the patient the next day (lets say Tuesday) in the hospital and then...
    • bmcampbell
    • Thread
    • admit hospital inpatient orthopaedic outpatient
    • Replies: 3
    • Forum: E/M
  21. T

    Wiki Sequela fx with pain

    Can someone answer this for me? Patient comes in 18 months after pilon fx (healed). Patient now has pain in that ankle with no OA. Should I code: M25.572 and Z87.81 or M25.572 and S82.872S
  22. T

    Wiki COSC Needed for Physician Office Orthopedic Coding

    Immediate, experienced COSC needed to perform orthopedic audits of office and surgical procedures as well as E&M visits for busy ortho practice. Must have current in depth knowledge of orthopedic surgical coding and compliance rules for billing. Knowledge of physical therapy and x-ray coding a...
  23. C

    Wiki Billing E/M Visit and Xray

    I need some help with documentation of some coding guidelines. I work for an orthopedic surgery practice and we are currently setting up our EMR to document E/M visits and have hit some road blocks. I have heard several different places that if you are billing for both the technical and...
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