Month: April 2016


Excision of Scar

Patient comes in for what they are calling scar revision and the note states that "standing cutaneous excess of the left abdominal scar” was sharply excised. We are billing with a diagnosis of hypertrophic scar (L91.0) and CPT codes of 11406 (excision of benign lesion) and 12034 (intermediate repair) for the procedure. On speaking with a co-worker regarding the note, since I’m new to plastics surgery, we are wondering if we should bill 15830 with 52 modifier because it appears to me that the excess skin is being removed. What do you think?


Synovectomy Coding

Since January we have not been able to get code 29875-59 paid. All of our claims are coming back bundled to code 29880. I have submitted the operative reports showing that it was a separate procedure, performed in a separate compartment however our appeals are also being denied. How do you recommend getting the claims processed correctly?


Coding Sphenopalatine

One of our physicians treats patients using Sphenopalatine however; he is not preforming this as an injection but as a topical anesthetic. What procedure code should I use? I have found a 64505 code, is this correct? Please advise.


Is Your Bariatric Practice Ready for Retail?

Mystery Shopping Results Indicate a Need for Improvement – April 2016 by Karen Zupko and Samantha Lappe After the news of a new, less invasive weight loss option hit the mainstream media last fall, millions of Americans began hearing about the gastric balloon procedure on television and in the news. And it’s likely that a number of...

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