Month: March 2017


ICD-10-CM for Sinusitis

We are having a discussion in the office about the correct way to code chronic sinusitis of multiple sinuses in our office. Some are saying to code each sinus condition separately as they have specific codes for each one, some say to code with the “other code”. Who is correct?


Advancement Flap

My physician excised a malignant skin lesion from the left cheek measuring 2.0 cm. The defect was repaired with a rotational advancement flap with total primary and secondary defect area of 4.75 sq cm. I submitted my claim with CPT 14040 (advancement flap), 12052-51 (repair), and 11642-51 (malignant lesion excision). My claim was denied. Did I code this correctly?


Scribe Question

In my office, we use a PA as a scribe for new patient office visits for our doctors. We have an electronic medical record and the scribe signs in under her own name when she begins notating for the doctor. What is the correct way to notate in the medical record that the PA is only acting as a scribe and not performing the service personally?


Modifier 59 or not for Medicare?

I am confused how to submit the following code combination to Medicare. The surgeon documented a right shoulder injection with US guidance (CPT code 20611) and a left knee injection without US guidance (20610). I know the codes are inclusive to each other and want to make sure I submit the claim correctly. I am sometimes confused when I should use modifier 59 and wonder if this is a situation where the modifier 59 is the most specific modifier.

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