My doctor’s operative note said he did a wound debridement of an ankle non-pressure ulcer (the patient is diabetic) “down to the muscle”. He wants to use 11043 (debridement including muscle) and I say it is 11042 (debridement of subcutaneous tissue). What do you think?
Month: June 2017
Hospitals require that we do an H&P within 30 days of taking a patient to the OR. If this visit is more than 48 hours prior to surgery, is that a billable visit?
Coding Assistant surgeon or co-surgery in trauma. Which is it?
I have a question about reinsertion of spinal instrumentation vs posterior segmental instrumentation. We have a patient who our neurosurgeon performed an exploration previous L4-S1 fusion with removal of rods bilaterally, L3-L4 laminectomy with PLIF and posterolateral fusion with placement of pedicle screws at L3 and new rods from L3-S1.
I billed 69631-RT for the transcanal tympanoplasty, 20926-RT for the temporalis fascia harvest, and 69440-RT for the middle ear exploration. Should I have used modifier 59 on 69440 because it didn’t get paid?
Our new hand surgeon evaluated a patient with a base of the fifth metacarpal fracture and distal radius fracture. Both fractures were non displaced and the hand surgeon applied a short arm cast. The hand surgeon submitted two CPT codes, one for the metacarpal fracture and one for the distal radius fracture. We told the surgeon that only one CPT code may be reported because a single cast was applied. The surgeon is in total disagreement and asked we reach out to KZA. Who is right?
Medicare Sharpens Focus on the Global Surgical Package – June 2017 by Margaret M. Maley, BSN, MS The Centers for Medicare & Medicaid Services (CMS) has expressed concern that services with 10- and 90-day postoperative periods are not valued accurately, and follow-up visits included in the value of the global services are not consistently being...