Month: November 2017

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Coding Transforaminal Injections

November 30, 2017 Question: How would you report a left lumbar transforaminal epidural injection (Left L5-S1 and left S1) with fluoroscopic guidance? Answer: This is reported as 64483 for the first lumbar level (L5-S1) and + 64484 for the additional level (S1). The fluoroscopy is included. *This response is based on the best information available...

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Complex Closure with a Soft Tissue Tumor Code

November 30, 2017 Question: Can I also bill for the complex repair when I’ve also excised a soft tissue tumor like a lipoma in the 21552-21555 series of codes? Answer: Actually CPT says these soft tissue tumor codes include the simple or intermediate repair and a complex repair may be separately reported.  That said, Medicare...

Cervicocerebral Imaging – What’s Not Included
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Cervicocerebral Imaging – What’s Not Included

November 30, 2017 Question: What’s not included in the diagnostic cervicocerebral imaging codes and can be reported separately? Answer: The diagnostic cervicocerebral imaging codes do not include: Interventional procedures such as angioplasty or embolization Endovascular stent placement Ultrasound guidance for vascular access, e.g., 76937 with 36221-36228 Selective arterial catheterization outside the carotid and vertebral arteries...

Billing Medicare Patient Admittance
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Billing Medicare Patient Admittance

November 30, 2017 Question: I was consulted to see a Medicare patient in the emergency room (ER) by the Emergency Department physician. When I arrived, the patient was still in the ER but had been admitted to the hospitalist and was waiting for a bed. Answer: Since the patient is Medicare and has been formally...

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High Deductible Health Plans: Take Accounts Receivable Action Now

High Deductible Health Plans: Take Accounts Receivable Action Now The American Journal of Orthopedics® – November/December 2017 by Karen Zupko, President If you missed the recent headlines, Why Patients Delay Medical Payments: 12 findings 1 and You think your health insurance costs too much. Try being a farmer.2, you may not be too worried about...

Debridement Prior to Skin Grafting
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Debridement Prior to Skin Grafting

November 16, 2017 Question: I’m taking a patient to the OR for debridement of a dehiscent surgical wound and will skin graft it for closure. I’m looking at getting 11042 (debridement) and the skin graft codes precertified. Is this right? Answer: Not exactly.  You’re right about the skin graft code(s).  However, we do not recommend...

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Cervicocerebral Imaging – What’s Included

November 16, 2017 Question: What’s included in the diagnostic cervicocerebral imaging codes and not separately reported? Answer: The diagnostic cervicocerebral imaging codes include: Accessing the vessel Non-selective aortic and selective innominate, carotid and vertebral catheterization Contrast injection(s) of aortic arch, carotid and vertebral systems, including arterial, capillary, and venous phase, when performed All fluoroscopy All...

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