Month: November 2017

Coding an Omental Flap
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Coding an Omental Flap

November 16, 2017 Question: Can add-on code 49905 (omental flap) be  reported for buttressing an incision or anastomosis?  For example after a colectomy?  Or is the intent of the code, reconstruction of a defect only. 49905 Omental flap, intra-abdominal (List separately in addition to code for primary procedure) Answer: No, buttressing a formed anastomosis (made...

Dizziness and E/M Code Level
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Dizziness and E/M Code Level

November 16, 2017 Question: When I see an adult new patient with a chief complaint of dizziness, I can automatically code a level 4, 99204, right? Answer: Oh, only if E/M coding were that easy!  Don’t forget, for 99204 you must have medical necessity for and perform a comprehensive History and a comprehensive Exam (8...

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Dispensing DME in Orthopaedics for Medicare

Dispensing DME in Orthopaedics for Medicare – November 2017 AAOSNow by Sarah Wiskerchen, MBA, CPC  Answers to key coding questions Orthopaedic practices often provide patients with supplies, such as casts and canes, integral to patients’ treatment plans. This article covers the essentials of coding and claims submission. Understanding the definitions and rules for DME can...

Intercostal and TAP Blocks
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Intercostal and TAP Blocks

November 2, 2017 Question: My doctor documents that she does bilateral intercostal chest blocks as well as bilateral TAP blocks to the abdomen and rectus fascia when she does breast reconstruction procedures.   I want to bill for these but my plastic surgeon thinks they are not billable? Answer: We agree with your surgeon.  These services...

Thrombectomy in the Dialysis Circuit
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Thrombectomy in the Dialysis Circuit

November 2, 2017 Question: If thrombectomy is performed once in the peripheral segment and once in the central segment of the dialysis circuit, can code 36904 be reported twice? Answer: Code 36904 is reported once, no matter how many times thrombectomy is performed in the peripheral and/or central segment. *This response is based on the...

Post-Op hemorrhage repair. Is it billable?
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Post-Op hemorrhage repair. Is it billable?

November 2, 2017 Question: Can I bill for taking the patient back to the OR to explore and repair post-op hemorrhage on day post-op? I heard that all complications are included in the payment of the original surgery. Answer: Yes, you may bill for this.   CPT and Medicare agree that taking the patient back to...

Direct Laryngoscopy and Laryngectomy
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Direct Laryngoscopy and Laryngectomy

November 2, 2017 Question: Can I bill 31525 (31526) for a diagnostic laryngoscopy performed at the same operative session as the laryngectomy (31360)?  I do this map out the tumor for the laryngectomy and make sure there are no secondary tumors that may have occurred since I scoped the patient previously. Answer: A diagnostic endoscopy...

Why am I Receiving a Denial When I Report a Joint Injection and a Trigger Point Injection on the Same Date of Service?
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Why am I Receiving a Denial When I Report a Joint Injection and a Trigger Point Injection on the Same Date of Service?

November 2, 2017 Question: Our orthopaedic surgeon performed and clearly documented a joint injection to the right shoulder and a trigger point injection bilaterally to the trapezius muscle. We are receiving denials when we report CPT code 20610 and 20552 on the same claim form? Are you able to assist us in understanding if we...

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