Month: February 2018

Unilateral/Bilateral Endoscopic Sinus Surgery with New Codes
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Unilateral/Bilateral Endoscopic Sinus Surgery with New Codes

February 1, 2018 Question: I’m confused on what to do when bilateral total ethmoidectomies were performed with a right sphenoidotomy. Do I report the new bundled code, 31257, with 31257-52 (reduced services)? Answer: Good question! In your situation you would report the following: 31257, RT Right total ethmoidectomy and sphenoidotomy 31255-59, LT Left total ethmoidectomy...

Nerve blocks S1 and S2.
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Nerve blocks S1 and S2.

February 1, 2018 Question: How do I report nerve block injections at S1 or S2? Are these considered facet injections? Answer: No, there are no facet joint at S1 or S2, so these injections are reported as “other peripheral nerve injection”, 64450. *This response is based on the best information available as of 02/01/18.

Breast Reconstruction with Tissue Expander and Latissimus Dorsi Flap
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Breast Reconstruction with Tissue Expander and Latissimus Dorsi Flap

February 1, 2018 Question: Can you tell me if the CPT code 19361 would include placement of a tissue expander? I have read conflicting information and certainly don’t want to bill for something that I shouldn’t. Answer: This procedure is reported using two codes: 19361 (lat. flap recon) and 19357 (tissue expander recon). Unfortunately, some...

Breast Cyst Aspiration
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Breast Cyst Aspiration

February 1, 2018 Question: The surgeon did a fine needle aspiration of two cysts in the same breast without any imaging. Is this billed once or twice? Answer: Fine needle aspiration of a breast cyst is reported per cyst. In this scenario, code 10021 with 2 units or 10021 and a second 10021 with a...

Blood Clot and Tumor Removal – 1 or 2 Codes?
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Blood Clot and Tumor Removal – 1 or 2 Codes?

February 1, 2018 Question: Hemorrhagic tumor – I removed tumor and blood clot surrounding the tumor. Can I use 61510 and 61313? Answer: No, use 61510 for the tumor removal which includes removing any associated hematoma.  Only one exposure/craniotomy was performed so only one code should be reported. *This response is based on the best...

OIG Work Plan for Orthotics
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OIG Work Plan for Orthotics

February 1, 2018 Question: We recently heard that the government will be focusing audits on off the shelf orthotics. We have tried to find information but have not been successful. Are you able to direct us? Answer: Yes, and thanks for reaching out.   The OIG Work Plan (updated January 2018) includes off the shelf orthotics,...

Coding Lower Extremity Venous Stenting
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Coding Lower Extremity Venous Stenting

February 1, 2018 Question: What codes are used for stenting of the lower extremity veins? Can the 37220-37235 be used? Answer: No, the 3720-37235 series of codes are specifically for treatment of arterial occlusion. For venous stenting use 37238,transcatheter placement of an intravascular stent(s), open or percutaneous, including all supervision and interpretation and including all...

How to code for shave biopsy?
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How to code for shave biopsy?

February 1, 2018 Question: One of the dermatologists in the office documents that he performs shave biopsies of lesions.  Those should just be coded as biopsies, right?  Not shaves? Answer: That is a great question.  By CPT definition, there is no such thing as a shave biopsy.  There are codes for shaving of lesions (11300-11313)...

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