Month: March 2018

Modifier 25 Use
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Modifier 25 Use

March 15, 2018 Question: If a patient is coming in for destruction of AKs, can my doctor bill for an E/M too?  He has to evaluate the sites before doing the destruction. Answer: If a patient is scheduled for the minor procedure, then the decision to perform it has already been made.  When the patient...

Fat Grafting with a Breast Revision
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Fat Grafting with a Breast Revision

March 15, 2018 Question: My doctor reports a breast revision with CPT codes 19380 and 20926 on the same breast.  Can we report the fat graft harvest in addition to the revision? Answer: CPT code 19380, Revision of reconstructed breast involves revising an already reconstructed breast. The code includes repositioning the breast; making adjustments to...

Spinal Hardware Block
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Spinal Hardware Block

March 15, 2018 Question: How is a spinal hardware block coded? Answer: There is not a specific CPT code for a spinal hardware block.  Use an unlisted code 64999. When reporting an unlisted code to describe a procedure or service, it is necessary to submit supporting documentation with the claim to provide an adequate description...

Placement of Lumbar Subarachnoid Drain
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Placement of Lumbar Subarachnoid Drain

March 15, 2018 Question: My neurosurgeon states he placed a subarachnoid drain in the lumbar spine after a craniotomy for CSF leak repair procedure. He thinks the correct code is 62350.  Is this accurate? Answer: No.  You’ll use 62272 (Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter) instead.  CPT 62350 is...

Removal of Tympanostomy Tube
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Removal of Tympanostomy Tube

March 15, 2018 Question: What is the code for removal of a tympanostomy tube when it was placed by another physician?  I can’t seem to find it in the CPT book anymore. Answer: Oh my goodness – that code describe was revised in 2003!  CPT 69424 now states: Ventilating tube removal requiring general anesthesia.  If...

Thrombectomy and Thrombolysis (1)
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Thrombectomy and Thrombolysis (1)

March 15, 2018 Question: Can a transcatheter thrombectomy and thrombolysis performed in the same artery/vessel both be coded? Answer: Yes, both may be reported if performed in the same vessel; 37184 for the thrombectomy and 37211 for the thrombolysis. *This response is based on the best information available as of 03/15/18.

Incident-To or Direct Billing to Medicare?
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Incident-To or Direct Billing to Medicare?

March 15, 2018 Question: Our physician performed an evaluation on a patient and made a decision to start the patient on a series of Hyaluronate injections. The patient returned a week later because we had to order the drug.  Our PA saw the patient and administered the first injection of the series. Is this visit by...

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When Loyalty Becomes a Liability

Articles When Loyalty Becomes a Liability Karen Zupko Healio ⋅ Orthopedics Today March 2018 I was approached by an orthopedic client at a recent conference. Our firm had conducted a revenue cycle assessment for his solo practice. He told me we had issued a good report with lots of practical ideas for improvement. The problem...

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Arthroscopy Coding for Major Joint – Shoulder

Articles Arthroscopy Coding for Major Joints – Shoulder Michael R. Marks, MD, MBA AAOS Now – March 2018 An accurate understanding of coding rules increases likelihood of receiving appropriate paymentCorrectly reporting and billing for arthroscopy services is often confusing. Last month, AAOS Now reviewed the knee arthroscopy codes and outlined the appropriate use of modifiers. This...

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