Month: March 2018

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Choosing an EVAR Device Code: 2018

March 1, 2018 Question: Before the new codes, I knew which codes to use based on the brand name of the device.  It doesn’t seem that easy under the new codes. Any advice? Answer: The five prior EVAR codes (34800, 34802, 34803, 34804, 34805) do not crosswalk exactly to the new main body EVAR codes....

Knee Pain Injection
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Knee Pain Injection

March 1, 2018 Question: My physician injects the superior medial and lateral branches of the genicular nerve for knee pain and wants to report 64450 and 64450-59.  Is this correct? Answer: No.  Even though more than one injection may be required during the session, the code 64450 is reported once per its description “peripheral nerve...

Coding an Incomplete Colonoscopy
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Coding an Incomplete Colonoscopy

March 1, 2018 Question: How do I report a diagnostic colonoscopy, if the prep is incomplete and the scope is able to be advanced past the splenic flexure, but does not get all the way to the cecum? Answer: Per CPT, if it is a diagnostic or screening colonoscopy, report, the diagnostic colonoscopy code (45378)...

Injection of Marcaine into Muscle/Skin
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Injection of Marcaine into Muscle/Skin

March 1, 2018 Question: My neurosurgeon always injects Marcaine into the muscle and skin incision prior to closure after spine procedures.  Can I bill this with a nerve block or trigger point code? Answer: This is a method to help with post-operative pain control and is not separately billable by the surgeon. *This response is...

Denials of 30930 with 30140
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Denials of 30930 with 30140

March 1, 2018 Question: We are getting denials when billing 30930 (outfracture of inferior turbinates) with 30140 (submucous resection of inferior turbinate). Do you know how we can get paid? Answer: Actually, it is not accurate to use both codes together for procedures on the same turbinate. CPT guidelines clearly state that 30930 (and 30801,...

My patient’s fallen on the ice and smashed their elbow. Help me select the proper code.
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My patient’s fallen on the ice and smashed their elbow. Help me select the proper code.

March 1, 2018 Question: We received an inquiry from a client where the surgeon wanted to report the repair of the elbow lateral collateral ligament (CPT 24343) along with radial head replacement surgery (CPT 24666) when used for addressing radial head fracture. Can we use this code combination? Answer: According to AAOS – Global Service Data GSD) –...

Multiple Procedure Payment Formula
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Multiple Procedure Payment Formula

March 1, 2018 Question: What is Medicare’s multiple procedure payment formula? When I do more than one procedure, I know Medicare reduces payment for some but I can’t remember by how much. Answer: It used to be 100%, 50%, 25%, 25%, etc but many years ago the formula changed to the physician’s advantage and now...

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