Month: June 2018

Multiple Procedure Payment Formula
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Multiple Procedure Payment Formula

June 14, 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...

Piriformis Syndrome
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Piriformis Syndrome

June 14, 2018 Question: What code do I use when my physician injects the piriformis muscle for piriformis syndrome under ultrasound guidance in the office? Do I report 64445 for the nerve injection? Answer: CPT code 20552 and 76942 for the ultrasound guidance. Per CPT Assistant April 2012; there is a significant difference in the...

Billing Diagnostic Angiograms and Lower Extremity Interventions
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Billing Diagnostic Angiograms and Lower Extremity Interventions

June 14, 2018 Question: I was told that diagnostic angiograms are always included in iliac, femoral and tibial angioplasty and stents. Is that true? Answer: No. Diagnostic angiograms with lower extremity revascularizations, are separately reported as long as the patient has not had a recent, adequate diagnostic angiogram.  For CPT this means a catheter based...

New Patient, or Not?
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New Patient, or Not?

June 14, 2018 Question: If I see a new patient in consultation for a suspicious lesion and release them to their primary care provider and they come back to see me for a skin problem one year later on their own, can I code them as a new patient? Answer: No.  According to the CPT...

Total Hip Arthroplasty Question
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Total Hip Arthroplasty Question

June 14, 2018 Question: We have a patient who underwent an open fixation of a femoral neck fracture five years ago and now presents for a total hip arthroplasty.   Someone mentioned that we should report a conversion to hip arthroplasty but we are not sure if this is a revision of one component plus a...

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Have You Heard the Latest Professional Liability Risk?

Have You Heard the Latest Professional Liability Risk? AAOS Now- June 2018 By: Michael R. Marks, MD, MBA HIPAA allows states to recognize cause of action for breach of confidentiality The list of liability risks for physicians continues to increase. On behalf of the Medical Liability Committee, this article presents new risks via highlights from...

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Tips for Utilizing ICD-10-CM

Tips for Utilizing ICD-10-CM – June 2018 AAOSNow by Sarah Wiskerchen, MBA, CPC  In May 2015, most orthopaedic surgeons and their staff were highly focused on learning the new diagnostic language of ICD-10-CM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, Clinical Modification). That’s because the new diagnosis codes were scheduled to...

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