Month: July 2018

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Ligating a Vessel in a Trauma Patient

July 12, 2018 Question: What codes are used for ligating a vessel due to a traumatic injury? Answer: See codes 37565-37618, below. Select a code based on the anatomic area of the vessel. For example, Ligation, major artery (eg, post-traumatic, rupture); neck for ligating the jugular vein.   CPT Code Description 37565 Ligation, major artery...

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Multiple Procedure Payment Formula

July 12, 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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Pain Management Resources

July 12, 2018 Question: What are some good organizations to reference for pain management guidance? Answer: Good reference information can be found from the AAPM&R, American Academy of Pain Medicine, The American Pain Society and the American Society of Interventional Pain Physicians.  It is also important that you reference the individual payor websites to access...

Wound VAC
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Wound VAC

July 12, 2018 Question: I performed a superficial debridement of the sternum with a 5 x 5 cm placement of Integra to the sternal wound.  Can I bill for the wound VAC? Answer: Since the wound VAC is acting as a dressing it should not be reported separately.  You should report CPT 15002 for the...

Bundling of +22845 with +22853
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Bundling of +22845 with +22853

July 12, 2018 Question: How do we avoid non-payment for 22845 with 22853? Answer: Good question! Medicare instituted a National Correct Coding Initiative (NCCI) edit between these two codes in April 2017.  This edit was established to make you really think and be sure about reporting both codes.  If indeed you are meeting the requirements...

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Coding Embolization of a Dialysis Graft/Fistula – Part 1

July 12, 2018 Question: The documentation indicates embolization of side branches/collateral vessels to help the dialysis graft mature. I’ve always coded it with the embolization code, 37241.  Is this correct? Answer: In 2017, new codes for embolization of the side branches emptying into the dialysis circuit were established. Code 37241 is no longer appropriate for...

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Intralesional Injection

July 12, 2018 Question: Do codes 11900 and 11901 include the medications used, or should we bill separately? Answer: The codes are specifically for the injection(s).  If you purchase the medications used for the injections, you should bill separately for them using HCPCS II codes. *This response is based on the best information available as...

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Physical Therapy and NPI Numbers

July 12, 2018 Question: We have multiple practice locations and have therapy departments at several of the locations.  Our question has to do with whether or not we should obtain NPI numbers and credential all of the therapists? Answer: KZA recommends that the practice obtain NPI numbers and credential the therapists for “direct billing”, especially...

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How to Hire a Superstar Scribe

Healio ⋅ Orthopedics Today – July 2018 by Cheryl Toth, MBA If you have you been thinking about hiring a scribe to handle your electronic health record data entry, then you are not alone. More physicians are hiring scribes to reduce administrative overload. Physicians who use them report improved quality of life, clinic efficiency and...

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