Month: November 2018

Payment for 20930/20936
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Payment for 20930/20936

November 1, 2018 Question: Will payors reimburse 20930 or 20936? Answer: Yes!  Payment depends on the specific payor and plan.  It is worthwhile to report the codes since CPT allows coding of 20930 (morselized allograft) and 20936 (local bone graft). *This response is based on the best information available as of 11/01/18.

New Patient or Established
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New Patient or Established

November 1, 2018 Question: If I see a new patient in consultation for a joint pain, treat and release them to their primary care provider and they come back to see me a year later for a different reason on their own, can I code them as a new patient?  Answer: No.  According to the...

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Myringoplasty with Graft Harvest Denials

November 1, 2018 Question: We are getting denials of 20926 when we bill with 69620.  Can you help us write an appeal letter? Answer: Actually, no we cannot.  The code descriptor for 69620 (myringoplasty) says “surgery confined to drumhead and donor area.”  This means that the harvest of donor graft (20926, tissue graft) is included...

CPT Code 20610 or 20611?
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CPT Code 20610 or 20611?

November 1, 2018 Question: Our physician performed a shoulder joint injection with ultrasound guidance.  The physician’s procedure note does not fully detail the ultrasound guidance, other than the ultrasound was used to do the injection. The physician does not document that images were saved (and we can’t find images).  The physician also does not have...

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Billing a Completion Angiogram

November 1, 2018 Question: After open surgery for a thrombectomy or endarterectomy, can a completion angiogram performed at the same session, be separately reported? Answer: No, per CPT, completion angiograms to assess restoration of blood flow is inherent in an open vascular procedure *This response is based on the best information available as of 11/01/18.

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