Month: January 2019

Does Your Fee Quote Need a Facelift?
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Does Your Fee Quote Need a Facelift?

January 22, 2019 I find that the start of a new year is a good time to review a few essential tools and processes, to ensure they are up to date and make your practice shine. One of the most important is the fee quote. We review about a hundred aesthetic fee quotes every year, and...

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Understand CMS Advanced Billing Practitioner Professional Billing

Understand CMS Advanced Billing Practitioner Professional Billing ICD-10 Monitor – January 2019  by Deb­o­rah Grider Not billing the APP service can result in serious revenue cycle errors. Many providers are still struggling with the non-physician practitioner (NPP) billing rules from the Centers for Medicare & Medicaid Services (CMS). Most facilities are now referring to NPPs as...

Revision Rhinoplasty
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Revision Rhinoplasty

January 17, 2019 Question: We can’t get a revision rhinoplasty paid.  Is it ok if we use the septoplasty code with modifier 22? Answer: No.  These procedures should be prior authorized in writing to ensure payment.  If you cannot obtain written approval from the payor prior to surgery, then we recommend you treat the patient...

Spinal Neurostimulators
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Spinal Neurostimulators

January 17, 2019 Question: My physician inserted a permanent spinal neurostimulator and we used CPT 64655.  He also billed CPT 95970 for the electronic analysis at the same operative session.  Is this the correct way to bill for the permanent placement and the analysis? Answer: The electronic analysis at the time of implantation is not...

Fem- Fem Bypass
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Fem- Fem Bypass

January 17, 2019 Question: How is a left femoral to right femoral artery bypass with PTFE reported? Answer: Report code 35661, Bypass graft, with other than vein, femoral- femoral. This code applies to fem-fem bypass in the same leg or from one leg to the opposite leg. *This response is based on the best information...

What is Simple?
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What is Simple?

January 17, 2019 Question: The incision and drainage codes 10060-10061 and 10080-10081 have one code for simple and one for complicated.  Does CPT define what is simple and complicated? Answer: No, CPT does not define them.  The AMA states that it is up to the physician’s discretion based upon the complexity of the incision and...

New or Established Patient
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New or Established Patient

January 17, 2019 Question: I am new to Orthopaedics. I am in a practice that employs a joint specialist, spine specialist and a pediatric orthopaedic surgeon in addition to general orthopaedic surgeons.   Do the new patient rules apply to each of these specialties? For example, a patient is first seen by the general orthopaedic surgeon...

Re-Do Discectomy
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Re-Do Discectomy

January 17, 2019 Question: Hello Kim!  Could please help me verify the best code to use?  This op note states it is a re-do discectomy but this is the first time my neurosurgeon has done a procedure on this patient. My question is…since my doctor did not do the first procedure, would I bill this...

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