Month: February 2019

Laparoscopic Pyloroplasty
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Laparoscopic Pyloroplasty

February 28, 2019 Question: How is a laparoscopic pyloroplasty reported? Can I use code 43800, Pyloroplasty? Answer: No, codes without the term laparoscopic in their description are intended as open codes and 43800 is an open code. There is no laparoscopic code for pyloroplasty so an unlisted code 43659 unlisted laparoscopic procedure, stomach, must be...

Skin Biopsy Codes
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Skin Biopsy Codes

February 28, 2019 Question: What happened to the skin biopsy codes?  Answer: CPT deleted CPT codes 11100 and 11101 and replaced them with six new codes: 11104 Punch biopsy of skin (including simple closure, when performed); single lesion (NF Allowable $143.48) +11105    each separate/additional lesion (List separately in addition to code for primary procedure)...

Skin Biopsy Codes
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Skin Biopsy Codes

February 28, 2019 Question: What happened to the skin biopsy codes?  I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.” Answer: CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the follow six new codes: Note that tangential biopsies are partial...

Debridement Coding
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Debridement Coding

February 28, 2019 Question: If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as 11042 and 11042-59 or 11042 RT and 11042 LT? Answer: If debridement is performed at the same depth of tissue (all subcutaneous tissue) it is...

Spinal Accessory Nerve Injection
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Spinal Accessory Nerve Injection

February 28, 2019 Question: What CPT code do I use to report a spinal accessory nerve injection? Answer: CPT code 64999 (unlisted) is reported for the injection of a spinal accessory nerve.  The CPT code previously used was CPT 64412 which was deleted in 2016. *This response is based on the best information available as...

Allergy Testing ICD-10-CM Coding
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Allergy Testing ICD-10-CM Coding

February 28, 2019 Question: I have a question on billing for allergy testing. All this time, and for any patient getting allergy testing, ICD-10 code J30.1 (Allergic Rhinitis due to pollen) has been the diagnosis code we are using. At the recent KZA workshop ICD-10 code Z01.82 (encounter for allergy testing) could also be used, but...

Bone Graft
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Bone Graft

February 28, 2019 Question: My surgeon performed a repair of a nonunion with bone graft harvested via a separate incision.  The surgeon submitted CPT code 25431 alone.   I added CPT code 20902 after reviewing the operative note, because the surgeon obtained the bone graft from a distant site via a separate incision.   My surgeon disagrees...

Telemedicine 101: When, Where, and How to Use It
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Telemedicine 101: When, Where, and How to Use It

February 27, 2019 My first experience with using telemedicine in orthopedics was in August 2015. I had performed an anterior cruciate ligament reconstruction on a 17-year-old male named Tom, who lived about 90 miles from our hospital. A week later, during a casual conversation with his father, I learned that Tom was doing well recovering...

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