Month: October 2019

T9-11 Epidural Tumor Removal
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T9-11 Epidural Tumor Removal

October 17, 2019 Question: I did bilateral laminectomies at T9, T10, T11 and removed an epidural tumor. I billed 63276-50, 63276-50-59 and 63276-50-59 but got paid for only 63276-50. Should I have used modifier XS (separate site) instead of 59? Answer: CPT 63276 (Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic) involves removal of the...

Providing the exposure for a neurosurgeon. How is it coded?
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Providing the exposure for a neurosurgeon. How is it coded?

October 17, 2019 Question: A neurosurgeon asked my vascular surgeon to perform the exposure for an anterior spine procedure.  Does he report an exploratory lap his work? Answer: No. providing the exposure for a neurosurgeon for an anterior spine  procedure is co-surgery, since code 22558,  Arthrodesis, anterior interbody technique includes both the exposure/approach and the...

E/M and Fracture Manipulation
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E/M and Fracture Manipulation

October 17, 2019 Question: We have joined a new health system and the coding staff members (new to orthopaedics) are removing all E/M-57 services when reported with a fracture manipulation code. The coding staff members are stating these are inclusive to the fracture, as the physician has to evaluate the patient to determine if the...

APP Billing
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APP Billing

October 17, 2019 Question: Our physicians have instructed us to bill under a physician’s NPI number for all Advanced Practitioners (PAs and NPs) for all patients for Medicare as we follow incident-to billing. We have been submitting claims for all new and established patient visits regardless of whether there is a physician in the office....

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Therapy Billing: Be Sure Your Team Is Doing Things Right

Therapy Billing: Be Sure Your Team Is Doing Things Right AAOSNow – October 2019  by Sarah Wiskerchen, MBA, CPC Many orthopaedic surgeons are adding physical and occupational therapy services to their practices. This can be daunting for in-house billing teams, as they may lack experience with the new services, therapy terminology, and associated Current Procedural...

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Coding Errors Can Cost You Money and Potentially a Sale

Coding Errors Can Cost You Money and Potentially a Sale Healio Orthopedics – October 2019  by Karen Zupko As more orthopedic practices are approached for potential acquisition, our firm is engaged by buyers and sellers to evaluate the accuracy of coding and documentation, and the efficiency of the revenue cycle. What we’re seeing in many...

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