Month: July 2020

New Patient Visit
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New Patient Visit

July 23 , 2020 Question: Is this a new patient visit? I saw a new patient last week in the ED for a wound infection and reported my service with the ED code 99284. He came into the office today for a new patient office visit. I documented a detailed history and examination and prescribed...

Endoscopic Septoplasty
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Endoscopic Septoplasty

July 23, 2020 Question: When I do an endoscopic septoplasty would I report both 31231 (nasal endoscopy) and 30520 (septoplasty)? Answer: We do not recommend reporting both codes. CPT says CPT 31231 (nasal endoscopy) denotes a “separate diagnostic procedure”. As such, it is not separately reported if any nasal/sinus definitive procedure (such as a septoplasty)...

Angiogram Billing for All Vessels Viewed
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Angiogram Billing for All Vessels Viewed

July 23, 2020 Question: Can we bill for all vessels mentioned if they are documented within the angiogram? Answer: No. You should only bill for vessels that are targeted and are medically necessary. Documentation alone doesn’t always mean that procedures are separately billable. *This response is based on the best information available as of 07/23/20.

Acupuncture Coverage
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Acupuncture Coverage

July 23, 2020 Question: My practice has decided to do acupuncture in our office. Does Medicare pay for acupuncture in 2020? Answer: Acupuncture CPT codes 97810-97814 are selected based on time and whether electrical stimulation is used. The only diagnosis currently that CMS covers is chronic low back pain. Medicare recently released Decision Memo for...

Removal of a Hemorrhagic Tumor
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Removal of a Hemorrhagic Tumor

July 23, 2020 Question: I did a craniotomy for removal of a tumor but it had a hemorrhagic component to it so I also removed the hematoma. Can I code for both the tumor removal and removal of intracerebral hematoma? Answer: No – the hematoma removal is considered “incidental” to the tumor removal. Therefore, you’d...

Lymph Node Biopsy
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Lymph Node Biopsy

July 9, 2020 Question: I took out 3 deep cervical nodes for biopsy on the left side. Can I bill 38510 x 3? Answer: No – you’d report 38510 once for any number of nodes removed from the same incision. *This response is based on the best information available as of 07/09/20.    

Are Wound Vacs Separately Reportable?
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Are Wound Vacs Separately Reportable?

July 9, 2020 Question: I’m a pediatric orthopedic surgeon.  Some of my team are reporting the NPWT codes 97605 and 97606 when applying wound vacs after closing at the completion of their surgical cases.  As a result, I am told by my coders that NCCI Standards of Medical Practice edits are being generated. The NCCI guidelines define the...

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