December 3, 2020 Question: My physician placed a permanent neurostimulator via laminectomy 6 days after the trial neurostimulator. I know I need to append a modifier to CPT code 63655 but do I use Modifier 78 or 79? Answer: You would not use either one. You would use Modifier 58 which is a staged or...
December 3, 2020 Question: Someone told us to bill 23395 for repairing the pectoralis muscle after removing breast implants. Here’s the common scenario: Removal of old bilateral breast implants with capsulectomies Repair of pectoralis muscle with re-attachment to chest wall Creation of pre-pectoral pocket with acellular dermal matrix Placement of bilateral breast implants for reconstruction...
December 3, 2020 Question: If the surgeon uses a covered stent and performs an embolization on a patient with a pseudoaneurysm, can we bill for both the stent and removal of the embolus? Answer: If a covered stent is deployed as the sole management of an aneurysm, pseudoaneurysm or vascular extravasation, then the stent deployment...
December 3, 2020 Question: Our surgeon performed a reconstruction of a patella dislocation and also did an arthrotomy of the knee with a lateral retinacular release. Our surgeon wants to report 27420 and 27425. When I look at the NCCI edits, I see there is an edit between the two codes. Am I allowed to...
December 3, 2020 Question: I did a right anterolateral thigh free flap and had to close the right thigh wound (4 x 8 cm) with undermining in either direction to close the wound without any significant tension. Can I also code a complex repair (13100, +13101) with the free flap code? Answer: Bringing the wound...
December 3, 2020 Question: I am new to Dermatology coding and need some help. The previous coder told me for CPT 11055 (paring or cutting) that if more than one is removed we bill the codes 11055 and 11056? My physician removed 4 calluses by cutting and I billed CPT 11055 and 11056. The claim...
December 3, 2020 Question: Our surgeon insists on billing for 49002 reopening of a recent laparotomy and a 44005 lysis of adhesions, since the case is complicated because the laparotomy was only 60 days ago. Can he bill for both in any circumstance? Answer: Although this was a reopening of a recent laparotomy, lysis of...
December 3, 2020 Question: What’s the best way to code a retrosigmoid approach and removal of a meningioma at the cerebellopontine angle? Should I use 61519 or 61520? Answer: CPT 61520 (Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor) is more accurate since it better describes the location of the...
November 12, 2020 Question: My coder just told me about the new guidelines for 2021 office visit codes. She said I no longer have to document a History. This doesn’t seem right to me. Answer: You are wise to ask because that’s not exactly true. It is correct that the History will no longer be...
November 12, 2020 Question: My coder just told me about the new guidelines for 2021 office visit codes. She said I no longer have to document a History. This doesn’t seem right to me. Answer: You are wise to ask because that’s not exactly true. It is correct that the History will no longer be...
