May 19, 2022 Question: I had to take a patient back to the operating room 6 weeks after breast reduction to excise a small dehiscence and close the wound. Can I bill for this? Answer: Yes, you may bill for the service and you’ll need to use modifier 78 (return to the OR for a...
May 19, 2022 Question: I’m confused about how to code the catheterization with the new EVAR codes. We still do a bilateral catheterization of the aorta. Can we code 36200 bilaterally? Answer: The new EVAR codes, updated and completely changed in 2018, bundle the aorta catheterization with the main body placement, so 36200, non-selective arterial...
May 19, 2022 Question: We are an academic orthopaedic practice with an orthopaedic GME-approved residency program in a large metropolitan city. We were just informed we have been incorrectly reporting E&M codes 99202-99215 to Medicare since January 2022. We select the level of service based on MDM or time, as we understood this to be...
May 19, 2022 Question: Since we have to bring the patients back in for COVID testing and H&P for Joint Commission, can we bill for this visit even though it’s another pre-op visit? Answer: Yes, since the original surgery was canceled and is now under consideration for rescheduling due to the pandemic and needs to...
May 19, 2022 Question: The new guidelines that are coming out in 2021 for all types of E/M services, right? Answer: No. The new guidelines are for office/outpatient visit codes only (99202-99215). You will still need to use the current guidelines for all other E/M services, even consultations in the office. *This response is based...
May 19, 2022 Question: I did an inpatient consultation and coded 99253 (non-Medicare). I did not need to follow the patient so I signed off. They asked me to re-consult a week later. What is the code for a re-consult? Answer: There are no specific E/M codes for an inpatient re-consultation. You’ll use the subsequent...
May 5, 2022 Question: What code do use when our pain doctor sees a patient in the emergency department for a consultation at the request of the ED physician? Our pain doctor treated the patient and discharged the patient from the ED. Answer: Since the patient was not admitted your physician to the hospital you...
May 5, 2022 Question: One of our spine surgeons has asked me to help with an upcoming case. The patient is obese and has had multiple prior spine procedures. The spine surgeon would like me to close using bilateral paraspinal muscle flaps. How do I code the procedure and will I even get paid? Answer:...
May 5, 2022 Question: We have an office-based vein center and have heard that something called LCDs should be followed before a procedure is performed. We’re not sure what these are or if they are important—if so, how do we integrate them into our office processes? Answer: An LCD is a Local Coverage Determination. These...
May 5, 2022 Question: I know in years past from attending KZA/ AAOS workshops that the instructors taught that bone grafts (CPT code 20900 and 20902) were only reportable if the graft was harvested via a separate incision. Our surgeon recently did an arthroplasty procedure and harvested local bone to fill in bone voids. The...
