Category: Coding Coach

Ear Biopsy
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Ear Biopsy

May 23, 2019 Question: What is the correct code for a tangential biopsy of the antihelical fold?  I was going to bill 11102, but I was told that there are different codes in other sections of CPT for some biopsies. Answer: The correct code would be 69100, Biopsy external ear.  As a bonus, this correct...

OOOPs. I nicked a vessel. Can I bill for repairing it?
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OOOPs. I nicked a vessel. Can I bill for repairing it?

May 23, 2019 Question: The surgeon accidentally nicked a vessel not involved in the bypass being performed, can he bill for repair of vessel since he had to repair it? Answer: Iatrogenic, intraoperative complications that are repaired at the same operative session are not separately reported. Since the vessel laceration was an iatrogenic injury, inadvertently...

Nerve Repair
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Nerve Repair

May 23, 2019 Question: I know that CPT code 64910 is the code I report for a nerve repair of the spine.  My question is when performing this procedure on three levels how to I report this. Answer: You would report CPT code 64910 for each level.  Since the second and third levels are bundled...

E-Consults?
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E-Consults?

May 23, 2019 Question: One of my colleagues told me that she was doing e-consults with other physicians for Medicare and getting paid.  Is this a billable service? Answer: Yes!  Medicare has added CPT codes 99446-99452 for interprofessional/ telephone/internet/electronic health record (EHR) consultations to the fee schedule, so they are now payable services.  These are...

Use of a Scribe
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Use of a Scribe

May 23, 2019 Question: We are hiring a scribe for the doctor because it will help improve his documentation.  Is there anything we need to know about how to document this? Answer: Yes, absolutely. This situation should be clearly delineated so a third party reviewer can identify the provider who performed the service, and the...

Coding for Platelet-Rich Plasma Injections in the Spine
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Coding for Platelet-Rich Plasma Injections in the Spine

May 23, 2019 Question: We are starting to do platelet-rich plasma injections in the spine.  Would we bill 64483?  Answer: No because 64483 is specifically for an “anesthetic agent and/or steroid” injection.  The most accurate code is 0232T (Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed).  Be sure to...

Modifier 78 vs 59
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Modifier 78 vs 59

May 9, 2019 Question: What modifier do we use if a patient is returned to the OR the same day as the original surgery for post-op hemorrhage? Isn’t it 78 for this complication? Answer: Modifier 78 is a global period modifier and the global period begins on post-op day one. So it is not appropriate...

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Coding Coaches