August 6 , 2020 Question: What HCPCS codes can I report when the physician administers EXPAREL after the procedure in the office? I cannot find the code. Answer: Exparel is a nerve block and is sometimes used in the office as part of the surgical procedure and is included in the practice expense for the...
August 6, 2020 Question: My surgeon performed all the components of a Hartmann procedure 44143 but did not create a colostomy. Can we use 44143 with a -52 modifier? Answer: The correct code for this procedure would be 44140. Code 44140 is the base code for 44143 with the only difference being a skin level...
August 6, 2020 Question: Our vascular surgeon documented a single intervention for a lesion that crosses the margin between the fem/pop and tibial/peritoneal territories. Should we bill one code or one for each territory? Answer: You would bill one code since a single intervention was performed. *This response is based on the best information available...
August 6, 2020 Question: My doctor documents “significant undermining” to the free flap donor site (radial forearm) for an advancement flap. Can I also code an adjacent tissue transfer code such as 14060 for the closure? Answer: Actually, undermining is not considered an adjacent tissue transfer code (14xxx). CPT guidelines require a secondary defect to...
August 6, 2020 Question: I cannot find a CPT code to report using a device to deliver medication through the nose when a sphenopalatine ganglion block is performed under fluoroscopic guidance for patients with migraine headaches. Can you provide me with the correct CPT code? Answer: There is no specific CPT code that accurately describes...
August 6, 2020 Question: How do I code for repair of a C6-7 fracture/dislocation where I did a laminectomy for decompression to repair the fracture as well as an arthrodesis? Answer: You’ll use CPT 22326 (Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical) for the...
August 6, 2020 Question: I am new in orthopaedics and am reviewing an operative note. The patient had a total knee arthroplasty five years prior to this surgery. The patient presented with patellofemoral knee pain and was taken to the OR for a chondroplasty and partial synovectomy were performed. The post-operative diagnosis, other than S/P...
August 6, 2020 Question: Our coder recently attended one of your coding courses and her takeaway was that it was better to bill cerumen removal using an E/M code rather than 69210. Do you remember that discussion? Do you agree? Answer: No – good grief! This is an example of “people hear what they want...
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...
July 23, 2020 Question: I work with a sports surgeon and we see just a few Medicare patients. The surgeon believes the revised 2021 E/M guidelines will not impact our office practice because of our low Medicare volume. Is this correct? Answer: This is not correct, but it is a common misconception. The revised documentation...
