September 5, 2019 Question: What is REBOA and how is it coded? Answer: REBOA is used in trauma for patients that are rapidly bleeding from injuries to the chest, abdomen or pelvis. A flexible catheter is placed in the femoral artery, advanced to the aorta and a balloon is inflated at its tip. This stops...
September 5, 2019 Question: Can we bill implantation of a trial neurostimulator (63650) with CPT code 95970 for the electronic analysis at the same time? Answer: Per CPT guidelines in 2019, Electronic analysis (95970) at the time of implantation is not separately reported. In addition, test stimulation to confirm correct target site placement of the...
September 5, 2019 Question: I billed 63655 (Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural) twice because I did laminectomies at T9, T10 and T11. I billed 63655 and 63655-59 but only 63655 was paid. Can you help me appeal? Answer: Actually, no we can’t help. CPT 63655 includes any number of levels of laminectomies...
September 5, 2019 Question: When can I report a debridement in addition to a graft? I performed a simple debridement with a full thickness graft of the trunk and reported 15200 and coded also for the debridement, but my coder told me I could not report the debridement. When can I report debridement separately? Answer:...
September 5, 2019 Question: Our physicians have instructed us to bill under a physician’s NPI number for all Advanced Practitioners (PA’s and NPs) for all patients for Medicare as we follow incident-to billing. We have been submitting claims for all new and established patient visits regardless of whether there is a physician in the office....
September 5, 2019 Question: I understand that the new FNA with ultrasound code, 10005, includes the ultrasound guidance for the FNA. But, can we also charge 76536? Answer: Yes, if you have performed a separate diagnostic ultrasound to support 76536. Remember, this is a radiology code. So if you are reporting 76536 without any modifiers...
September 5, 2019 Question: Our local hospital employs Physician Assistants. When our doctors are on call for the ED, the hospital-employed PA will call our doctor for their opinion and advice after seeing and evaluating the patient. At times our physician will go to the ED, see the patient and perform surgery. The question my...
September 5, 2019 Question: I’ve been dictating CPT and ICD-10-CM codes in my procedure note so that my coder knows what to bill. Recently, we had an insurance company call us out because the codes we billed were not the same as the codes in the procedure note. Now I am not sure what to...
August 22, 2019 Question: I’ve been dictating CPT and ICD-10-CM codes in my procedure note so that my coder knows what to bill. Recently, we had an insurance company call us out because the codes we billed were not the same as the codes in the procedure note. Now I am not sure what to do. What is...
August 22, 2019 Question: A patient presents to the office who meets Medicare’s definition for medical necessity for routine foot care. Nails are noted to be elongated and thickened, and hyperkeratotic lesions are noted to be on the right plantar heel and right foot second metatarsal head. The podiatrist debrides all ten nails and trims...
