April 2, 2020 Question: I heard that Medicare patients don’t have to pay their deductible or coinsurance if they have a telemedicine visit. Is this true? Answer: Medicare is not waiving deductibles or co-insurance. However, they are allowing providers to do so at their discretion without penalty for telemedicine visits. This means the provider will...
March 19, 2020 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 and, if so, how to integrate them into our office processes. Answer: An LCD is a Local Coverage Determination. These...
March 5, 2020 Question: I’m a general surgeon. Some of my team are reporting the negative pressure wound therapy codes 97605 and 97606 when applying wound vacs after closing at the completion of their surgical cases. As a result, I am told by my coders that billing for these wound vacs is not appropriate, since there...
February 20, 2020 Question: In the past, when I did a total thyroidectomy and I needed to re-implant a parathyroid gland I would also code 60512. I am now being told by my coders that I cannot code 60512 if I implant a parathyroid gland in the sternocleidomastoid muscle. They say I can only charge...
February 6, 2020 Question: If a code does not specify whether the procedure described is laparoscopic or open, is it acceptable to use it if the procedure was performed laparoscopically? Answer: No. Laparoscopic codes will always have the term “laparoscopic” in the code description. If there is no laparoscopic code for a procedure you performed...
January 23, 2020 Question: How do I report placement of a mesh implant in the abdomen that is not a biological implant and not for an open incisional hernia? Answer: Placement of a non-biological implant in the abdomen is reported with code +0437T Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of...
January 9, 2020 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...
December 19, 2019 Question: Can you give guidance on CPT 15860 as it pertains to colorectal surgery? My surgeons have been using this code when they use the isocyanine green fluorescence imaging either with the robot (Firefly) or open (SpyPhi). They are saying this code is relevant because they are assessing vascular flow in a...
December 5, 2019 Question: What happened to the skin biopsy codes? I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.” Answer: CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the follow six new codes: 11102 Tangential biopsy of skin (eg,...
November 14, 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...
