Category: CC-Orthopaedics

Knee Ligament Repair vs Reconstruction
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Knee Ligament Repair vs Reconstruction

June 16, 2022 Question: What type of graft or fixation material is required to report open extra-articular knee ligament reconstruction code 27427? Our physician is listing “MCL repair” and “MCL reconstruction” within the same operative note. It first describes repair of the ligament using Suture Tape. In a separate paragraph the physician describes insertion of...

Grafts/Implants
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Grafts/Implants

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...

Tendon Repair
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Tendon Repair

April 21, 2022 Question: I am new to orthopaedic hand coding. I have a case where the surgeon repaired two flexor tendons in the finger. I am being told that I may only report one CPT code because they were both repaired via the same incision. Is this correct? The surgeon, who is new, disagrees...

Prolotherapy
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Prolotherapy

April 7, 2022 Question: Our sports medicine physician is planning to perform a Prolotherapy procedure on a patient who has tendinitis. The physician would like to know what CPT code to report. Answer: There is no Category I or Category III CPT code for Prolotherapy; however there is a HCPCS code M0076. Medicare does not...

Billing Additional Pre-op Visit
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Billing Additional Pre-op Visit

March 10, 2022 Question: Our surgeon placed a patient on the OR schedule as an inpatient case. The surgery was elective and not an emergency case. The patient’s case was canceled because our hospital limited inpatient elective OR cases due to the spike in COVID 19 cases in our area. The patient is now being...

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