July 11, 2019 Question: What CPT codes do I use for comparison when the surgeon performs a superior capsular reconstruction? I know I have to use an unlisted code. Answer: Great job in knowing that this procedure is reported with an unlisted code. The AAOS recommends comparing this procedure to CPT codes 29827 and 29806. ...
June 20, 2019 Question: I perform an arthroscopic repair of the supraspinatus and subscapularis tendons through separate incisions/portals. May I report CPT code 29827 twice? Answer: CPT code 29827, arthroscopic rotator cuff repair is reported one time regardless of whether one or all four tendons are repaired. Consider adding modifier 22 for the additional complexity...
June 6, 2019 Question: We are in a state that must report CPT code 99024 to Medicare for the defined procedures. I perform the surgical procedure but one of my partners rounds for me in the hospital. Is it appropriate for my partner to submit CPT code 99024 even though I did the surgery? I...
May 23, 2019 Question: If a cubital tunnel release is performed by endoscopy how should it be reported? We report 64718 when it’s performed as an open procedure. Just not sure how to report it when it is done by endoscope. Answer: Thanks for your submission. There is currently no Category I CPT code for...
May 9, 2019 Question: A patient presents with a CD of an X-Ray that was performed at another institution that was previously read by the radiologist. If one of my surgeons reads the X-Ray I can we bill for the second reading? Answer: No, reading an X-Ray that was taken elsewhere, and previously interpreted by...
April 25, 2019 Question: My surgeon did a C2-C7 laminoplasty and reconstructed with mini-plates. What code should I use? Answer: This procedure is reported using CPT 63051 (Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and...
April 11, 2019 Question: I appreciate your patience in answering my questions. I understand the E&M scenarios so let me throw in another type of call coverage relationship. Recently, I returned a patient to the OR for the physician I was covering; the patient had dislocated their hip after a hip arthroplasty. I reported CPT...
March 28, 2019 Question: Thanks for answering my question last time – I get it now that I would not charge for rounding on post-op patients of my call partners. What about non-surgical patients? Occasionally we may have a patient hospitalized with a non-operative condition such as septic arthritis for IV antibiotics that require evaluation...
March 14, 2019 Question: I have just a quick question regarding weekend rounding. I share weekend call with another practice that I am not affiliated with. We sign off our patients to each other when we cover our respective calls. Sometimes when rounding I check on 5-10 of their patients, some of which are their...
February 28, 2019 Question: My surgeon performed a repair of a nonunion with bone graft harvested via a separate incision. The surgeon submitted CPT code 25431 alone. I added CPT code 20902 after reviewing the operative note, because the surgeon obtained the bone graft from a distant site via a separate incision. My surgeon disagrees...
