June 30, 2022 Question: I heard someone say the 2022 CPT manual will be updated in July with new codes. I have never heard of this before. Is this a rumor or will there be a new CPT Manual released in July? Answer: No, there will not be any changes to the 2022 AMA CPT...
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...
June 2, 2022 Question: We are looking at CPT code 0707T for reporting subchondroplasty in our practice. We have never billed a Category III code and do not know how to set the fee. Answer: Setting the fee for the Category III code will follow the same methodology as an unlisted procedure code. KZA recommends...
May 19, 2022 Question: We are an academic orthopaedic practice with an orthopaedic GME-approved residency program in a large metropolitan city. We were just informed we have been incorrectly reporting E&M codes 99202-99215 to Medicare since January 2022. We select the level of service based on MDM or time, as we understood this to be...
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...
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...
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...
March 24, 2022 Question: Our surgeon documented an interposition arthroplasty and removal of both the trapezoid and trapezium bones. I reported CPT code 25447 for the arthroplasty and 25210-59 for the removal of the trapezoid (in this case the second bone). I know CPT code 25447 includes the removal of one bone but not both....
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...
February 24, 2022 Question: Can we code a laminectomy for disc herniation, such as 63030 or 63042, with a TLIF/PLIF code (22630, 22633)? Answer: Good question! There was an update in CPT 2022 to this very complicated and lengthy issue. No – a discectomy may not be separately reported (e.g., 63030, 63042, 63056) since it...
