Category: CC-Orthopaedics

Dislocation CPT Codes: Traumatic vs Non-traumatic
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Dislocation CPT Codes: Traumatic vs Non-traumatic

January 9, 2020 Question: Is it appropriate to report CPT code 28645 for both traumatic and non-traumatic dislocations? Answer: Yes, CPT code 28645 (Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed) may be reported whether the nature of the dislocation is traumatic or non-traumatic, as long as the dislocation required an open...

Osteoporosis Clinic
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Osteoporosis Clinic

December 19, 2019 Question: We have an osteoporosis clinic where our providers see patients on referral. Many times this referral comes from our own colleagues after the patient is seen through the ED for a fracture. A consult and global fracture care is billed in the ED by the first provider, and the referral is...

Periacetabular Osteotomy
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Periacetabular Osteotomy

December 5, 2019 Question: We have a new pediatric orthopaedic surgeon who has joined our practice. He recently performed periacetabular osteotomies for hip dysplasia. He wants us to report CPT codes 27228 and 27146 x3 for this procedure based on information he received during his fellowship training. We have told him that we must report...

Is a 99214 supported?
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Is a 99214 supported?

November 14, 2019 Question: We have patients who return to the clinic for results of MRI or other diagnostic tests.  The physician performs a repeat exam, reviews the images, and makes a decision for surgery.  We always code these as level four established visits because of the decision for surgery. Our question is, if the...

Modifier 58 or 78
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Modifier 58 or 78

October 31, 2019 Question: We have a patient scheduled for manipulation under anesthesia for arthrofibrosis during the post-operative period for a total knee arthroplasty. The patient was informed prior to the TKA surgery that they may need to have the manipulation done post op. Is it appropriate to use modifier 58 for the manipulation because...

E/M and Fracture Manipulation
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E/M and Fracture Manipulation

October 17, 2019 Question: We have joined a new health system and the coding staff members (new to orthopaedics) are removing all E/M-57 services when reported with a fracture manipulation code. The coding staff members are stating these are inclusive to the fracture, as the physician has to evaluate the patient to determine if the...

Hematoma I&D with Fasciotomy
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Hematoma I&D with Fasciotomy

October 3, 2019 Question: Our surgeon performed an I&D of a hematoma in the same compartment as an anterior and lateral fasciotomy in the leg for compartment syndrome. I submitted a code for the I&D in addition to the fasciotomy code and the surgeon removed the I&D code, stating it would be inclusive to the...

Stem Cell Implant Knee Osteoarthritis
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Stem Cell Implant Knee Osteoarthritis

September 19, 2019 Question: Our surgeons are harvesting adipose tissue and creating an injectable implant that they are injecting in the knee for treatment of osteoarthritis. We want to verify that our use of an unlisted CPT code is correct. We have some payors who do reimburse for this service; others require the patient to...

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