September 17, 2020 Question: Our physicians are looking at purchasing generic Hyaluronan instead of purchasing the name brand Orthovisc or MonoVisc for example. In doing research, I am not finding any NDC codes or HCPCS codes that specifically address the generic Hyaluronan. I also came across this list of Hyaluronic Acid Derivatives. If I am...
September 3, 2020 Question: Which CPT code is used 20550 or 20551 for a trigger finger /A1 pulley injection? Answer: CPT code 20550 defines an injection to a single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia”). CPT code 20551 defines an injection to single tendon at the origin/insertion site. Trigger finger injections are most...
August 6, 2020 Question: I am new in orthopaedics and am reviewing an operative note. The patient had a total knee arthroplasty five years prior to this surgery. The patient presented with patellofemoral knee pain and was taken to the OR for a chondroplasty and partial synovectomy were performed. The post-operative diagnosis, other than S/P...
July 23, 2020 Question: I work with a sports surgeon and we see just a few Medicare patients. The surgeon believes the revised 2021 E/M guidelines will not impact our office practice because of our low Medicare volume. Is this correct? Answer: This is not correct, but it is a common misconception. The revised documentation...
July 9, 2020 Question: I’m a pediatric orthopedic surgeon. Some of my team are reporting the NPWT 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 NCCI Standards of Medical Practice edits are being generated. The NCCI guidelines define the...
June 25, 2020 Question: I am a pediatric orthopaedic surgeon and many of my patients are too young to give a history. My coders have never given me medical decision making (MDM) credit because they say it is part of dealing with children. Is there anything in the 2021 CPT guidelines for outpatient E/M services...
June 11, 2020 Question: I am writing on behalf of myself and my other Orthopedic coding colleagues regarding tarsal tunnel injections. We have done some research on this and cannot find a concrete answer on what CPT code to use for the injection. Are we to be using 64450 or 28899? Answer: According to the...
May 28, 2020 Question: What is the correct code to report for the insertion and subsequent lengthening of the VEPTR device? Answer: VEPTR is the abbreviation for Vertical Expandable Prosthetic Titanium Rib Currently there are no codes for this procedure, where the device is typically attached to the ribs, spine or pelvis. Report an unlisted...
May 14, 2020 Question: Since we have to bring the patients back in for COVID testing and H&P for Joint Commission, can we bill for this visit even though it’s another pre-op visit? Answer: Yes, since the patient was rescheduled due to the pandemic and needs to be seen for a COVID swab prior to surgery,...
April 30, 2020 Question: Our physician conducted a face-to-face telemedicine encounter with an established patient this week. The physician evaluated the patient who had fallen two days prior to the encounter and reviewed online X-Rays from the Urgent Care. His diagnosis was non-displaced right clavicle fracture; he agreed with the treatment plan initiated in the...
