September 5, 2019 Question: I understand that the new FNA with ultrasound code, 10005, includes the ultrasound guidance for the FNA. But, can we also charge 76536? Answer: Yes, if you have performed a separate diagnostic ultrasound to support 76536. Remember, this is a radiology code. So if you are reporting 76536 without any modifiers...
August 22, 2019 Question: We have a new ENT and he’s doing a procedure my other guys don’t perform. The patient goes to radiology for injection of radioactive isotopes then to the operating room where he then excises the skin cancer and then injects blue dye and uses a gamma probe to identify a sentinel...
August 8, 2019 Question: What happened to the skin biopsy codes? I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.” Answer: CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the follow six new codes: 11102 Tangential biopsy of skin (eg,...
July 25, 2019 Question: When you inject Botox for migraine headaches, can you bill the injection code more than one time? We normally go about this as a cosmetic procedure, but I just wanted to look into this to see if I could bill out CPT code 64615 for each muscle group that is injected?...
July 11, 2019 Question: What’s the best way to do the diagnosis coding for postop visits? I mean, does it really matter since we aren’t billing for a visit? Answer: The ICD-10-CM guidelines for postop/aftercare include the following: If the original diagnosis is trauma (eg, using an S diagnosis code) or a code that requires...
June 20, 2019 Question: Can I bill for taking the patient back to the OR to explore and repair post-op hemorrhage on day 3 post-op? I heard that all complications are included in the payment of the original surgery. Answer: Yes, you may bill for this. CPT and Medicare agree that taking the patient back...
June 6, 2019 Question: I’ve been dictating CPT codes in the operative note so that my coder knows what to bill. Recently, we had an insurance company call us out because the codes we billed were not the same as the codes in the operative note. Now I am not sure what to do. What...
May 23, 2019 Question: My work RVUs are down this year. I do a lot of inferior turbinate submucous resection surgery and I code 30140 (Submucous resection inferior turbinate, partial or complete, any method). I noticed that the wRVUs for 30140 are now 3.00 and last year they were 3.57. This is a big hit...
May 9, 2019 Question: When would I ever use G0268 for cerumen removal vs 69210? Answer: G0268 is a HCPCS II code for “Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing” while CPT code 69210 says “Removal impacted cerumen requiring instrumentation, unilateral.” Historically, G0268...
April 25, 2019 Question: We are receiving denials for 31237, performed right after endoscopic sinus surgery, stating we did not get prior approval and there was no documentation stating the need for the debridement in my office notes. Have you heard of this? Answer: Yes. Some payors require precertification for this surgical procedure even when performed...
