November 14, 2019 Question: Do the free flap breast reconstruction codes, 19364 and S2068, allow billing for surgeon, co-surgeon and assistant? Answer: CPT 19364 does allow payment for the surgeon, co-surgeon (modifier 62) and assistant surgeon (modifier 80, 82 and AS). However, many payors do not recognize modifiers 62, 80, 82 and/or AS on S2068....
October 31, 2019 Question: A patient had bilateral breast augmentation 5 weeks ago. She developed some drainage out of the lateral aspect of her left breast inframammary incision. The area was probed in the office with a Q-tip and it communicated with the implant pocket so I did a wash out of the left...
October 17, 2019 Question: My doctor specializes in breast reconstruction and has been asking me to bill 19328 (removal of intact breast implant) along with 19371 (capsulectomy) when he has to do a capsulectomy and remove the implant. It has come to my attention that this may be wrong and that 19328 is included in...
October 3, 2019 Question: My doctor has introduced us to a code he would like to bill. I have researched this pretty heavily and included another coder in the research and she could find no reason why we could not code it. However, I have found that our billing system is sometimes giving me a...
September 19, 2019 Question: Someone told me we can bill CPT 23395 (Muscle transfer, any type, shoulder or upper arm; single) when I do a DIEP flap. I checked it out with our compliance department and they said there are no Medicare bundling edits between the two codes so it should be alright. I thought...
September 5, 2019 Question: When can I report a debridement in addition to a graft? I performed a simple debridement with a full thickness graft of the trunk and reported 15200 and coded also for the debridement, but my coder told me I could not report the debridement. When can I report debridement separately? Answer:...
August 22, 2019 Question: What code should we use for a chemical peel of less than the entire face? Answer: CPT codes 15788 (Chemical peel, facial; epidermis) and 15789 (Chemical peel, facial; dermis) are reported for peels of the entire face. There is no code for less than the entire face. When a chemical peel...
August 8, 2019 Question: Is the correct code for microdermabrasion 15780 or some other code? Answer: CPT code 15780 (Dermabrasion; total face) is for total face dermabrasion using a tool that penetrates into the dermis. Microdermabrasion only involves the epidermis, so CPT code 15783 (Dermabrasion; superficial, any site) is the correct code to report for...
July 25, 2019 Question: A patient presents for division and inset of a neck-to-ear pedicle flap. Should we report 15620 or 15630? Answer: The CPT codes reported for the division and inset are chosen by the permanent inset site, not the donor site. So in your case, CPT code 15630 (Delay of flap or sectioning...
July 11, 2019 Question: If our docs perform two adjacent tissue transfers on two separate lesions in the same anatomic group by CPT standards, do we add the ATTs together and report one code like with the repair codes? Answer: No, if two lesions from the same anatomic group are removed and both require separate...
