September 17, 2020 Question: I work with a plastic surgeon and we don’t see many Medicare patients. The plastic 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! The revised documentation requirements are from CPT – the...
September 3, 2020 Question: At the time of the second stage tissue expander exchange, my plastic surgeon wants to bill 19380 for either liposuction, removing excess scar tissue, removing redundant excess skin or removing adipose tissue. “The lateral aspect of the mastectomy scar is excised along with redundant skin and subcutaneous tissue to revise the...
August 20, 2020 Question: My Plastic Surgeon is asking about breast reconstruction coding. We use either S2068 and or 19364 depending on the payor. Will these codes allow a co-surgeon (modifier 62) and assistant surgeon (modifier 80) for a total of 3 billed surgeons? When asking providers I can’t seem to get a clear answer....
August 6, 2020 Question: My doctor documents “significant undermining” to the free flap donor site (radial forearm) for an advancement flap. Can I also code an adjacent tissue transfer code such as 14060 for the closure? Answer: Actually, undermining is not considered an adjacent tissue transfer code (14xxx). CPT guidelines require a secondary defect to...
July 23, 2020 Question: Can we report 35701 for the carotid vessel exploration in the recipient site when doing a fibula free flap (20969)? Answer: No, this activity is included in the free flap code. CPT specifically states not to 35701 to explore and identify a recipient artery [eg, external carotid artery] when performed in...
July 9, 2020 Question: I did a right anterolateral thigh free flap and had to close the right thigh wound (4 x 8 cm) with undermining of additional 3 cm in either direction to close the wound without any significant tension. Can I also code a complex repair (13100, +13101) with the free flap code?...
June 25, 2020 Question: I did a partial excision of the left ear wedge with a layered closure. Can I code 69110 and a complex repair code since 69110 says “simple repair”? Answer: CPT 69110 includes the direct closure (bringing wound edges together) because it says “simple repair” so that would include a simple, intermediate...
June 11, 2020 Question: During the post-operative global period following breast reconstruction the patient presents with a seroma. Can I bill for the seroma excision and also bill for an office visit since it is a new problem? Answer: Medicare says treating the patient for issues related to the procedure, such as a seroma, are...
May 28, 2020 Question: Hello! I have a plastic surgery question. I perform DIEP surgeries and when I do a bilateral DIEP I have a colleague scrub with me, and one of us will do the belly dissection while another does the chest dissection. We are both plastic surgeons. At my previous institution we were...
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...
