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...
April 30, 2020 Question: We cannot locate a response from any reliable coding resource about how to bill telephone calls lasting more than 30 min. Do you have any guidance on this topic? Answer: Although telephone calls for both new and established patients are temporarily billable during the current COVID-19 public health emergency, there is...
April 16, 2020 Question: What is the place of service for telehealth visits? Answer: For Medicare, on all claims for dates of service March 1, 2020, and forward through the duration of the current public health emergency, use the place of service code where the provider would have normally performed the face-to-face service (e.g., 11,...
April 2, 2020 Question: Do we have to use start and stop times or can we use minutes when billing by time for telemedicine visit? Answer: Exact minutes documented within the permanent record are sufficient, as there is no indication that start and stop times are required for telemedicine visits. *This response is based on...
March 19, 2020 Question: I did a biopsy of the breast defect before doing the reconstruction. Can I also code for the breast biopsy? Answer: A biopsy from the same surgical location as a primary procedure (breast reconstruction) is not separately reported. *This response is based on the best information available as of 03/19/20.
March 5, 2020 Question: We have a patient who is a year status post breast reconstruction and not we are going to do fat grafting to her right breast. We typically do two to three stages. I was told to use modifier 58, for staged procedure, on all claims even the first one. Is this...
