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...
February 20, 2020 Question: For patients that are having surgery that day, I’ve been doing pre-op visits that morning (coming in earlier), and not doing a preop visit in clinic the week before surgery. Can I bill a follow up visit for the meeting/note (H&P) that occurs the morning of surgery? Answer: No – a...
February 6, 2020 Question: I sent a patient out to the hospital for a CT scan and the patient brought in the actual images and the radiologist’s report for me to review. Can I charge 76140 (Consultation on X-ray examination made elsewhere, written report) when I personally interpret those images and write my own report?...
January 23, 2020 Question: My physician is utilizing an open laceration on the patient’s chin for open reduction of a mandibular symphysis fracture and he wants to also charge for a complex laceration repair for that laceration. Is this billable or is it part of the ORIF code? Answer: If the fracture is repaired through...
January 9, 2020 Question: Can you refresh my memory on when to use the diagnosis code for skin lesion “uncertain behavior” vs “uncertain behavior”? I know one is to be used before we get pathology results and one is for after, I just don’t remember which is which. If you could give me the ICD10...
December 19, 2019 Question: Can we use 15777 Implantation of biologic implant (e.g. acellular dermal matrix) for soft tissue reinforcement for other tissues beside the breast or trunk? Answer: Code 15777 specifically points to breast and/or trunk only, as “i.e.” stands for “in other words”. Report code 17999 Unlisted procedure, skin, mucous membrane and subcutaneous...
December 5, 2019 Question: A patient came to us for a redo of nipple micropigmentation, as she was not pleased with the result from the tattoo artist. Our surgeon did not perform the initial nipple reconstruction, but our PA will be re-tattooing the patient. How do we bill for this? Answer: Since your surgeon did...
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....
