September 3, 2020 Question: I work with a neurosurgeon and we don’t see many Medicare patients. The neurosurgeon 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 coding rule....
September 3, 2020 Question: The surgeon described the procedure as a ‘hand assisted laparoscopy” He brought part of the bowel outside of the body for evaluation. Does this convert the procedure to open? Answer: Mobilizing the bowel outside the body (extracorporeally) during a laparoscopic procedure does not convert the procedure to open, it is still...
September 3, 2020 Question: I am new to pain management coding and have a question. What is the correct way to bill for a transforaminal injection of L3-L4 and L4-5? He is injecting L3-L4 bilaterally and L3-L4 on one side. Can I report 64483 three times? Answer: No, you would report 64483 (first level) and...
September 3, 2020 Question: I work with a surgeon and we see just a few Medicare patients. The 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, but it is a common misconception. The revised documentation requirements...
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...
September 3 , 2020 Question: When using liquid nitrogen to for irritated actinic keratoses what CPT codes should I use? I have been using 17110 and my coder told me that was wrong. Answer: You should report 17000 for the first AK (Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic...
August 20, 2020 Question: My physician performed an SI joint injection in the ASC under ultrasound guidance and wants to bill 27096 and 76942. Is this correct? The description of the codes say imaging is included. Answer: If ultrasound is used instead of fluoroscopy, or CT, report a trigger point injection with 76942. Some payor...
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 20, 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...
August 20, 2020 Question: The surgeon used a stent and then inserted an embolization coil for an aneurysm. Are both billable? Answer: If the stent is placed to provide a latticework for deployment of the embolism coil, then no. You would just bill for the embolization. If the stent itself is the sole definitive procedure...
