December 5, 2019 Question: What happened to the skin biopsy codes? I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.” Answer: CPT deleted CPT codes 11100 and +11101, effective 1/1/19, and replaced them with the follow six new codes: 11102 Tangential biopsy of skin (eg,...
November 14, 2019 Question: We are hiring a scribe for the doctor because it will help improve his documentation. Is there anything we need to know about how to document this? Answer: Yes, absolutely. This situation should be clearly delineated so a third party reviewer can identify the provider who performed the service, and the...
October 31, 2019 Question: Our physicians utilize residents during surgery but we have a discrepancy in what is considered a “Qualified Resident”. Some physicians consider a resident qualified to assist day 1 of their residency rotation, while others consider only 4th and 5th year residents as qualified to assist. Can you guide us to documentation...
October 17, 2019 Question: Can you code a PTH (blood draw, during a parathyroidectomy? Answer: Monitoring the Parathyroid hormone (PTH), including the blood draw, is included in the parathyroidectomy and not separately reported. *This response is based on the best information available as of 10/17/19.
October 3, 2019 Question: I was told I cannot bill for FAST exams done in the ED for a trauma patient, if permanent recordings of the images are not retained. Is that correct? Answer: Yes. All diagnostic ultrasounds require 1) a separate interruption of the structures visualized and the findings in each and 2) a...
September 19, 2019 Question: What code is used for percutaneous tracheostomy? Answer: Code 31600 is reported for “percutaneous” tracheostomy. This procedure is performed with a small incision and some direct visualization of the structures with or without a bronchoscope. The bronchoscope, used as a light source and to remove blood and secretions, is NOT separately...
September 5, 2019 Question: What is REBOA and how is it coded? Answer: REBOA is used in trauma for patients that are rapidly bleeding from injuries to the chest, abdomen or pelvis. A flexible catheter is placed in the femoral artery, advanced to the aorta and a balloon is inflated at its tip. This stops...
August 22, 2019 Question: I placed a non-biological implant for abdominal soft tissue reinforcement. Can this be coded as +15777? Answer: No. Code +15777 is reported specifically for a biological implant for soft tissue reinforcement implant in breast or trunk only. Code +0437T, a Category III code, is reported for implantation of a nonbiologic or...
August 8, 2019 Question: If a patient undergoes an open cholecystectomy and has a reducible umbilical hernia repaired during the same operative session, through separate incisions, can both be reported? Answer: Yes, if both procedures were performed through separate incisions both may be reported. Conversely, if both were repaired through the same incision, only the...
July 25, 2019 Question: If a cholangiogram was performed by the surgeon during a cholecystectomy, but the radiologist interprets it, is 47563, Laparoscopy, surgical; cholecystectomy with cholangiography still appropriate? Answer: Yes, the codes “with cholangiogram” are valued for intraoperative physician work, not the interpretation. *This response is based on the best information available as of...
