July 11, 2019 Question: I heard you speak at the recent AANS coding course – you were awesome and the course was fantastic…everyone should go. The surgeon I work with has a question regarding billing. Some of the hospitals in the area have a Nurse Practitioner or Physician Assistant on staff that see Neurosurgery consults...
June 20, 2019 Question: We get calls from patients to renew their medications. When the patient comes to office to pick up prescription, can we bill for a nurse visit with 99211? Answer: No. CPT makes it very clear that picking up a prescription does not constitute a billable E/M service. *This response is based...
June 6, 2019 Question: My surgeon uses the intraoperative ultrasound to assist with a brain tumor removal. I am billing 76998 with modifier 26 for the professional component. Sometimes we don’t get paid. Should I appeal these denials? Answer: No….actually, intraoperative ultrasound is included in the global surgical package for the neurosurgeon and should not...
May 23, 2019 Question: We are starting to do platelet-rich plasma injections in the spine. Would we bill 64483? Answer: No because 64483 is specifically for an “anesthetic agent and/or steroid” injection. The most accurate code is 0232T (Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed). Be sure to...
May 9, 2019 Question: I have a question regarding one of your previous Coding Coach Q&As that I recently saw. The question is about coding stenosis. Wouldn’t the code(s) for foraminal stenosis be M99.8 and then 5th digit based on the area of the spine? Answer: Actually, no. Why? Because the guidelines just under the...
April 25, 2019 Question: When would I ever use 63042? I am not sure I understand the meaning of this code. Answer: Good question! CPT 63042 (Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar) is used when the diagnosis is recurrent herniated...
April 11, 2019 Question: We are being told by our billing service that “CPT 22551 as the procedure/diagnosis code combination is not compatible” when we use the diagnosis code of M50.11 for an ACDF at C3 -4. This is the first time that we have ever had an issue with M50.11 for 22551. Is there...
March 28, 2019 Question: My neurosurgeon did a craniotomy with removal of a frontotemporal meningioma with stereotactic navigation and the microscope. I coded as 61512, 61781, and 69990-59. However, my doctor disagrees and wants to code as 61583, 61512-51. What do you think? Answer: First, 61583 – a skull base surgery approach code that requires...
March 14, 2019 Question: What’s the best way to do the diagnosis coding for postop visits? I mean, does it really matter since we aren’t billing for a visit? Answer: The ICD-10-CM guidelines for postop/aftercare include the following: If the original diagnosis is trauma (eg, using an S diagnosis code) or a code that requires...
February 28, 2019 Question: Can I bill for taking the patient back to the OR to explore and repair post-op hemorrhage on day 3 post-op? I heard that all complications are included in the payment of the original surgery. Answer: Yes, you may bill for this. CPT and Medicare agree that taking the patient back...
