June 30, 2022 Question: Can I use modifiers on an unlisted code? Answer: There is not a single right answer to this question. CPT said, in an old CPT Assistant, that generally modifiers are not appended to an unlisted code. Payors have their own rules. For example, some payors will accept modifier 62 (two surgeons/co-surgery)...
June 16, 2022 Question: The patient had a re-do laminectomy for stenosis at L3-L4. Can code 63042 be used for this procedure? Answer: No. CPT 63042 is intended for a re-do discectomy and would be inappropriate to use for a re-do laminectomy. Rather, use 63047 for this service and modifier 22 may be appended if...
June 2, 2022 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 original surgery was canceled and is now under consideration for rescheduling due to the pandemic and needs to...
May 19, 2022 Question: I did an inpatient consultation and coded 99253 (non-Medicare). I did not need to follow the patient so I signed off. They asked me to re-consult a week later. What is the code for a re-consult? Answer: There are no specific E/M codes for an inpatient re-consultation. You’ll use the subsequent...
May 5, 2022 Question: What code do we charge for an ER visit when our physician was called to the ER by the ER doctor. The patient has Medicare. Answer: If the patient was not admitted by you to the hospital (e.g., they were admitted by another service or discharged), then you code it as...
April 21, 2022 Question: I did a posterior fossa craniectomy for resection of a cerebellopontine angle tumor requiring the dura to be repaired with a synthetic graft and reconstruction of the cranial defect with a titanium mesh cranioplasty. I know I will use 61520 for the tumor removal. Can I use 62140 for the cranioplasty?...
April 7, 2022 Question: Can a PA bill a consult if going to the ED at the request of the ED dr for a stroke? Assume this is a non-Medicare patient and the consult code gets paid. Answer: Yes, assuming that doing a consult in the ED is within the PA’s scope of practice in...
March 24, 2022 Question: We are going to start doing this new procedure called High Intensity Focused Ultrasound to treat essential tremor and other tremors. I can’t find a CPT code for this procedure. Do we need to use an unlisted code? Answer: Actually there is a Category III CPT code for this procedure so...
March 10, 2022 Question: Can we bill for a PA to assist on a cerebral angiogram? What about aneurysm coiling? Answer: Well you can try but there are two things to consider: 1. The operative note should have really good documentation showing why a PA was necessary and what exactly the PA did to assist....
February 24, 2022 Question: Can we code a laminectomy for disc herniation, such as 63030 or 63042, with a TLIF/PLIF code (22630, 22633)? Answer: Good question! There was an update in CPT 2022 to this very complicated and lengthy issue. No – a discectomy may not be separately reported (e.g., 63030, 63042, 63056) since it...
