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...
February 14, 2019 Question: I’ve been dictating CPT codes in the operative note so that my coder knows what to bill. Recently, we had an insurance company call us out because the codes we billed were not the same as the codes in the operative note. Now I am not sure what to do. What...
January 31, 2019 Question: Is there ever a situation where it would be appropriate to bill 76000, or any other fluoroscopy code, in addition to a discectomy, laminectomy, fusion, etc., for any payor? Answer: No. *This response is based on the best information available as of 1/31/19.
January 17, 2019 Question: Hello Kim! Could please help me verify the best code to use? This op note states it is a re-do discectomy but this is the first time my neurosurgeon has done a procedure on this patient. My question is…since my doctor did not do the first procedure, would I bill this...
