September 17, 2020 Question: I just signed up for your 2021 E/M webinar – I’m so excited! Will these changes apply to inpatient codes too? Answer: Great – I look forward seeing you! At this time, the changes are only for new patient and established patient codes – office services. Learn more from Kim Pollock...
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....
August 20, 2020 Question: What if we have to re-program a VP shunt during the global period because the settings need to be adjusted – can we bill for it or is it considered part of the 90-day post-operative global period? Answer: Good question. The initial shunt programming, at the time of insertion, is included...
August 6, 2020 Question: How do I code for repair of a C6-7 fracture/dislocation where I did a laminectomy for decompression to repair the fracture as well as an arthrodesis? Answer: You’ll use CPT 22326 (Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical) for the...
July 23, 2020 Question: I did a craniotomy for removal of a tumor but it had a hemorrhagic component to it so I also removed the hematoma. Can I code for both the tumor removal and removal of intracerebral hematoma? Answer: No – the hematoma removal is considered “incidental” to the tumor removal. Therefore, you’d...
July 9, 2020 Question: I placed subdural stereo-EEG electrodes for epilepsy monitoring. What is the code for removal of these electrodes? I’ve been billing 61880 for removal of each electrode up to 10 or 13 units depending on how many electrodes I remove. My new coder said she’s not sure we are using the correct...
June 25, 2020 Question: When placing pedicle screws, do I bill per pedicle screw or per level? For example, pedicle screws and rods at L5-S1, is it 22840 x 4 units or just 22840? Answer: The posterior spinal instrumentation codes are used once per construct. So pedicle screws and rods at L5-S1 is 22840 only....
June 11, 2020 Question: I did a posterior lumbar fusion bilaterally. Can I bill 22612 with modifier 50 for bilateral procedures? I looked at CPT and it doesn’t say that I can’t bill modifier 50 on any of the fusion codes. Answer: Interesting question! This brings up the point that the CPT book can’t possibly...
May 28, 2020 Question: We are doing a combined case with ENT and are not sure how to code it. The patient has a semi-circular canal dehiscence of the temporal bone. ENT is going to do the approach and I’m going to do the repair of the defect with local bone. We will use mesh...
May 14, 2020 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 patient was rescheduled due to the pandemic and needs to be seen for a COVID swab prior to surgery,...
