April 2, 2020 Question: I am a PT with an NPI. Since I can bill under my name which codes do I use for Online Digital Visits? Answer: Physical therapists should use the e-visit codes (98970-98972 or for Medicare use G2061-G2063). Although PTs do have an NPI, they do no bill E/M visits so (99421-99423)...
March 19, 2020 Question: I am looking forward to attending a 2020 KZA National Coding Course. I had schedule conflicts in 2019, but have been told these courses are a “must” for orthopaedic surgeons. There was a patient with a hand fracture that was treated at a different hospital by another surgeon outside of my...
March 5, 2020 Question: Can I bill for a medial meniscus repair and a lateral meniscus meniscectomy done on the same knee? I see CMS has an NCCI edit between the two codes, 29881 and 29882. Answer: Yes, you may report both codes and append modifier 59 to indicate the procedures were performed on different...
February 20, 2020 Question: Our surgeon documented the diagnosis as “oblique fracture lower end shaft/diaphysis of radius”. What diagnosis code does KZA recommend based on this documentation? The surgeon and I are not in agreement. I am looking at shaft fracture and the surgeon states it should be an “other physis” diagnosis. Answer: KZA recommends...
February 6, 2020 Question: Can our PA perform joint injections for Medicare patients Incident-to the physician? Answer: This depends on the scope of practice for the PA in your state as well as whether the incident-to rules are met. If the physician determines the joint injection is indicate in the plan of care, and it...
January 23, 2020 Question: Our surgeon performed an ACDF at C2-3 and C6-7 through separate incisions for treatment of anterior fractures. We are wondering if we are able to report 22551 twice or if we should use the add-on code, 22552; this is rare for our practice and we think we should use the primary...
January 9, 2020 Question: Is it appropriate to report CPT code 28645 for both traumatic and non-traumatic dislocations? Answer: Yes, CPT code 28645 (Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed) may be reported whether the nature of the dislocation is traumatic or non-traumatic, as long as the dislocation required an open...
December 19, 2019 Question: We have an osteoporosis clinic where our providers see patients on referral. Many times this referral comes from our own colleagues after the patient is seen through the ED for a fracture. A consult and global fracture care is billed in the ED by the first provider, and the referral is...
December 5, 2019 Question: We have a new pediatric orthopaedic surgeon who has joined our practice. He recently performed periacetabular osteotomies for hip dysplasia. He wants us to report CPT codes 27228 and 27146 x3 for this procedure based on information he received during his fellowship training. We have told him that we must report...
November 14, 2019 Question: We have patients who return to the clinic for results of MRI or other diagnostic tests. The physician performs a repeat exam, reviews the images, and makes a decision for surgery. We always code these as level four established visits because of the decision for surgery. Our question is, if the...
