Category: Orthopaedics

Balloon Spacer in the Shoulder
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Balloon Spacer in the Shoulder

October 14, 2021 Question: Our orthopaedic shoulder surgeon treated a patient with two massive rotator cuff tears that were not amenable to repair. Due to patient age, the patient would not withstand a reconstructive procedure. Our surgeon placed a balloon spacer arthroscopically in the subacromial space. We are wondering how to code for this procedure....

Dry Needling
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Dry Needling

September 16, 2021 Question: Our pain management physician stated he performed a trigger point injection into 1 muscle. In reviewing the procedure note we find that the documentation supports dry needling was performed. Is CPT code 20552 (Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)) the correct code? Answer: No, you would not...

Barbotage Procedure
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Barbotage Procedure

August 19, 2021 Question: We recently employed a new sports medicine physician and met with her about the type of procedures she will be performing in the office. We are comfortable with most of them but have never heard of the Barbotage Procedure. She describes it as performed under ultrasound guidance and uses a needling...

“Elbow Injection”
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“Elbow Injection”

August 5, 2021 Question: Our sports medicine physician submitted an office note with documentation that he performed an “elbow injection.” We are new to orthopaedic coding and wondering if CPT code 20605 (he did not use ultrasound guidance) is the correct code. Answer: Your question is not just because you’re new to orthopaedics; we hear...

Failed Hardware Removal
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Failed Hardware Removal

July 22, 2021 Question: Our surgeon attempted to remove deep hardware in the operating room but was unable after multiple attempts. No other surgical procedures were performed. Are we able to bill anything for the attempted surgery? Answer: Yes, you may. Your scenario indicates “deep hardware” indicating CPT code 20680 (Removal of implant; deep (eg,...

RVUs for J codes
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RVUs for J codes

July 8, 2021 Question: I’m using Code-X at my practice and, unfortunately, I couldn’t find physician fee reimbursement in the RVU tracker for some of the codes in our location. Are you able to guide me or should I contact the AAOS? Here are the three codes: J7320- GenVisc (Intra-articular Injection), J7322 – Hymovis J7332...

Open or Arthroscopic CPT Code
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Open or Arthroscopic CPT Code

June 24, 2021 Question: Our foot and ankle surgeon performed a right talar arthroscopic intraosseous bioplasty core decompression for an insufficiency fracture. We coded this with an unlisted procedure code, 29999. Our hospital is instructing us that this is incorrect and we must report 28899, unlisted procedure foot or toes; they state this code is...

Non-Manipulative Treatment of Finger Fractures: One Code or Four Codes?
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Non-Manipulative Treatment of Finger Fractures: One Code or Four Codes?

June 10, 2021 Question: Our physician diagnosed non-displaced middle phalangeal fractures on the right index, middle, ring, and little fingers on a high school student. The physician applied a short arm cast as treatment and wants to report CPT code 26720 four times. I explained to the physician that she may only report this code...

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