Category: <span>Orthopaedics</span>

Weekend Rounds (Part 1)
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Weekend Rounds (Part 1)

March 14, 2019 Question: I have just a quick question regarding weekend rounding. I share weekend call with another practice that I am not affiliated with. We sign off our patients to each other when we cover our respective calls.   Sometimes when rounding I check on 5-10 of their patients, some of which are their...

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How to Avoid Common Mistakes When Coding Hand Procedures

How to Avoid Common Mistakes When Coding Hand Procedures AAOSNow – March 2019  by Sarah Wiskerchen and Raymond Janevicius, MD Billing for hand procedures is among the most complex types of orthopaedic coding. Here, we highlight eight frequently encountered errors when coding hand procedures and how to fix them. Lack of specificity in documentation of tendon...

Bone Graft
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Bone Graft

February 28, 2019 Question: My surgeon performed a repair of a nonunion with bone graft harvested via a separate incision.  The surgeon submitted CPT code 25431 alone.   I added CPT code 20902 after reviewing the operative note, because the surgeon obtained the bone graft from a distant site via a separate incision.   My surgeon disagrees...

Suture Removal
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Suture Removal

February 14, 2019 Question: We had a patient come into our office to have their sutures removed from a hand laceration repaired by someone else. The patient was hurt while out of state on vacation and couldn’t have the sutures removed while away; the original provider performed a layered repair. The problem is the patient...

Joint Injection
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Joint Injection

January 31, 2019 Question: We have a non-Medicare patient that brings in her own Viscosupplement drug that she purchases through her drug plan at an outside pharmacy.  We know we cannot bill the drug to the private payors, but want to make sure we are able to report the injection code. Answer: First, please verify...

New or Established Patient
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New or Established Patient

January 17, 2019 Question: I am new to Orthopaedics. I am in a practice that employs a joint specialist, spine specialist and a pediatric orthopaedic surgeon in addition to general orthopaedic surgeons.   Do the new patient rules apply to each of these specialties? For example, a patient is first seen by the general orthopaedic surgeon...

ED Treatment of Fracture by Advanced Practice Provider
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ED Treatment of Fracture by Advanced Practice Provider

November 29, 2018 Question: Our physicians are asking us to report closed treatment without manipulation codes when their Advanced-Practice Provider evaluates a patient with a fracture in the ED, in preparation for definitive care to be done in the operating room the following day.  What services should be coded for the services rendered by the...

Fracture Treatment and Teaching Physician Requirements
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Fracture Treatment and Teaching Physician Requirements

November 15, 2018 Question: Our physicians teach residents in an academic medical center.  Often the residents see fracture patients in the ED and reduce fractures without the attending physician present.  When the patients follow up with the teaching physicians in the office, they want us to report the global fracture codes that say “without manipulation”,...

CPT Code 20610 or 20611?
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CPT Code 20610 or 20611?

November 1, 2018 Question: Our physician performed a shoulder joint injection with ultrasound guidance.  The physician’s procedure note does not fully detail the ultrasound guidance, other than the ultrasound was used to do the injection. The physician does not document that images were saved (and we can’t find images).  The physician also does not have...

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