Category: Plastic Surgery

Nasal Wall Reconstruction
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Nasal Wall Reconstruction

December 2, 2021 Question: One of our physicians is scheduling a nasal wall reconstruction with Latera®. He is wanting to use code 30465 (repair nasal vestibular stenosis). I know there is a code for Latera which is 30468 and I feel we should use this code. Please give me your opinion. Answer: CPT 30468 was...

Open Septoplasty
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Open Septoplasty

October 28, 2021 Question: What is the code for an open septoplasty? I’m doing extracorporeal work removing the septum and reinserting it. It’s more difficult than a regular intranasal septoplasty, 30520. Answer: There is not a separate code for an open septoplasty – 30520 is all we’ve got. You could append modifier 22 (increased procedural...

Counting Problems Addressed for Medical Decision Making
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Counting Problems Addressed for Medical Decision Making

October 14, 2021 Question: If a patient has one stable chronic illness and one acute uncomplicated illness without systemic symptoms, can we “up” the level of Problems Addressed to Moderate? Answer: No, sorry, unfortunately it doesn’t work that way. The problems are no additive or cumulative. One stable chronic illness and one acute uncomplicated illness...

Diagnosis Issue for Breast Reconstruction Wound Debridement
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Diagnosis Issue for Breast Reconstruction Wound Debridement

September 30, 2021 Question: We did a debridement and repair of a wound dehiscence on a breast reconstruction patient. The denial said we did not have the right diagnosis code. We used S21.029A. What diagnosis code should we have used? Answer: S21.0029A is for traumatic laceration with foreign body of unspecified breast, initial encounter. The...

Denial of Breast Reconstruction
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Denial of Breast Reconstruction

August 19, 2021 Question: We received a denial for 19357-50 (tissue expander reconstruction) and +15777 x 2 units. The denial reason was “the diagnosis code and CPT code combination is inappropriate”. We used a diagnosis of C50.911 (Malignant neoplasm of unspecified site of right female breast). What diagnosis code(s) should we have used? Answer: For...

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