January 23, 2020 Question: My physician is utilizing an open laceration on the patient’s chin for open reduction of a mandibular symphysis fracture and he wants to also charge for a complex laceration repair for that laceration. Is this billable or is it part of the ORIF code? Answer: If the fracture is repaired through...
January 9, 2020 Question: Can you refresh my memory on when to use the diagnosis code for skin lesion “uncertain behavior” vs “uncertain behavior”? I know one is to be used before we get pathology results and one is for after, I just don’t remember which is which. If you could give me the ICD10...
December 19, 2019 Question: Can we use 15777 Implantation of biologic implant (e.g. acellular dermal matrix) for soft tissue reinforcement for other tissues beside the breast or trunk? Answer: Code 15777 specifically points to breast and/or trunk only, as “i.e.” stands for “in other words”. Report code 17999 Unlisted procedure, skin, mucous membrane and subcutaneous...
December 5, 2019 Question: A patient came to us for a redo of nipple micropigmentation, as she was not pleased with the result from the tattoo artist. Our surgeon did not perform the initial nipple reconstruction, but our PA will be re-tattooing the patient. How do we bill for this? Answer: Since your surgeon did...
November 14, 2019 Question: Do the free flap breast reconstruction codes, 19364 and S2068, allow billing for surgeon, co-surgeon and assistant? Answer: CPT 19364 does allow payment for the surgeon, co-surgeon (modifier 62) and assistant surgeon (modifier 80, 82 and AS). However, many payors do not recognize modifiers 62, 80, 82 and/or AS on S2068....
October 31, 2019 Question: A patient had bilateral breast augmentation 5 weeks ago. She developed some drainage out of the lateral aspect of her left breast inframammary incision. The area was probed in the office with a Q-tip and it communicated with the implant pocket so I did a wash out of the left...
October 17, 2019 Question: My doctor specializes in breast reconstruction and has been asking me to bill 19328 (removal of intact breast implant) along with 19371 (capsulectomy) when he has to do a capsulectomy and remove the implant. It has come to my attention that this may be wrong and that 19328 is included in...
October 3, 2019 Question: My doctor has introduced us to a code he would like to bill. I have researched this pretty heavily and included another coder in the research and she could find no reason why we could not code it. However, I have found that our billing system is sometimes giving me a...
September 19, 2019 Question: Someone told me we can bill CPT 23395 (Muscle transfer, any type, shoulder or upper arm; single) when I do a DIEP flap. I checked it out with our compliance department and they said there are no Medicare bundling edits between the two codes so it should be alright. I thought...
September 5, 2019 Question: When can I report a debridement in addition to a graft? I performed a simple debridement with a full thickness graft of the trunk and reported 15200 and coded also for the debridement, but my coder told me I could not report the debridement. When can I report debridement separately? Answer:...
