May 23, 2019 Question: The surgeon accidentally nicked a vessel not involved in the bypass being performed, can he bill for repair of vessel since he had to repair it? Answer: Iatrogenic, intraoperative complications that are repaired at the same operative session are not separately reported. Since the vessel laceration was an iatrogenic injury, inadvertently...
May 9, 2019 Question: The vascular surgeon is called to the OR to repair a blood vessel that was inadvertently lacerated during a colectomy. I she a co-surgeon? Answer: No. The vascular surgeon will report her work with a repair vessel code (35221 if repaired directly). The other surgeon will report the work that he/she...
April 11, 2019 E-Consults? Question: One of my colleagues told me that she was doing e-consults with other physicians for Medicare and getting paid. Is this a billable service? Answer: Yes! Medicare has added CPT codes 99446-99452 for interprofessional/ telephone/internet/electronic health record (EHR) consultations to the fee schedule, so they are now payable services. These...
March 28, 2019 Question: What modifier do we use if a patient is returned to the OR the same day as the original surgery for post-op hemorrhage? Isn’t it 78 for this complication? Answer: Modifier 78 is a global period modifier and the global period begins on post-op day one. So it is not appropriate...
March 14, 2019 Question: I thought the global period of debridement of muscle or bone was 10 days. Is that true? Answer: The debridement codes were revised in 2011 and the global period for all codes (11042-11047) was revised to 0 days. *This response is based on the best information available as of 3/14/19.
February 28, 2019 Question: If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as 11042 and 11042-59 or 11042 RT and 11042 LT? Answer: If debridement is performed at the same depth of tissue (all subcutaneous tissue) it is...
February 14, 2019 Question: What does “separate procedure” mean when it follows a CPT code description? Answer: Per CPT : Some of the procedures or services listed in the CPT codebook that are commonly carried out as an integral component of a total service or procedure have been identified by the inclusion of the term...
January 31, 2019 Question: A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case? Answer: Neither. The vascular surgeon will report his work, repair of vessel, and you will report yours. *This response...
January 17, 2019 Question: How is a left femoral to right femoral artery bypass with PTFE reported? Answer: Report code 35661, Bypass graft, with other than vein, femoral- femoral. This code applies to fem-fem bypass in the same leg or from one leg to the opposite leg. *This response is based on the best information...
December 13, 2018 Question: I was told catheterization is included in the embolization codes, 37241-37244. Is that correct? Answer: No, per CPT catherization is separately reported with all the embolization codes, 37241- 37244. *This response is based on the best information available as of 12/13/18.
