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Epidural Lysis of Adhesions

Epidural Lysis of Adhesions

July 22, 2021 Question: I am trying to find a CPT code for an Epidural Adhesiolysis. Can you tell what codes I should use? Answer: It depends on the method.…
Harvest of Graft for Repair of Nasal Vestibular Stenosis

Harvest of Graft for Repair of Nasal Vestibular Stenosis

July 22, 2021 Question: We did a septoplasty and repair of nasal vestibular stenosis with spreader grafts using septal cartilage. We billed these codes: 30465, 30520 and 20912. Medicare does…
E-Consults?

E-Consults?

July 22, 2021 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!…
Failed Hardware Removal

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…
Tracheostomy with Glossectomy

Tracheostomy with Glossectomy

July 22, 2021 Question: We billed 31600 for a tracheostomy along with 41140 (total glossectomy). CPT 31600 was denied. How can we appeal? Answer: Good question, however, the denial was…
Lesion Destruction on the Eyelid Margin

Lesion Destruction on the Eyelid Margin

July 22, 2021 Question: My physician used liquid nitrogen to destroy a benign lesion on the eyelid margin.  Can I use CPT code 67850 when using liquid nitrogen to destroy…
Skin Biopsy Codes

Skin Biopsy Codes

July 22, 2021 Question: What happened to the skin biopsy codes? I submitted a claim for 11101 (skin biopsy) and +11101 (additional lesion) and it was denied for “invalid code.”…
TDA with ACDF

TDA with ACDF

July 22, 2021 Question: My surgeon did an ACDF at C5-C6 and C6-C7 but also did an artificial disc (TDA) at C4-C5.  Can I bill for all three procedures? Answer:…
Help with Ultrasound Guidance for Injection

Help with Ultrasound Guidance for Injection

July 8, 2021 Question: We have been using codes 0228T/0229T for epidurals (cervical or thoracic) and 0230T/0231T for lumbar epidurals using ultrasound guidance. In the past we have been paid…
Use of Cadaver Cartilage

Use of Cadaver Cartilage

July 8, 2021 Question: We have a patient that needs a major revision rhinoplasty requiring cadaver cartilage. There is no remaining local cartilage that can be utilized in this case…
Modifier 78 vs 59

Modifier 78 vs 59

July 8, 2021 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…
RVUs for J codes

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.…
CPT 62165 with 30140, 31254

CPT 62165 with 30140, 31254

July 8, 2021 Question: Are CPT 30140 (submucous resection inferior turbinate) and 31254 (endoscopic anterior ethmoidectomy) bundled with code 62165 (Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal…
Telehealth Billing During the Public Health Emergency

Telehealth Billing During the Public Health Emergency

July 8, 2021 Question: We have been providing Telehealth visits using audio and visual means to many of our patients during the Covid-19 pandemic. Can we bill telehealth visits by…
Use of a Scribe

Use of a Scribe

July 8, 2021 Question: We are hiring a scribe for the doctor because it will help improve his documentation. Is there anything we need to know about how to document…
Non-Segmental vs Segmental Instrumentation

Non-Segmental vs Segmental Instrumentation

July 8, 2021 Question: The provider listed one of the procedure statements as bilateral percutaneous L4-L5 segmental instrumentation placement along with the fusion and decompression procedures. In the body of…
Counting” Data for 2021 Office E/M Codes

Counting” Data for 2021 Office E/M Codes

June 24, 2021 Question: I am confused about the Data component for the new office visit guidelines. Many of my new patients will bring in their x-rays or CT reports…
Adjacent Tissue Transfer

Adjacent Tissue Transfer

June 24, 2021 Question: A few years ago I was at your plastic surgery coding workshop in Chicago – you were great, Kim! I remember discussing the adjacent tissue transfer…
Global Period for Debridement

Global Period for Debridement

June 24, 2021 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…
Open or Arthroscopic CPT Code

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,…
Flexible Laryngoscopy in the OR

Flexible Laryngoscopy in the OR

June 24, 2021 Question: What is the CPT code for flexible laryngoscopy performed in the OR under anesthesia? Answer: Right now we have only 31575 for this procedure.  If you…
MDM Credit for Office Visits in 2021

MDM Credit for Office Visits in 2021

June 24, 2021 Question: I am a Dermatologist. I have a patient who was referred to my office who has dementia and was unable to provide her medical history. The…
How Do You Define “No Qualified Resident Available”?

How Do You Define “No Qualified Resident Available”?

June 24, 2021 Question: Our physicians utilize residents during surgery but we have a discrepancy in what is considered a “Qualified Resident”. Some physicians consider a resident qualified to assist…
ACDF and Carpal Tunnel Decompression

ACDF and Carpal Tunnel Decompression

June 24, 2021 Question: The neurosurgeon performed an ACDF and then also did a carpal tunnel decompression at the same time.  When we were paid by insurance, they paid us…
Trigger Finger Injection

Trigger Finger Injection

June 10, 2021 Question: Which CPT code is used 20550 or 20551 for a trigger finger /A1 pulley injection? Answer: CPT code 20550 defines an injection to a single tendon…
Breast Reduction with Liposuction

Breast Reduction with Liposuction

June 10, 2021 Question: If I do both a breast reduction, 19318, and liposuction of the breast, 15877, do I bill both codes? Answer: No – the liposuction is not…
Debridement Coding

Debridement Coding

June 10, 2021 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…
Non-Manipulative Treatment of Finger Fractures: One Code or Four Codes?

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…
Laceration and Fracture Repair

Laceration and Fracture Repair

June 10, 2021 Question: My physician is utilizing an open laceration on the patients chin for open reduction of a mandibular symphysis fracture. He wants to also charge for complex…
Using Time to Select Office E/M Service

Using Time to Select Office E/M Service

June 10, 2021 Question: If I use time to select my E/M service in the office, can I just document the total time? Answer: No, you must document the actual…
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