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Coding for REBOA

Coding for REBOA

September 5, 2019 Question: What is REBOA and how is it coded? Answer: REBOA is used in trauma for patients that are rapidly bleeding from injuries to the chest, abdomen…
Neurostimulators

Neurostimulators

September 5, 2019 Question: Can we bill implantation of a trial neurostimulator (63650) with CPT code 95970 for the electronic analysis at the same time? Answer: Per CPT guidelines in…
Multiple Laminectomies to Place a Spinal Cord Stimulator

Multiple Laminectomies to Place a Spinal Cord Stimulator

September 5, 2019 Question: I billed 63655 (Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural) twice because I did laminectomies at T9, T10 and T11. I billed 63655 and 63655-59…
Coding Debridement with Grafts

Coding Debridement with Grafts

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…
Incident-To Billing

Incident-To Billing

September 5, 2019 Question: Our physicians have instructed us to bill under a physician’s NPI number for all Advanced Practitioners (PA’s and NPs) for all patients for Medicare as we…
New FNA Codes and Diagnostic Ultrasound

New FNA Codes and Diagnostic Ultrasound

September 5, 2019 Question: I understand that the new FNA with ultrasound code, 10005, includes the ultrasound guidance for the FNA.  But, can we also charge 76536? Answer: Yes, if…
Can we bill for a PA employed by the hospital?

Can we bill for a PA employed by the hospital?

September 5, 2019 Question: Our local hospital employs Physician Assistants. When our doctors are on call for the ED, the hospital-employed PA will call our doctor for their opinion and…
Documenting Codes In the Procedure Report

Documenting Codes In the Procedure Report

September 5, 2019 Question: I’ve been dictating CPT and ICD-10-CM codes in my procedure note so that my coder knows what to bill. Recently, we had an insurance company call…
Documenting Codes in the Procedure Report

Documenting Codes in the Procedure Report

August 22, 2019 Question: I’ve been dictating CPT and ICD-10-CM codes in my procedure note so that my coder knows what to bill. Recently, we had an insurance company call us…
Nail and Lesion Debridement During the Same Visit

Nail and Lesion Debridement During the Same Visit

August 22, 2019 Question: A patient presents to the office who meets Medicare’s definition for medical necessity for routine foot care. Nails are noted to be elongated and thickened, and…
Vertebral Augmentation Coding

Vertebral Augmentation Coding

August 22, 2019 Question: Is it ever appropriate to bill 22513 with 3 units? Answer: CPT 22513 states Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included…
Sentinel Node Identification

Sentinel Node Identification

August 22, 2019 Question: We have a new ENT and he’s doing a procedure my other guys don’t perform.  The patient goes to radiology for injection of radioactive isotopes then…
Chemical Peel

Chemical Peel

August 22, 2019 Question: What code should we use for a chemical peel of less than the entire face? Answer: CPT codes 15788 (Chemical peel, facial; epidermis) and 15789 (Chemical…
Use of a Scribe

Use of a Scribe

August 22, 2019 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…
New Patient Visit

New Patient Visit

August 22, 2019 Question: One of our pain management doctor saw a patient in the hospital at the request of the orthopedic surgeon. The patient was discharged and is coming…
Code +15777 for placement of a non-biologic implant. Is this the correct code?

Code +15777 for placement of a non-biologic implant. Is this the correct code?

August 22, 2019 Question: I placed a non-biological implant for abdominal soft tissue reinforcement. Can this be coded as +15777? Answer: No. Code +15777 is reported specifically for a biological…
Microdermabrasion

Microdermabrasion

August 8, 2019 Question: Is the correct code for microdermabrasion 15780 or some other code? Answer: CPT code 15780 (Dermabrasion; total face) is for total face dermabrasion using a tool…
Mohs Staging

Mohs Staging

August 8, 2019 Question: My physician performed Mohs surgery on a patient with a basal cell carcinoma on his cheek. He took the first stage with 6 tissue blocks, but…
How do you define “No Qualified Resident Available”?

How do you define “No Qualified Resident Available”?

August 8, 2019 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…
Skin Biopsy Codes

Skin Biopsy Codes

August 8, 2019 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.”…
Reporting a Cholecystectomy and an Umbilical Hernia at the Same Operative Session

Reporting a Cholecystectomy and an Umbilical Hernia at the Same Operative Session

August 8, 2019 Question: If a patient undergoes an open cholecystectomy and has a reducible umbilical hernia repaired during the same operative session, through separate incisions, can both be reported?…
PA Performing Joint Injections

PA Performing Joint Injections

August 8, 2019 Question: Can our PA perform joint injections for Medicare patients Incident-to the physician? Answer: This depends on the scope of practice for the PA in your state…
How do you define “No Qualified Resident Available”?

How do you define “No Qualified Resident Available”?

August 8, 2019 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…
Use of a Scribe

Use of a Scribe

August 8, 2019 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…
Reporting a Cholecystectomy with a Cholangiogram

Reporting a Cholecystectomy with a Cholangiogram

July 25, 2019 Question: If a cholangiogram was performed by the surgeon during a cholecystectomy, but the radiologist interprets it, is 47563, Laparoscopy, surgical; cholecystectomy with cholangiography still appropriate? Answer:…
DBS Battery Replacement

DBS Battery Replacement

July 25, 2019 Question: When our doctors replace a DBS generator because the battery is depleted and they reprogram at the same time, we can bill for the programming, correct?…
Botox for Migraine Headaches

Botox for Migraine Headaches

July 25, 2019 Question: When you inject Botox for migraine headaches, can you bill the injection code more than one time? We normally go about this as a cosmetic procedure,…
Why Did I Receive This Denial?

Why Did I Receive This Denial?

July 25, 2019 Question: Our surgeon performed a meniscectomy on a Medicare beneficiary.   During the 2nd post-operative visit the surgeon started a series of Hyaluronate injections in the operative knee…
Lesion Excision and Repair

Lesion Excision and Repair

July 25, 2019 Question: I saw a patient for an excision of a squamous cell carcinoma on his chest. The size is 4.2 cm diameter. I know I report 11606…
Division and Inset of Flap

Division and Inset of Flap

July 25, 2019 Question: A patient presents for division and inset of a neck-to-ear pedicle flap.  Should we report 15620 or 15630? Answer: The CPT codes reported for the division…
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