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Incident-To Billing

Incident-To Billing

July 11, 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…
Confirmation Pathology Report

Confirmation Pathology Report

July 11, 2019 Question: Can we perform Mohs surgery without a pathology report? Answer: If you review CMS and other payor policies they all require a recent pathology report usually…
Adjacent Tissue Transfer

Adjacent Tissue Transfer

July 11, 2019 Question: If our docs perform two adjacent tissue transfers on two separate lesions in the same anatomic group by CPT standards, do we add the ATTs together…
Billing Diagnostic Angiograms with an Intervention

Billing Diagnostic Angiograms with an Intervention

July 11, 2019 Question: When are diagnostic angiograms and an intervention (angioplasty, stent, etc) both billable? Answer: Diagnostic angiograms are separately billable during an intervention if no adequate, prior adequate…
Billing for an iatrogenic injury, not my patient. (Stage 2)

Billing for an iatrogenic injury, not my patient. (Stage 2)

July 11, 2019 Question: My surgeon was called to the OR by an OB-GYN who accidentally lacerated the bowel during an open gynecological procedure.  She repaired the bowel with sutures.…
Billing for Hospital NP/PA Consults

Billing for Hospital NP/PA Consults

July 11, 2019 Question: I heard you speak at the recent AANS coding course – you were awesome and the course was fantastic…everyone should go.  The surgeon I work with…
Diagnosis Code for Post Op Visits

Diagnosis Code for Post Op Visits

July 11, 2019 Question: What’s the best way to do the diagnosis coding for postop visits? I mean, does it really matter since we aren’t billing for a visit? Answer:…
Superior Capsular Reconstruction

Superior Capsular Reconstruction

July 11, 2019 Question: What CPT codes do I use for comparison when the surgeon performs a superior capsular reconstruction? I know I have to use an unlisted code. Answer:…
Billing for an iatrogenic injury, not my patient. (Stage 1)

Billing for an iatrogenic injury, not my patient. (Stage 1)

June 20, 2019 Question: My surgeon was called to the OR by an OB-GYN who accidently lacerated the the small bowel during an open gynecological procedure.  She repaired the small…
Subscapularis and Supraspinatus Repair

Subscapularis and Supraspinatus Repair

June 20, 2019 Question: I perform an arthroscopic repair of the supraspinatus and subscapularis tendons through separate incisions/portals.   May I report CPT code 29827 twice? Answer: CPT code 29827, arthroscopic…
Post Op Hemorrhage Repair: Is it Billable?

Post Op Hemorrhage Repair: Is it Billable?

June 20, 2019 Question: Can I bill for taking the patient back to the OR to explore and repair post-op hemorrhage on day 3 post-op? I heard that all complications…
Prescription Refill Visits

Prescription Refill Visits

June 20, 2019 Question: We get calls from patients to renew their medications.  When the patient comes to office to pick up prescription, can we bill for a nurse visit…
Coding TCAR

Coding TCAR

June 20, 2019 Question: What is TCAR and how is it coded? Answer: TCAR stands for Transcarotid Artery Revascularization.  It is essentially an open carotid stent procedure. A small incision…
Pilonidal Cyst Removal and Repair

Pilonidal Cyst Removal and Repair

June 20, 2019 Question: If one of our doctors removes a complex pilonidal cyst that requires a rhomboid flap repair, is the repair part of the code 11772 for complicated…
E/M with Procedure

E/M with Procedure

June 20, 2019 Question: Can you provide the CPT code for this procedure? Also can I report an E/M service for this patient encounter? Patient is a pleasant 60 year-old…
Modifier 59

Modifier 59

June 20, 2019 Question: I destroyed 8 AKs and 3 SKs on a patient and also took a shave biopsy of another site.  My codes are 17000, 17003 X 7,…
SI and Trigger Point Injections

SI and Trigger Point Injections

June 6, 2019 Question: A patient comes to our office for a sacroiliac joint injection and is also requesting a cervical trigger point injections as he woke with a stiff…
Modifier 50 for ATT?

Modifier 50 for ATT?

June 6, 2019 Question: My doctor did two adjacent tissue transfers, on the each leg of the patient. The ATT on the left leg was 6sq cm and the one…
Documenting Codes in the Operative Note

Documenting Codes in the Operative Note

June 6, 2019 Question: I’ve been dictating CPT codes in the operative note so that my coder knows what to bill.  Recently, we had an insurance company call us out…
Documenting Codes in the Operative Note

Documenting Codes in the Operative Note

June 6, 2019 Question: I’ve been dictating CPT codes in the operative note so that my coder knows what to bill.  Recently, we had an insurance company call us out…
Diagnosis Code

Diagnosis Code

June 6, 2019 Question: A pathology report came back from a skin biopsy stating “compound dysplastic lesion with severe atypia.  Re-excision recommended.”  Should the diagnosis code be D48.5 for lesion…
Should we be reporting CPT code 99024?

Should we be reporting CPT code 99024?

June 6, 2019 Question: We are in a state that must report CPT code 99024 to Medicare for the defined procedures.  I perform the surgical procedure but one of my…
Intraoperative Ultrasound for Tumor Removal

Intraoperative Ultrasound for Tumor Removal

June 6, 2019 Question: My surgeon uses the intraoperative ultrasound to assist with a brain tumor removal. I am billing 76998 with modifier 26 for the professional component.  Sometimes we…
Billing for an iatrogenic injury, my patient.

Billing for an iatrogenic injury, my patient.

June 6, 2019 Question: The surgeon reported an intestinal perforation caused by a trocar during a laparoscopic cholecystectomy due to extensive adhesions.  He completed the cholecystectomy and also did a…
Ear Biopsy

Ear Biopsy

May 23, 2019 Question: What is the correct code for a tangential biopsy of the antihelical fold?  I was going to bill 11102, but I was told that there are…
30140 (Submucous Resection) vs 30130 (Excision)

30140 (Submucous Resection) vs 30130 (Excision)

May 23, 2019 Question: My work RVUs are down this year.  I do a lot of inferior turbinate submucous resection surgery and I code 30140 (Submucous resection inferior turbinate, partial…
OOOPs. I nicked a vessel. Can I bill for repairing it?

OOOPs. I nicked a vessel. Can I bill for repairing it?

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?…
Endoscopic Cubital Tunnel Release

Endoscopic Cubital Tunnel Release

May 23, 2019 Question: If a cubital tunnel release is performed by endoscopy how should it be reported? We report 64718 when it’s performed as an open procedure. Just not…
Nerve Repair

Nerve Repair

May 23, 2019 Question: I know that CPT code 64910 is the code I report for a nerve repair of the spine.  My question is when performing this procedure on…
E-Consults?

E-Consults?

May 23, 2019 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! …
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Coding Coaches