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New 2021 Evaluation and Management Code Guidelines
November 12, 2020 Question: I heard that the E/M code guidelines are changing in 2021. Will this apply to all…
SI Joint Injection Help
October 29, 2020 Question: My physician performed an SI joint injection in the ASC under ultrasound guidance and wants to…
Subacromial Decompression (29826)
October 15, 2020 Question: Our surgeon frequently documents in the procedure title that an arthroscopic subacromial decompression was performed. We…
Modifier 78: Global Period Impact
October 1, 2020 Question: We have a patient who had knee surgery and required a return to the operating suite…
Generic Hyaluronic Acid Derivatives
September 17, 2020 Question: Our physicians are looking at purchasing generic Hyaluronan instead of purchasing the name brand Orthovisc or…
Trigger Finger Injection
September 3, 2020 Question: Which CPT code is used 20550 or 20551 for a trigger finger /A1 pulley injection? Answer:…
Chondroplasty after a Total Knee Arthroplasty
August 6, 2020 Question: I am new in orthopaedics and am reviewing an operative note. The patient had a total…
E/M 2021- Do I have to use the revised guidelines?
July 23, 2020 Question: I work with a sports surgeon and we see just a few Medicare patients. The surgeon…
Are Wound Vacs Separately Reportable?
July 9, 2020 Question: I’m a pediatric orthopedic surgeon. Some of my team are reporting the NPWT codes 97605 and…
2021 MDM Credit for Taking a History!
June 25, 2020 Question: I am a pediatric orthopaedic surgeon and many of my patients are too young to give…
VEPTR Insertion and Lengthening
May 28, 2020 Question: What is the correct code to report for the insertion and subsequent lengthening of the VEPTR…
Billing Additional Pre-op Visit
May 14, 2020 Question: Since we have to bring the patients back in for COVID testing and H&P for Joint Commission,…
Telemedicine and Fracture Care
April 30, 2020 Question: Our physician conducted a face-to-face telemedicine encounter with an established patient this week. The physician evaluated…
Billing Telehealth by Time
April 16, 2020 Question: Can we bill telehealth visits by time alone? Answer: For Medicare claims, telehealth visits can now…
PT Codes for Online Digital Visits
April 2, 2020 Question: I am a PT with an NPI. Since I can bill under my name which codes…
E/M and ICD-10-CM for Fracture Patient Treated Prior to Physician Encounter
March 19, 2020 Question: I am looking forward to attending a 2020 KZA National Coding Course. I had schedule conflicts…
Meniscal Repair and Meniscectomy
March 5, 2020 Question: Can I bill for a medial meniscus repair and a lateral meniscus meniscectomy done on the…
Distal Shaft Fracture Diagnosis Code
February 20, 2020 Question: Our surgeon documented the diagnosis as “oblique fracture lower end shaft/diaphysis of radius”. What diagnosis code…
PA Performing Joint Injections
February 6, 2020 Question: Can our PA perform joint injections for Medicare patients Incident-to the physician? Answer: This depends on…
Two Level ACDF (non-contiguous)
January 23, 2020 Question: Our surgeon performed an ACDF at C2-3 and C6-7 through separate incisions for treatment of anterior…
Dislocation CPT Codes: Traumatic vs Non-traumatic
January 9, 2020 Question: Is it appropriate to report CPT code 28645 for both traumatic and non-traumatic dislocations? Answer: Yes,…
Osteoporosis Clinic
December 19, 2019 Question: We have an osteoporosis clinic where our providers see patients on referral. Many times this referral…
Periacetabular Osteotomy
December 5, 2019 Question: We have a new pediatric orthopaedic surgeon who has joined our practice. He recently performed periacetabular…
Is a 99214 supported?
November 14, 2019 Question: We have patients who return to the clinic for results of MRI or other diagnostic tests. …
Modifier 58 or 78
October 31, 2019 Question: We have a patient scheduled for manipulation under anesthesia for arthrofibrosis during the post-operative period for…
E/M and Fracture Manipulation
October 17, 2019 Question: We have joined a new health system and the coding staff members (new to orthopaedics) are…
Hematoma I&D with Fasciotomy
October 3, 2019 Question: Our surgeon performed an I&D of a hematoma in the same compartment as an anterior and…
Stem Cell Implant Knee Osteoarthritis
September 19, 2019 Question: Our surgeons are harvesting adipose tissue and creating an injectable implant that they are injecting in…
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…
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…
Articles
Five Coding Tips for Dealing with Third-party Billing Entities
Five Coding Tips for Dealing with Third-party Billing Entities AAOSNow – February 2020 by Sarah Wiskerchen, MBA, CPC Whether due…
Prior Authorization Chaos is the New Normal for Spine Surgery
ORTHOWORLD – December 11, 2019 In 2017, the American Medical Association surveyed physicians across all specialties about the amount of…
Therapy Billing: Be Sure Your Team Is Doing Things Right
Therapy Billing: Be Sure Your Team Is Doing Things Right AAOSNow – October 2019 by Sarah Wiskerchen, MBA, CPC Many…
Coding Errors Can Cost You Money and Potentially a Sale
Coding Errors Can Cost You Money and Potentially a Sale Healio Orthopedics – October 2019 by Karen Zupko As more…
How to Bill and Get Paid for Unlisted Procedures
How to Bill and Get Paid for Unlisted Procedures AAOSNow – September 2019 by Cheryl Toth Orthopaedic surgeons often perform…
Does Your Practice Treat Pain?
Does Your Practice Treat Pain? AAOSNow – August 2019 by Cheryl Toth Interventional pain management is a growing specialty, and…
Practice Acquisition: How to be Easy to Do Business With
Practice Acquisition: How to be Easy to Do Business With Healio Orthopedics – August 2019 by Karen Zupko When was…
Seven Common Questions in Foot and Ankle Coding
AAOS Now – July 2019 by Sarah Wiskerchen A previous article published in AAOS Now (“How to Avoid Common Mistakes…
Tips and Best Practices for Using Code-X
Tips and Best Practices for Using Code-X AAOS Now – June 2019 by Cheryl Toth After speaking with Michael Marks,…
Coding Experts Weigh in on the Value of Code-X
Coding Experts Weigh in on the Value of Code-X AAOS Now – May 2019 by Cheryl Toth If you are…
Are Physicians Required to Return Overpayments?
Articles Are Physicians Required to Return Overpayments? Michael R. Marks, MD, MBA Michael Sacopulos, JD AAOS Now – May 2018…
Arthroscopy Coding for Major Joint - Shoulder
Articles Arthroscopy Coding for Major Joints – Shoulder Michael R. Marks, MD, MBA AAOS Now – March 2018 An accurate understanding…
Arthroscopy Coding for Major Joints - Knee
Arthroscopy Coding for Major Joints – Knee AAOS Now – February 2018 By: Michael R. Marks, MD, MBA When the…
What is in that alphabet soup? Deciphering coding acronyms to support reimbursement
Articles What is in that alphabet soup? Deciphering Coding Acronyms to Support Reimbursement Sarah Wiskerchen, MBA, CPC Healio Orthopedics •…
Have You Heard the Latest Medical Liability Risk?
Have You Heard the Latest Medical Liability Risk? AAOS Now – January 2018 By: Michael R. Marks, MD, MBA and Daniel R.…
Dispensing DME in Orthopaedics for Medicare
Dispensing DME in Orthopaedics for Medicare – November 2017 AAOSNow by Sarah Wiskerchen, MBA, CPC Answers to key coding questions…
Medical Imaging and HIPAA Compliance
Medical Imaging and HIPAA Compliance AAOS Now – October 2017 By: Michael R. Marks, MD, MBA What orthopaedic surgeons need…
Six Steps for Conducting an Internal Evaluation & Management Audit
Six Steps for Conducting an Internal Evaluation & Management Audit Healio Orthopedics • Orthopedics Today – September 2017 by Sarah Wiskerchen,…
Work RVU compensation formulas and surgery modifiers: To discount RVUs or not
Work RVU compensation formulas and surgery modifiers: To discount RVUs or not Orthopedics Today – September 2017 by Sarah Wiskerchen,…
Telehealth at a Tipping Point
Telehealth at a Tipping Point – September 2017 By: Betty A. Hovey, CCS-P, CPC, CPMA, CPCD, and Cheryl Toth, MBA…
Top 10 HIPAA Mistakes for Practices to Avoid
Top 10 HIPAA Mistakes for Practices to Avoid – September 2017 By: Michael R. Marks, MD, MBA, and Michael Sacopulos,…
Documentation Guidelines for Medical Decision Making
Documentation Guidelines for Medical Decision Making – August 2017 by Margaret M. Maley, BSN, MS With a brief history of…
Got a Good Governance Agreement? Use This 12-Point Checklist to Find Out
Healio Orthopedics Today – August 2017 by Karen Zupko A governance agreement is a written directive for how a practice’s…
Medicare Sharpens Focus on the Global Surgical Package
Medicare Sharpens Focus on the Global Surgical Package – June 2017 by Margaret M. Maley, BSN, MS The Centers for…
Pain Management In Orthopaedic Practices
AAOSNow – April 2017 by Karen Zupko Frequently Asked Questions – Pain Management In Orthopaedic Practices Increasingly, pain management specialists—physical medicine…
2017 Medicare Guidelines for Imaging
2017 Medicare Guidelines for Imaging – March 2017 by Margaret M. Maley, BSN, MS Effective Jan. 1, 2017, “FX” is a…
CPT 2017 for Foot and Toes
AAOS Now – January 2017 by Michael R. Marks, MD, MBA Every autumn, the American Medical Association’s (AMA) Current Procedural…
7 Golden Rules for Reducing Hip Arthroscopy Denials
AAOS Now – December 2016 by Michael R. Marks, MD, MBA If a constant stream of denials for hip arthroscopy…
2017 Spine CPT Code Changes
AAOS Now – November 2016 by Kim Pollock, RN, MBA, CPC, CMDP Spine surgeons face a multitude of Current Procedural…
Don't Be Intimidated by ICD-10-CM Changes
Don’t Be Intimidated by ICD-10-CM Changes – October 2016 by Margaret M. Maley, BSN, MS A systematic look at the code…
