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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…
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…
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…
Superior Capsular Reconstruction
July 11, 2019 Question: What CPT codes do I use for comparison when the surgeon performs a superior capsular reconstruction?…
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…
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…
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…
Endoscopic Cubital Tunnel Release
May 23, 2019 Question: If a cubital tunnel release is performed by endoscopy how should it be reported? We report…
Reading an X-ray the Patient Brought In
May 9, 2019 Question: A patient presents with a CD of an X-Ray that was performed at another institution that…
Laminoplasty
April 25, 2019 Question: My surgeon did a C2-C7 laminoplasty and reconstructed with mini-plates. What code should I use? Answer:…
Call Coverage: Return to OR
April 11, 2019 Question: I appreciate your patience in answering my questions. I understand the E&M scenarios so let me…
Weekend Rounds (Part 2)
March 28, 2019 Question: Thanks for answering my question last time – I get it now that I would not…
Weekend Rounds (Part 1)
March 14, 2019 Question: I have just a quick question regarding weekend rounding. I share weekend call with another practice…
How to Avoid Common Mistakes When Coding Hand Procedures
How to Avoid Common Mistakes When Coding Hand Procedures AAOSNow – March 2019 by Sarah Wiskerchen and Raymond Janevicius, MD Billing…
Bone Graft
February 28, 2019 Question: My surgeon performed a repair of a nonunion with bone graft harvested via a separate incision. …
Suture Removal
February 14, 2019 Question: We had a patient come into our office to have their sutures removed from a hand…
Joint Injection
January 31, 2019 Question: We have a non-Medicare patient that brings in her own Viscosupplement drug that she purchases through…
New or Established Patient
January 17, 2019 Question: I am new to Orthopaedics. I am in a practice that employs a joint specialist, spine…
I&D in the Office during the Global Period
December 13, 2018 Question: Our surgeon saw a patient in the office for a routine post-op check during the global…
ED Treatment of Fracture by Advanced Practice Provider
November 29, 2018 Question: Our physicians are asking us to report closed treatment without manipulation codes when their Advanced-Practice Provider…
Fracture Treatment and Teaching Physician Requirements
November 15, 2018 Question: Our physicians teach residents in an academic medical center. Often the residents see fracture patients in…
CPT Code 20610 or 20611?
November 1, 2018 Question: Our physician performed a shoulder joint injection with ultrasound guidance. The physician’s procedure note does not…
New patient or not?
October 18, 2018 Question: One of our providers serves as a team physician for a local high school. I was…
CERT Reviews for Arthroscopic Rotator Cuff Repairs
October 4, 2018 Question: We recently heard about Medicare doing CERT reviews for CPT code 29827 (arthroscopic rotator cuff repair). …
Answers to Five Common Coding Questions
Answers to Five Common Coding Questions AAOS Now – October 2018 by Margaret M. Maley, BSN, MS and Sarah Wiskerchen What…
Don't Be the Next Victim of Billing Fraud and Abuse
Don’t Be the Next Victim of Billing Fraud and Abuse AAOS Now- October 2018 By: Michael R. Marks, MD, MBA…
Viscosupplementation Injections
September 20, 2018 Question: There is a lot of confusion in our office when the doctor injects viscosupplementation and it…
Modifier 56
September 6, 2018 Question: Why would we receive a Medicare denial when reporting a major surgical procedure with a modifier…
Reasons Why Diagnostic Coding Matters in Value-based Care
Reasons Why Diagnostic Coding Matters in Value-based Care AAOS Now – September 2018 by Margaret M. Maley, BSN, MS Payers…
Articles
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…
Spine Practices May Lose Money When They Do Not Bill for Consults
Healio- October 2016 by Kim Pollock, RN, MBA, CPC, CMDP and Teri Romano, BSN, MBA, CPC, CMDP Medicare eliminated payment…
Are CMS and Other Payers Requiring –X{EPSU} Modifiers?
Commonly Asked Coding Questions – September 2016 by Sarah Wiskerchen, MBA, CPC Q: Are the Centers for Medicare & Medicaid Services…
Setting Up Your New Physician for Success
The American Journal of Orthopedics – September/October 2016 by Cheryl Toth, MBA Practices and hospitals invest significant time and money…
PA and NP Billing: Are You Doing It Correctly?
PA and NP Billing: Are You Doing It Correctly? – May 2016 by Sarah Wiskerchen, MBA, CPC The effective use of…
“Clean Up” Diagnosis Coding for Staged Revisions
“Clean Up” Diagnosis Coding for Staged Revisions – July 2015 by Margaret M. Maley, BSN, MS Assigning diagnosis codes for joint…
Don’t Let Sprain and Strain Drain Your Brain
Don’t Let Sprain and Strain Drain Your Brain – April 2015 by Margaret M. Maley, BSN, MS Reporting sprains and strains…
Billing Essentials for Using a PA or NP in Orthopaedics
AAOS Now – February 2015 by Sarah Wiskerchen, MBA, CPC In last month’s AAOS Now roundtable, “Making the Most of…
Measuring Up: What An Orthopaedic Group Should Expect In A Practice Manager/CEO
AAOS Now – May 2014 by Jennifer A. O’Brien, MSOD On any given issue within a group practice—whether operational or organizational—it…
