Recent content by melanied

  1. M

    Wiki Osteotomies 22212 22214

    Hello I have a debate on these codes and the dx codes that we can bill with them. AANS tells us that we can only bill the 22212 and 22214 etc. with deformity codes correct? I have sent a case to be audited and heve been told that I can bill the SPO codes withdx of M47.816 and M47.817 (...
  2. M

    Wiki Billing 59 mod vs AS modifiers, which is listed first on a claim? please advise

    I work with Neurosurgeons and NPPs. Our NPP assisted on a surgical case and we billed the modifer 59 before we added AS modifier ( see example line 2). Our claim was paid but now they are recouping a portion of that line item (line 2) example: 22551 AS 22845 59 AS 22552 AS 22853x2 AS 20937...
  3. M

    Wiki post op modifier

    hello Looking for a post op modifier. Our surgeon did a wound washout on a patient that we did not do the surgery on. Thank you
  4. M

    Wiki Box 22 on HCFA, difference between 8 and 7 (submit reason)

    What is the difference in using and 8 or a 7 for the submission reason in box 22 on a electronic claim? Our Office was told to use an 8 instead of a 7 when we were correcting a claim. Thank you for the clarification
  5. M

    Wiki Open Kyphoplasty CPT

    Hi Can anyone tell me if they have heard of the CPT for open Kyphoplasty? Thank you in advance
  6. M

    Wiki reprograming a shunt in Hospital setting

    Hi I work for a Neurosurgeon and we consulted on a patient in the Hospital and reprogrammed his shunt. He is a Medicare patient and Medicare added a 26 modifier to our claim. Why would they do that if we did the work? Thank you Melanie D
  7. M

    Wiki cpt code 62223 billed with 61781 and 69990 is this payable?

    Our Neurosurgeon did a 62223 and used stereotactic navigation 61781 and the microscope is the payable? Medicare says the 61781 is for reporting purposes on the ERA. Thank you
  8. M

    Wiki Guidelines on Billing Rules

    yes, we know that some follow CMS and some follow AMA. But is it appropriate for them to make up their own rules??
  9. M

    Wiki Guidelines on Billing Rules

    Medicare did drop 9925 codes and consolidated the other codes, Medicare pays 99221- 99223 consult codes as our Neurosurgeons see patients daily in the Hospital as well as pay for Office Consult codes.
  10. M

    Wiki Guidelines on Billing Rules

    Hello Who establishes guidelines on billing rules? AMA or CMS? Thank you
  11. M

    Wiki arthrodesis 22614 billing question for Neurosurgery

    Hi Can you bill for an new arthrodesis code (22614) on a patient you are doing a surgery on that has had a previous arthrodesis at the same level? . Thank you
  12. M

    Wiki surgery (professional) coding, billing allowable units vs units in procedure

    Hello, I bill for a Neurosurgery office and we are seeing denials for units billed (example 22853 in a procedure)for Medicare. Medicare allows up to 4 units paid and we did a procedure with 5 levels, so we billed 5 units. The line item is denied for too many units. Do we will bill the claims...
  13. M

    Wiki neurosurgery coding

    I have a question on some coding that I am up against. maybe someone can help? C4 Corpectomy C4C5 C6C7 acdf C3C4 C4C5 fusion interbody device C3 C7 anterior plate C3 C7 allograft C1T2 poserior arthrodesis and fusion C2 C6 laminectomy C1 T2 istrumentation thank you for your help Melanie
  14. M

    Wiki surgery coding question

    I have a large surgery that I would like some help on. C4 Corpectomy C4C5 C6C7 ACDF C3C4 C4C5 Anterior Fusion C3 C7 Interbody device C3 C7 Anterior plate Allograft C1 T2 Posterior Cerv arthrodesis C2 C6 Laminectomy C1 T2 instrumentation thank you so much
  15. M

    Wiki PA Billing and Tricare, Mod AS and SA

    Hi Wondering if anyone is experiencing issues with Tricare and PA billing and the modifiers SA for non surgical claims? Alsa AS modifier on surgical claims? thank you
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