Recent content by NPSDEB

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    Wiki Scar Revision

    Hello all- Has anyone found a way to bill for scar revision? Since we can no longer use the complex repair codes we are at a loss as to what to use. Cannot use the lesion removal codes since there is a LCD for that and L90.5 is not on that list. I am meeting with my provider this afternoon to...
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    Wiki Discontinued free flap reconstruction (SIEA)

    Hello- Any input is greatly appreciated. Patient was coming in for free flap reconstruction and removal of tissue expanders post mastectomy. The free flap was discontinued due to extensive clotting and necrosis of flap. Also there was a co-surgeon involved. We have been trying to figure out...
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    Wiki Breast revision and implant replacement

    Hello- My surgeon wants to bill 19380 with 19342. When I ran it thru NCCI edits, it edited out. But in the CPT guidelines, it states to report 19342 separately. Do I bill it with a 59 modifier? For some reason, that just doesn't feel right. Any input? Thank you for any and all input. Deb
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    Wiki Breast reconstruction; TRAM w/co surgeon (19364)

    I did a search on procedure code 19364 for this thread and it looks like this question goes way back. We have had a few insurance companies deny the co-surgeons (62 modifier) for procedure code 19364 stating they are not of different specialties (two board certified plastic surgeons doing the...
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    Wiki Total mastectomy Bi with Bilateral first-stage breast reconstruction with insertion of tissue expanders and use of acellular dermal matrix bilaterally

    Look at the guidelines for 15777. You do not use 50 modifier when it is related to breast procedures. You report it twice with RT & LT modifiers.
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    Wiki Diastasis Repair

    Good day fellow coders- Has anyone figured out a way to bill for Diastasis recti repair. I just went over quite a few old forum posts and the only CPT that was really mentioned was an unlisted code. (I think it was 49999). Just can't believe there isn't a code for this yet. Just thought I...
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    Wiki muscle repair of the foot

    Hi- I am trying to code muscle repair of a patients foot. He stated he repaired "intrinsic muscle of left foot". The intrinsic muscle of the medial aspect of the foot was isolated both proximally and distally and 2 figure of eight 3-0 Vicryl sutures were used to repair this muscle. I asked...
    • NPSDEB
    • Thread
    • muscle repair foot
    • Replies: 1
    • Forum: Podiatry
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    Wiki nerver repair with wound exploration 64910 20103

    Physician wants to bill for nerve repair (64910) and wound exploration (20103) for this note. I feel as though the procedure started out as an exploration and FB removal but since he found a nerve that was lacerated and repaired that he should only bill for the nerve repair. The do not CCI out...
    • NPSDEB
    • Thread
    • 64910 20103 nerve repair wound exploration
    • Replies: 0
    • Forum: Plastic Surgery
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    Wiki intrinsic muscle repair of foot

    Hello- Can anyone help me with a CPT code for this? The notes state "The intrinsic muscle of the medial aspect of the foot was isolated both proximally and distally and 2 figure of eight 3-0 Vicryl sutures were used to repair this muscle. Thank you- Deb
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    Wiki intrinsic muscle repair of foot

    Hello- Can anyone help me with a CPT code for this? The notes state "The intrinsic muscle of the medial aspect of the foot was isolated both proximally and distally and 2 figure of eight 3-0 Vicryl sutures were used to repair this muscle. Thank you- Deb
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    Wiki Getting paid for units for 26356 25260

    I submitted a claim to MN Medical Assistance for tendon repair. He repaired multiple tendons in the forearm and hand. I submitted 26356 with 3 units (MUE is 4) and 25260 with 3 units (MUE is 9). MN MA only paid for one unit for each. When I called them they said they only allow one unit for...
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    Wiki lesion removal documentation

    Medicare requested prepayment documentation for lesion removal. (11642 11422 & 11441) I sent they operative report which showed lesion size in the heading of the op report. Procedures: 1. Excision of left brow carcinoma in situ (1.5 cm) 2. Left lateral canthus skin lesion excision (0.6 cm) 3...
    • NPSDEB
    • Thread
    • 11422 11441 11642 documentation lesion removal
    • Replies: 1
    • Forum: Dermatology
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    Wiki Epidermal inclusion cyst

    Hi All- I am trying to code for removal of epidermal inclusion cyst. The tricky part is the physician only did a 8 mm X 2mm incision in which he circumferentially dissected the cyst and removed it. I understand his point of view in that it was more work to dissect the cyst & remove it from such...
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    Wiki epidermal inclusion cyst

    Hi All- I am trying to code for removal of epidermal inclusion cyst. The tricky part is the physician only did a 8 mm X 2mm incision in which he circumferentially dissected the cyst and removed it. I understand his point of view in that it was more work to dissect the cyst & remove it from...
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    Wiki Assistant Surgeon modifier 80

    I just wanted to verify some things before I submitted a charge. Is it correct that when billing with modifier 80, the assistant surgeon gets paid 16% of the allowable and the primary surgeon's reimbursement is not affected? Also is it correct that the assistant surgeon does not have to...
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