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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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    Wiki Billing work comp for sales tax for surgical procedures

    Hello- I’m turning to my colleagues for your knowledge. Today I was told that surgical practices can bill for sales tax for surgical services (not office visits) for work comp cases. Has anyone ever heard this before? Thank you. Deb
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    Wiki ICD 10 for Shoulder Grooving

    Hello- My physician just brought me an ASPS Plastic Surgery News article stating they should use M95.4 for shoulder grooving. What do you guys use? We had been using L98.9. :confused: Thank you for any input. Deb
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    Wiki Exploration and debridement of nonhealing abdominal wound?

    I need help with a CPT code. I will attach the OP report. He wanted to bill 20102 and I know that is incorrect but I couldn't find anything else to bill. Any pointers? PROCEDURE: Exploration and debridement of nonhealing abdominal wound. Excision of abdominal stitch abscess...
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    Wiki 40530 CCI edits

    Thank you Thomas!!
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    Wiki 40530 CCI edits

    Even though 59 states it has to be a separate incision/excision?
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    Wiki 40530 CCI edits

    My physician billed for 40530 and 13152 and when I ran it thru our scrubber it kicked out for CCI as bundled. So I look up 40530 (Resection of lip WITHOUT RECONSTRUCTION) and under the excludes it states Excludes reconstruction (13131-13153)??? I am confused! Please help. Thank you for any...
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    Wiki infected breast implan

    I don't know specific infection that is why I am confused as to what to chose. She was just in for office visit. Path will be sent when implant is removed. This is not her initial visit, she is coming in for monitoring of her implant status.
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    Wiki infected breast implant

    Don't know the infection as she was just in for OV and path won't be sent until implant is removed. That's why I asked as I don't know what to code since no path was sent. Not her initial visit as she is coming in for monitoring of her implant.
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    Wiki infected breast implan

    Coding question.... patient is in for an infected breast implant. The physician put T85.79XD for the diagnosis and when I looked that up it said "use additional code to identify infection". I guess I'm confused as to what they are looking for? Her symptoms are pain, tenderness and non...
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    Wiki infected breast implant

    Coding question.... patient is in for an infected breast implant. The physician put T85.79XD for the diagnosis and when I looked that up it said "use additional code to identify infection". I guess I'm confused as to what they are looking for? Her symptoms are pain, tenderness and non...
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    Wiki Coding for history of breast cancer

    Hello- I was just at an ICD 10 meeting over the weekend and we got to talking about history of cancer codes. It was brought up that if the patient no longer has the cancer, it should be coded as history of which makes complete sense to me. I wanted to get this in writing to show one of my...
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    Wiki any changes in the icd 10 2016 versus 2014

    new ICD 10 code books So essentially we don't need to get new ICD 10 codes books if we download the updated guidelines? I just got off the phone with our supplier & she insisted there were coding changes and we should get at least one 2015 book. I have a 2014 draft. Thank you. Deb
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    Wiki Operative Reports

    We just had an ICD 10 meeting with our physicians and we were discussing that documentation for ICD 10 has to be more specific. I pointed out that when they document the Pre and Postoperative diagnosis on the op report they have to list the diagnosis as they did for the consult. For example...
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    Wiki NGS denials on benign lesion removals

    Debra- V71.1 looks like a good choice but it is not on the list of covered codes for NGS's LCD. That is where we are running into the problem....
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    Wiki NGS denials on benign lesion removals

    In our practice, we remove suspicious lesions then send them to pathology. Once the path report comes back, we bill for the removal using benign or malignant lesion CPT codes. In the past when WPS was the Medicare carrier, they paid benign lesion removals. We are finding with NGS, their LCD...
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    Wiki operating micorscope 69990

    One of my physicians bills for 69990 when he does nerve repair which is allowed. Most of the time when he does nerve repair, he also does tendon repair and it is not allowed with that per CCI. He is questioning when this got changed. I have been doing surgical coding for 6 years and it's been...
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    Wiki Excision of infraorbital cyst

    Happy Friday! Having trouble coding a procedure.... procedure performed was excision of a left infraorbital cyst 2 cm diameter. "We then infiltrated the left lower eyelid area and made a small incision overlying the lesion in the left lower eyelid. Dissection was carried down to and through...
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    Wiki Bilateral muscle flaps

    Hello all- Physician did bilateral pectoralis major muscle flaps. He billed for 15734 X2. My question is do I bill this with RT & LT modifiers and 59 or do I bill it with 76 modifier. It cannot be billed with two units. Thank you for any input. 15734 RT 15734 LT 59 or 15734 15734 76
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    Wiki breast implant expansion

    Is there any way to get paid for the expander fill kits?
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