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  1. J

    Wiki 28470 with 27822

    Physician does open left ankle (trimalleolar fracture) ORIF. CPT 27822. He also states that he does closed treatment for left 2-4 metatarsal fractures. CPT 28470. This is a Medicare patient. There is NCCI that closed fracture treatment is included if open treatment done in same area. I’d like to...
  2. J

    Wiki neuroendoscopy transphenoidal approach

    A co-surgery between otolaryngology and neurosurgery. The initial approach ((endoscope) trans-sphenoidal to pituitary was by otolaryngology. The neurosurgeon takes over the surgery for the pituitary tumor excision but finds out that the tumor/mass is not pituitary tumor. The mass turns out to be...
  3. J

    Wiki 27228 with 27130

    Patient has posterior column, posterior wall and femoral head fractures. Physician does ORIF for acetabular fractures and total hip replacement for femoral head fracture. Can I bill both CPT 27228 and 27130? They bundle but I feel it is a lot of work if only one of the code is billed.
  4. J

    Wiki EEG report

    The neurology physician is billing CPT 95813 (EEG) but there is no report available. Does anyone here have an example of the report that he needs to provide to support his EEG charge ? Thanks in advance.
  5. J

    Wiki Pemberton osteotomy of the left acetabulum

    How do I code Pemberton osteotomy of the left acetabulum (for development dysplasia of hip)? It looks more than just CPT 27146 (physician bills).. Below is the note: Procedure Performed: Open reduction and capsulorrhaphy of the left hip. Pemberton osteotomy of the left acetabulum An incision...
  6. J

    Wiki cpt 23570

    "Dx: Closed left scapula fracture. Plan for closed treatment of fracture. Sling given for comfort. Ok for ROMAT. NWB LUE. F/U orthopedic clinic 2 weeks for clinical exam." My physician puts in documentation above and bills CPT 23570. Is it good enough? Or what is lacking? Thanks Jyotsna
  7. J

    Wiki closed fracture documentation

    I am looking for : 1. What documentation is necessary to qualify for closed treatment of a fracture ? (ankle/pelvis/etc)? (fyi: posterior pelvis closed treatment fx has 0 days global) 2. What form should physician put this in to qualify? (Separate procedure note, addendum to consultation note...
  8. J

    Wiki tibia fracture with lateral meniscus and LCL tear

    hello, Can I bill for all? 1. Open reduction and internal fixation of bicondylar tibial plateau fracture. CPT 27536 2. Open repair of lateral meniscus, including the body and anterior horn and the anterior root and intermeniscal ligament insertion. CPT 27403 3. Open repair of the lateral...
  9. J

    Wiki knee dislocation

    Pt has knee dislocation diagnosis and physician bills 27427, 27428 for AL, PCL and MCL tear reconstruction. I think 27558 more appropriate. Or 27429?
  10. J

    Wiki i&d ?

    Pt goes to surgery every 3 days for recurrent infection in wrist and hand. Previous sutures removed, exploration, irrigation and nonviable tissue removed. I have coded 25028 and 26025 (hypothenar irrigated). The codes don't look right because there is no incision, only removal of previous...
  11. J

    Wiki 27532,20690

    Physician does closed reduction and apply uniplane fixation for tibial proximal fx. This is "likely be a temporary measure to allow swelling to subside before definitive surgery". Do I bill 27532 as well with 20690? Thanks in advance
  12. J

    Wiki 20650

    Can I bill for skeletal traction CPT 20650 one day prior to surgery? There is planned surgery next day. Thanks in advance.
  13. J

    Wiki inpatient phone e&m

    I have this neurology doctor who does EEG to inpt on 5/1, he also does phone call visit on 5/1 and sees patient on 5/2. Patient is in hospital all this times. Physician bills 95822 (EEG), 99447 for 5/1 and bills 99233 for 5/2. I'd like to know if 99447 can be billed, or if the phone visit can...
    • JYSPA
    • Thread
    • Replies: 0
    • Forum: E/M
  14. J

    Wiki spinal cord stimulator

    neurosurgeon did : a. remove spinal cord stimulator battery b. remove epidural spinal cord stimulator paddle including leads c. placement new spinal cord stimulator epidural paddle d. placement new battery including connector leads e. interrogation of device He is billing...
  15. J

    Wiki unfair policy

    AAPC has unfair policy to revoke credential if membership is not current/paid. My previous job paid for my membership but current job does not pay. AAPC tells me to pay-up otherwise they will cancel my credential. I feel like blackmailed ..
  16. J

    Wiki 62142 with 62141

    The patient had a bone flap put back by neurosurgeon months ago but it has now started to reabsorb and sink in. It needs to be removed and put in a new custom plate. Can neurosurgeon submit 62142 while plastic surgeon submits 62141?
  17. J

    Wiki Complex closure

    Physician bills 21012,13131-59. They bundle per CCI. Is it allowed to unbundle for same lesion/location?
    • JYSPA
    • Thread
    • allowed bills cci lesion/location unbundle
    • Replies: 4
    • Forum: Dermatology
  18. J

    Wiki 23 hr stay

    Does anyone know if we (facility) could bill and get paid for 23 hr stay after surgery in ASC. If payable, what would be the CPT, ICD and revenue codes? Thank you in advance
  19. J

    Wiki Modifiers in asc

    I am new to ASC coding and have 2 questions: 1. The CPT book states list of ASC modifiers in Appendix A and modifiers 51,22 etc is not there but it is mentioned everywhere including in this forum regarding adding modifiers 51,22 etc (pro-fee modifiers). Can I use these modifiers or not for ASC...
  20. J

    Wiki 22633 with 63277

    My physician did a 63277 (removal of mass) at L4 and 22633 (interbody fusion) at L4-L5 as that area was also very degenerated. He is saying that as both were distinc and separate, both can be billed. My manager agrees that the lesion (mass) is separate and per 59 guideline "a different session...
  21. J

    Wiki spine surgery

    maybe some orthopedics coders do spine coding as well: Patient has L4 fracture, my physician did anterior and posterior fusion. The anterior was done first with 22558,22846,22851,63090(L4). Then the posterior with 22612,22614(x3),22842,22524,22525(x3),72291. For the fracture at L4, the...
  22. J

    Wiki anterior+posterior fusion

    Patient has L4 fracture, my physician did anterior and posterior fusion. The anterior was done first with 22558,22846,22851,63090(L4). Then the posterior with 22612,22614(x3),22842,22524,22525(x3),72291. For the fracture at L4, the physician also wants to add CPT 22325 even though not...
  23. J

    Wiki injections

    If three separate bursa is injected at the same hip joint, can CPT 20610 be billed 3X ? CPT 20552 is bundled with CPT 20610, can I use modifier 59 to unbundle if the location is the same knee/shoulder/hip etc? How to use 59 modifier appropriately when CPT 20552 done with CPT 20610
  24. J

    Wiki AVF or skin suture? - The patient's AVF bled

    How do I code this? Does this qualify for any CPT code or just part of E&M? The patient's AVF bled from the ulceration profusely. Vascular surgery was consulted for bleeding from the ulceration overlying his AVF site 1. 2-0 prolene U-stitch placed around ulcerated site to control bleeding...
  25. J

    Wiki avf fistula

    How do I code this? The patient's AVF bled from the ulceration profusely. Vascular surgery was consulted for bleeding from the ulceration overlying his AVF site 1. 2-0 prolene U-stitch placed around ulcerated site to control bleeding, without issue. – Jyspa
  26. J

    Wiki power port removal

    is 36590 the code? Procedure: left-sided PowerPort removal Technique: Informed consent was obtained. The left chest was prepped and draped in usual sterile manner and the skin site anesthetized. The existing 3 cm incision was opened with an 11-blade. The 3 sutures securing the PowerPort were...
  27. J

    Wiki transfascial abscess

    Can I use 20005 for this procedure? It looks right to me - I want a second opinion. Procedure: Bedside incision and drainage of a trans-fascial abscess. Procedure: Informed consent was obtained. The previous incision site was sterilized. 1% lidocaine (20cc) was used to obtain local...
  28. J

    Wiki extensive cleaning

    How do I code one layer laceration repair with extensive cleaning. The physician only states extensive cleaning with jet lavage and does not mention any contamination etc. Do I use the simple repair or intermediate? Jyspa
  29. J

    Wiki fracture

    How do i code proximal radius fracture and ulna head dislocation closed treatment with manipulation? Can I code both separately or is there one code that covers both? Thanks
  30. J

    Wiki laceration - I need help with patient coming

    Hello, I need help with patient coming to with deep laceration in forearm. Repair was done to : radial artery, radial nerve, brachial radialis, flexor carpi radialis, extensor radialis longus & brevis. I am not used to coding laceration to artery/muscle/tendon/nerves. Can someone help me with...
  31. J

    Wiki please help

    Hello, I need help with patient coming to Emergency Dept. with deep laceration in forearm. Repair was done to : radial artery, radial nerve, brachial radialis, flexor carpi radialis, extensor radialis longus & brevis. I am not used to coding laceration to artery/muscle/tendon/nerves. Can...
  32. J

    Wiki help with repair

    Hello, I need help with patient coming to ER with deep laceration in forearm. Repair was done to : radial artery, radial nerve, brachial radialis, flexor carpi radialis, extensor radialis longus & brevis. I am not used to coding laceration to artery/muscle/tendon/nerves. Can someone help me...
  33. J

    Wiki amputed finger

    Can someone help me with this. I was thinking of CPT 13131 but that's not right and none of the orthopedic codes seem right: Two views of her left hand show soft tissue amputation of 1cm at the distal tip of the 5th finger of the left hand. No bony involvement. Patient sustained an amputation...
  34. J

    Wiki help

    Can someone help me with this. I was thinking of CPT 13131 but that's not right: Two views of her left hand show soft tissue amputation of 1cm at the distal tip of the 5th finger of the left hand. No bony involvement. Patient sustained an amputation of her distal finger tip of her 5th finger...
  35. J

    Wiki Limited Ultrasound

    We get many reports with limited ultrasound done bedside. I'd like to know if there needs to be a film and separate US report for me to charge the ultrasound. Often, the attending just states US findings in the ER report - is that good enough to code? Jyotsna
  36. J

    Wiki ambulatory surgery

    I'd like to know if there is any difference in professional fee coding and ambulatory surgery coding. If I already have professional fee coding, can I jump in to do ambulatory surgery? Jyotsna
  37. J

    Wiki infusion/hydration

    I have a case with : 1411 - 1541 Levaquin ivpb 1605 - 1705 - Zosyn ivpb 1531 - 1601 - Amoxicilin ivpb 1541 - 1803 - Hydration How do I code this? Thank you. Jyotsna
  38. J

    Wiki neurosurgery

    The neurosurgery doc says he did 61559 and the plastic doc did 21175. The report states the neurosurgery doc did bifrontal craniotomy and barrel-stave osteotomies. I am wondering: 1. Can 61557 be billed with 61559. 2. Is it ok for me to bill 61557,61559 (for neurosurgery doc) with 21175 (for...
  39. J

    Wiki code for this ?

    Is there a code for "In order to prevent the contents of the sella from herniating through the dural opening a Porex plate was cut to fit and replace the floor of the sella. It was positioned in place with the pituitary forceps and then anchored with fibrin glue". Surgery done is endoscopic...
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