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  1. J

    Wiki Arthroscopic Microfracture of hip

    We had an Ortho seminar put on by Karen zupko and associates in July 2021 and were told to use the unlisted code for a hip microfx using the knee code 29879 as a comparable code. It is hard to know if things are bundled since the code is unlisted. I would think you could bill it with the...
  2. J

    Wiki How would you code this sx for the Thumb Distal phalanx reconstruction? Need help on this - please

    DX : Traumatic Laceration / Avulsion RT Thumb Distal Phalanx Procedure: I & D , reconstruction thumb distal phalanx, and Thumb nail repair Implant : Temporary Aluminum Nail The procedure began with grossly debriding any contamination by utilizing the sponges available. We then conducted a...
  3. J

    Wiki Codes for a Bicompartmental arthroplasty?

    I have researched and found 27446 and 27438-59 OR unlisted. I am thinking since patellafemoral is unlisted by itself - bill 27446 and unlisted for the patellafemoral? Anyone billed for this - thoughts ?
  4. J

    Wiki Remplissage Procedure

    We Had Karen Zupko and Associates do an Ortho seminar at the Hospital I work for last July and they said 29806 w/ mod 22
  5. J

    Wiki ORIF D. Radius and D. Ulna fx code help

    I did see that old one. Thank you for responding :)
  6. J

    Wiki ORIF D. Radius and D. Ulna fx code help

    Provider does not indicate whether extra-articular, intra-articular 2 part, or intra-articular 3 part For the D. Radius fx. Would it be unlisted for the D. Ulna ? Only code for the Ulna is a shaft code and radial styloid code.
  7. J

    Wiki Lipoma Excision code

    He didn’t give size in op note so will have to use the minimum- us this the right code range for sub muscular ?
  8. J

    Wiki Lipoma Excision code

    Shoulder Lipoma Mass excision - sub-muscular per path report size 6.4 x 4.7 x 1.8 cm - looking at 23073 ? I struggle with figuring out the size on these.
  9. J

    Wiki Loose body removal

    The new guidelines indicate that you can now bill Loose body removal if the portal is enlarged to remove it. When I put it in our software (Vitalware) with other codes it says mod not allowed. My understanding is that the G0289 is for MCR only. We had a seminar by Karen Zupko & Associates and...
  10. J

    Wiki Revision of a reverse TSA

    He did not revise the stem only the tray that is why I was wondering about the 52 mod.
  11. J

    Wiki Revision of a reverse TSA

    If the provider only revises the Glenoid and Humeral tray do you bill the revision code both components with a 52 mod ?
  12. J

    Wiki Arthroscopic Hip Labral reconstruction

    I code for ortho doctors and the practice is owned by the hospital. We send an email to Revenue Integrity with the unlisted code and the comparable code and then they send back the amt that we are to charge and the RVU’s. So If unlisted I have to have a comparable code and am not finding any...
  13. J

    Wiki Arthroscopic Hip Labral reconstruction

    I billed the 29916 and the doctor thinks it should be unlisted because it is a lot more work then just doing a repair. I saw that post for unlisted comparing it to 29916 but then you aren’t getting paid for more work. I thought about mod 22. Will have to ask her if that would be an option.
  14. J

    Wiki Arthroscopic Microfracture of hip

    I this an unlisted code ? 29862 says abrasion arthroplasty (doesn’t mention drilling or microfracture like the knee code)
  15. J

    Wiki Arthroscopic Hip Labral reconstruction

    Unlisted procedure - what would you use as a comparable code ?
  16. J

    Wiki Closed treatment/ perc pinning of a LT 4th & 5th Carpal Metacarpal fx/dislocation

    What CPT code would you use - the perc pinning of the metacarpal Fx code or carpometacarpal dislocation code? He also says there is a small hamate fx. I was thinking 26676 but the facility billed 26608. One resource said to bill fx codes / dX. The facility used the hamate fx code only...
  17. J

    Wiki 11983 vs 20704, 20705

    Patient has problems with infection in his knee - provider did an arthrotomy and put in a static antibiotic spacer. Now he is taking the spacer out and putting a new one in and doing a temporary knee fusion. Was going to bill 20705 for removal and 20704 for the new one with the knee fusion...
  18. J

    Wiki Revision of a hip hemiarthroplasty due to femur fx

    Thank you - I went with the revision code. Both the head and stem were replaced.
  19. J

    Wiki Revision of a hip hemiarthroplasty due to femur fx

    Would you bill the Hemi again or revision of total hip femoral component
  20. J

    Wiki lapidus fusion with MTP realignment

    Ok thank you!
  21. J

    Wiki lapidus fusion with MTP realignment

    Do you know why 28298 Akins osteotomy has the option of RT or LT modifier OR T5 / T A . 28292 Silver bunionectomy is LT only and they bundle with no modifiers and with the LT modifiers but if I use TA and LT they don’t. The software we use is called Vitalware.
  22. J

    Wiki lapidus fusion with MTP realignment

    Thank you - I queried the doctor and he explained that was done open. The percutaneous was confusing.
  23. J

    Wiki lapidus fusion with MTP realignment

    op note says: Through Percutaneous incision the lateral collateral ligaments were sharply released off the second and third MTP joints. Good correction was achieved. The second and third toes were then pinned in this improved alignment. What CPT code would you use for this? Dr has used 28313...
  24. J

    Wiki Mod 52 and 22 hip revision

    Not sure what insurance - posted for a coworker - but with dealing with MCR in the past they ignore the 22 mod and then you have to ask them to request the notes and then they review it for add’t pmt. But at least it would be reviewed vs. Automatic reduction. Appreciate your response. Makes...
  25. J

    Wiki Screw tightened but no hardware removed

    Thank you !
  26. J

    Wiki Screw tightened but no hardware removed

    Would you code 20680 -52 or unlisted and if unlisted what code would be comparable?
  27. J

    Wiki Cpt code for adjusting internal fixation

    Looking for an answer on this also.
  28. J

    Wiki Mod 52 and 22 hip revision

    With 27138 you would be getting paid for the stem removal which was not done and getting paid for the extra work mod 22. To me that is getting overpaid. They should just let you use both modifiers with a note and they can figure it out from there. Thanks for your input! :)
  29. J

    Wiki Mod 52 and 22 hip revision

    Hip revision of the head and liner only - 27134-52 but the doctor wants to bill 22 mod for obesity and took 1.5 hrs longer - how would you bill this?
  30. J

    Wiki removal of index finger nailbed tissue

    Thank you - reached out to the provider and he said 11750 and 12041
  31. J

    Wiki removal of index finger nailbed tissue

    with closure of index finger traumatic amputation wound through the level of distal phalanx 2.5 cm. 11730 / 11750 for nail plate removal don't seem to fit. Would you just do the closure since it includes debridement? Patient had a traumatic amputation to the tip of his right index finger...
  32. J

    Wiki Finger surgery question (seperate procedure rule)

    If a procedure code has (separate procedure) but it doesn't bundle (NCCI) with the other code can you bill it? Example CPT code 26390 Right index finger flexor tendon resection and placement of silicone Hunter Rod and 26500 (separate procedure) Right index finger A1 pulley reconstruction. All...
  33. J

    Wiki Converting a Hemiarthroplasty to a reverse total shoulder

    Do you use a revision code or total code since no conversion code. Humeral head and stem were removed and a new stem, humeral bearing, Glenosphere with mini baseplate was put in.
  34. J

    Wiki unlisted code for perc pinning of medial malleolus fx

    what would be a comparable code for this procedure ?
  35. J

    Wiki 1-5 metatarsal fx's with multi plane fixation

    Would you bill closed treatment with manipulation of metatarsal fractures (28475) along with the multiplane fixation 20692
  36. J

    Wiki Reamer Irrigator Aspirator coding

    I also looking for an answer to this question.
  37. J

    Wiki Shoulder Arthroscopy

    Per encoder pro expert None of those codes are bundled. Per CPT Use 29826 in conjunction with 29806-29825 and 29827, 29828. The debridement does need to be separate from the prep for the RCR.
  38. J

    Wiki Wrist fusion code

    thank you - that was what we were leaning towards
  39. J

    Wiki Wrist fusion code

    What code is used for a STT fusion of the wrist?
  40. J

    Wiki Thank you Alan Pechacek, M.D.

    Thank you we appreciate your expertise.
  41. J

    Wiki AX debridement for Pattella clunk status post knee Replacement

    What CPT code are you using for this. My doctor wants to bill 29876 Synovectomy, major, 2 or more compartments. Some research has indicated code 29884 for Lysis of adhesions. The synovectomy code indicates resection of Pathologic Synovial disease and not to be used for simply "cleaning up the...
  42. J

    Wiki Athroscopic Cyclops Lesion Code

    Look at 29875 synovectomy vs. 29884 Lysis of adhesions.
  43. J

    Wiki jont replacement aftercare codes

    We were told by Brown's consulting that after 6 mos to start using Z09.
  44. J

    Wiki Denial of office visit with 25 mod w/cast application

    WC is denying OV when billed with mod 25 and application of cast being applied. These were both NP and a detailed dictation / exam / x-ray/ ROS/ PFHS, etc. Orthopedic Pink sheet for Jan 2017 says there are circumstances when E & M can be billed with cast application but doesn't indicate what...
  45. J

    Wiki DX denials for new sedation codes 99152-99153 with ESI injections

    We billed an ESI back injection with sedation and MCD is denying based on diagnosis code. It had three codes on it and they said it didn't like two of the codes but of course can't tell you which one. We have been resubmitting to see which one they will accept. We never had an issue with the...
  46. J

    Wiki E&M and cast applicaton

    WC is denying a NP visit where the doctor determined that patient had an avulsion fracture. We billed an E & M code 99203 with mod 25, application of cast 29075, supply code, and x-ray. We appealed it and the adjuster told them to pay it but they are still denying because it is a minor surgical...
  47. J

    Wiki MCD denied cpt code 27193

    27193 Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; without manipulation - we billed Fracture care in the office. Medicaid denied stating this is an inpatient procedure and cannot be billed in office?? Can not find anything to support this.
  48. J

    Wiki Osteotomy, Subtrochanteric with internal fixation, hardware removal, and bone graft

    We are billing 27165 - in encoder pro it states graft 20900/20902 is billable if from a distant site. I have always understood that to mean opposite limb or separate incision but when I put the two codes into encoder pro they are not bundled??
  49. J

    Wiki Using Mod 54 & 55

    I bill surgeries out with 54 mod if I know patient is not doing post op care with us. They usually are from out of state and return home after surgery. I have never rec'd a call from another office asking what code I billed etc so they can bill the 55 mod. We in turn have never contacted...
  50. J

    Wiki coding from chart notes

    coding from notes Thank you for responding.
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