Search results

  1. P

    Wiki CPT for intercuneiform fx?

    You are saying pt has a fracture of cuneiform...I would code ORIF with 28465...if both were fx'd and both were fixed..I would use this code 2 times
  2. P

    Wiki I-10 hip fx confusion

    I am confused by the upper femur fx codes A Subcapital fx (S72.011A) of the femur IS a transcervical fx (S72.031A) , why are they giving different code sets for same section of femur ? And the Subcapital fx codes are "unspecified" - but transcervical fx ARE specified - it seems to me that...
  3. P

    Wiki Does ankle instability support Brostrom procedure? 27695?

    I have been paid for Brostrom with ankle instability code, however, that was before I-10 and it was on 27698 27695 is for primary repair - so you would "expect" an acute code Ankle instability by itself in I-10 is kind of not specific - I typically will see "instability due to old injury/...
  4. P

    Wiki Removal of offending Spicules of Ingrown toenails

    I count this in my E/M....you are correct that it really does not fall into a category When I started out, I tried it with 11730 ...then 11720....always denied
  5. P

    Wiki Percutaneous trigger finger release

    I would look at 26060
  6. P

    Wiki WC/ non-WC, TPL/ non-TPL

    I am no expert on this topic....but...I have been told in seminars that it causes HIPAA issues....if patient is being seen for WC injury to right shoulder and also being seen for toenail fungus (comm ins) and all documentation is included in one note...then when you send med recs to WC (all my...
  7. P

    Wiki Documentation required to bill 29826

    sorry I was talking to someone about bunionectomy my doc documents 29826 - "significant subacromial bursitis somewhat hemorrhagic appearing was noted and a thorough subacromial bursectomy was performed with an arthroscopic ablator...anterior impingement lesion with spur was noted...the CA...
  8. P

    Wiki Documentation required to bill 29826

    you want to see an osteotomy of the metatarsal (typically with fixation ) and removal of the bony eminence (bunion) at the metatarsal head
  9. P

    Wiki Pelvis xrays for knee pain

    have you already been denied for this ? I would bill it out - watch how/if they pay/deny I bill neck xrays with shoulder pain dx - lumbar xrys with leg pain dx - never had a problem getting them paid (mostly never) just make sure documentation is good - they are looking for source of pain
  10. P

    Wiki 2 codes in place of 1 code

    HAHA - he does not even let me finish that sentence anymore.....I am very lucky he has fantastic sense of humor thanks for the confirmation - I think I may need to post the question right to APMA - this is the 3rd round of this particular debate we are having
  11. P

    Wiki 2 codes in place of 1 code

    my doc wants to bill bunionectomy - 28292 with fusion - 28740 instead of billing 28297 he says "all the other drs are doing it " - he has 2 SEPARATE dx bunion/HAV and also OA of tars/met joint - he feels the 2 diff dx's should justify the use of 2 codes. I was taught - coding 101 - you never...
  12. P

    Wiki Physician payment for synvisc medicine during surgery

    my docs take meds to OR sometimes as well....We require them to document in operative report that the meds were brought from "our office"...(state your name/company) - then I have to bill the med separately with our office location as POS I have not had to do this for Synvisc One - but have...
  13. P

    Wiki pain at bone graft donor site

    I cant seem to find a code for post-op pain at donor site... Looking at post-op pain G89.18 ? or T86.838A - other comp of bone graft ? any thoughts would be appreciated...
  14. P

    Wiki CPT code for partial resection of distal phalanx

    I agree with 28124
  15. P

    Wiki painful hardware

    your hardware removal codes 20670 ; 20680 are listed as "separate" procedures , you cannot bill together same time/same body part
  16. P

    Wiki advise -unspec meniscus tears

    I am really unsure how to code dx for meniscus tears that are not spec. as current / vs/ old I have no indications what so ever if injury took place/ or not in op reports - DR WILL NOT correct/addend/specify I have to put some kind of code on it ? should i use an unspec internal...
  17. P

    Wiki bone spur code for hallux

    I use 28124 - I have on occasion had to send in definition of bossing and it gets paid (dont use the skull def...find an ortho def "rounded bony prominence ") I know some people use 28108 - but I have had this denied before? could not find any documentation to suggest bone cyst = spur....all...
  18. P

    Wiki Rotator Cuff Repair (with acromioplasty) and Superior Capsular Reconstruction

  19. P

    Wiki Arthroscopic TFCC repair with Tenolysis

    best guess Best guess...the 29846 also states "joint debridement" I would imagine they are considering the tenolysis as local debridement......just because it was done "open" does not mean it is not local...it is still same body part/area...."local" debridement is included in many codes.
  20. P

    Wiki malignant lesion femur

    I have a pt who received prophylactic tx to proximal shaft for malignant lesion in femur.......doc "thinks" it is secondary to lung lesion...however.. no biopsy has been performed on the lung..yet... pt is inpatient....not sure if i should code the femur lesion as 2ndary lesion ? should i code...
  21. P

    Wiki PT Orders - We use Epic

    We use Epic. I am finding unspecific physical therapy orders being entered....they ARE linked to the encounter e/m my question is am I allowed to use the chartnote to give a more specific dx to the PT data entry specialist ? I was under the impression that I MUST code to the ORDER ? example...
  22. P

    Wiki NON specialized chart reviewer

    One of our payors use a company to do their "chart review" for surgeries We send our op reports to this company - and they determine if the documentation supports codes submitted and they tell the payor to pay/deny claim My problem is they use a Urologist to review (and deny) my ortho...
  23. P

    Wiki Is is appropriate to use fluoroscopy in place of x-ray?

    I know for Medicare they do not accept "spot shots" in place of an xray - you cant just take a pic of metatarsal to rule out fx (example) we have our own fluoro - we use it for needle localization -77002 and we get paid for that. we also do use it for viewing a joint - 76000 - this requires a...
  24. P

    Wiki arthritis of the knee

    My I-9 book said it ...my I-10 does not BUT M19.90 code description says osteoarthritis
  25. P

    Wiki Shoulder Compartments

    I am not aware of any payor who splits the shoulder into compartments. Per CMS NCCI edits....the should is NOT separate compartments....you can find this in the NCCI edits instruction manual
  26. P

    Wiki un-bundle legal cases

    My coding department is being told not to bundle any coding on our Legal cases...these cases are not submitted to ins.company, the charges sit under a letter of protection until the case is settled. We have always gone by NCCI edits in our practice, but now we are being told not to bundle any...
  27. P

    Wiki overthinking thumb dislocation

    I am so sorry that I am a coder who is not specific...thanks for confirming the 2 joints in the thumb...i did think i was losing it for a minute but..my point was.....THERE ARE I-10 CODES FOR 3 JOINTS IN THE THUMB for dislocation.....I guess we will just never be using the distal IPJ
  28. P

    Wiki overthinking thumb dislocation

    I am confused with the thumb dislocation codes....there is no distal IPJ of the thumb correct ? I can only find 2 joints in the thumb S63.114A - dislocation MPJ thumb S63.134A - dislocation proximal IPJ thumb S63.144A - dislocation distal IPJ thumb ?? did I miss some evolution.....I would...
  29. P

    Wiki Post op visits - Trying to educate my doctors

    awesome article AAOS Now , article "check your schedule for an audit time bomb"....correctly code postoperative visits outside the global period July 2009 issue.
  30. P

    Wiki Staff using cheat sheets ?

    Does your staff use I-10 cheat sheets ? I am trying to get my admin staff to use them....as I am giving out carpal tunnel I-10 code on the daily...every day sometimes multiple times a day. they do not know how to look up code in Epic. they are not coders. Just want to know if i am being...
  31. P

    Wiki April 1 2016 CMS total joint billing

    I work for independent ortho surgeons. We are being told (by a rep) that with this new rule the hospitals will do the "billing" for total joint replacements for OUR providers ? I cant seem to verify this? I don't think it is accurate info. Can anyone direct me to guidelines for private...
  32. P

    Wiki Push Back on How Something is Coded

    unfortunately I am going to have to tell you to get used to it. I have been coding for 15 years and I still get "are you sure" I would recommend making yourself a reference book with copies of your rules/regulations from reliable/respected sources...this may include copies of pages directly...
  33. P

    Wiki Debridement during post op period

    per ncci post op wound care is included in global
  34. P

    Wiki I-10 degenerative ligament tear

    DR is dx "degenerative scapholunate ligament tear" I am using M24.231 disorder of ligament,wrist. any thoughts? can you just tell me I seem correct. thx I-10 !
  35. P

    Wiki I-10

    I cannot find code for "degenerative post. horn medial meniscus tear" does Derangement/old = degenerative ? thx for any help.
  36. P

    Wiki initial vs subsequent

    OK I have been through and through my I-10 book and cannot seem to find where they are defining or directions as to WHAT initial vs subsequent means..... can someone direct me to where you are finding this info? initial = active ? thx
  37. P

    Wiki ICD-10 - Healed Fracture

    Take a look at Z09 I am thinking about it
  38. P

    Wiki Quadriceps rupture

    I am very confused about quad tears S76.111 states quad rupture - but it specifically says "hip and thigh region" I used S83.211A - because the tear was at the knee, off the patella anyone have any insight ? or am I correct in going to the knee code thanks for any help.
  39. P

    Wiki Lcd information

    It depends on which one...but...I use them all the time on xrays - no probs typically its V58.78
  40. P

    Wiki Bilateral Pelvis Orthopaedic coding 72170

    72170 is 1 or 2 views pelvis 72190 complete, min 3 views pelvis SOME of the hip xray codes bundle pelvis xry codes....so ck your edits
  41. P

    Wiki 25447 with Tendon Transfers

    my description of 25447 states "surrounding tendons may be split or cut....tendon or fascia is inserted in place of excised bone" I read this as local tendon work is typical part of procedure. you may have better luck using 20924..IF tendon is taken from distant site....leg,ankle hope that...
  42. P

    Wiki E/M w/ inject

    I am feeling some pressure to bill 99213 with 20610. I have read the ncci manual and it states "the decision to perform minor surgical procedure is included in the payment for the minor proced and should not be reported separately as an E/M service" my boss says a "new problem" w/ decision...
  43. P

    Wiki ICD-10 defaults

    According to my ICD10 book the default on "deformities" ex: hammertoe, goes to "acquired" ..... are you REQUIRING your doc to state "acquired" ? I am not sure if I want to hound them, when I know I have a default....even though I don't really like relying on defaults......they do ALWAYS...
  44. P

    Wiki emr hx reviewed by

    my doc is stating in her note for new PFSH that "it was reviewed in Epic".....when I go to look for the hx, I can see it has been enterted BUT it has been reviewed /signed by the MA. Am I correct that I cannot count this ? must be reviewed/signed by DR. ? thx
  45. P

    Wiki Pttd icd10

    what ICD10 code are we using for posterior tibial tendon dysfunction? I was looking at "acquired flatfoot" M21.41 ? my doc feels maybe some type of enthesopathy code would be more appropriate? what are our thoughts ? THX
  46. P

    Wiki Auditor opinion plz

    My docs dictate "3 views lt foot" into their xray report, rather than stating each specific view, ap/lateral/oblique ect... Is this acceptable to give # of views instead of name of views? thx
  47. P

    Wiki Fibular Osteotomy/Total Ankle Arthroplasty

    I show that 27707 is included in 27702 (cci), so you would not bill for the 27707 unless it was done on opposite ankle. I am not aware of any exceptions to this.
  48. P

    Wiki help with fracture reduction with bone graft codes please

    I would also use the 20900 as it was taken from distant site.
  49. P

    Wiki Acromion Injection?

    I use it when they say "I injected the area"
  50. P

    Wiki Capsular plication shoulder

    I agree with you. I believe there is an aaos article stating to use 29806. You can only bill once per shoulder....there is only ONE capsule per shoulder, this is per ncci edits.
Top