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    Wiki baclofen test injection CPT

    I would appreciate anyone's help. My provider has submitted 62323 for baclofen test injection w/ dx R25.2 (cramp & spasm) . I am filling in for this dept and I am unfamiliar with this px. We have recv'd a denial from Medicare stating dx does not support medical necessity. What CPT code is...
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    Wiki Telehealth -HPHC audio only

    What CPT does HPHC require for audio only visits for 2024? There is plenty of info for behavioral health claims but that is not what I looking for. I have tried 9921x and also 9944x, pos as 10 w/ mod 93. Both CPT's are denying. I have tried checking their policy only and I either get an...
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    • Replies: 0
    • Forum: E/M
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    Wiki 11970 & 19370 on same breast

    Please help!! For 2024, can 11970 & 19370 both be reported for same breast. I read all the guidelines & articles but honest, the way some of them are worded I get confused. 😓
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    Wiki Amputation finger w/ deep nerve embedment

    thank you!
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    Wiki Amputation finger w/ deep nerve embedment

    My provider wants to use +64787 for the transection of the digital nerve with deep tissue embedment along w/ amputation of distal phalanx. As you know 64787 is an add on code for excision of neuroma(s)codes 64774-64786. The were no neuromas excised. Would the digital nerve transection w/ deep...
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    Wiki 15733 or 15734

    My provider wants to submit 15733 for the named muscle flaps listed in the statement below. I know the semispinalis & splenius capitis are in the neck area but I am leaning more towards 15734 only because the description of 15733 states neck but list only the anterior muscles (buccinators...
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    Wiki 64787

    Please help..... my provider wants to submit 64708 & +64787. Add on code, 64787 can only be billed w/ 64774-64786. The note clearly states that the neuroma was not excised. I agree with 64708 but I would appreciate any help . The proximal end of the prior incision along the lateral leg...
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    Wiki Titanium Mesh used for bilateral breast sx

    Thank you!
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    Wiki Nasal Flap debulking

    Would appreciate anyone's help. Provider has submitted 14060 / 15839 / 30420. I am not sure of 15839 for debulking and I do not think there is a code for a cadaver rib graft. Thanks in advance for your help!! Post-Op Diagnosis Codes: * Cancer of lateral nasal wall (CMS/HCC) [C11.2] *...
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    Wiki Titanium Mesh used for bilateral breast sx

    I am trying to determine the appropriate code for titanium mesh used in bilateral breast surgery. I have not come across the use of titanium use before. The common px for us is 15777 for ADM. I would appreciate anyone's help! TIA The sizer was removed. The implant pocket was irrigated...
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    Wiki dx code for removal of implant to reduce risk of ALCL

    What is everyone using for a dx code for removal of breast implant surgery to reduce risk of ALCL? Pt show no signs or symptoms as of yet. Strictly preventive, she is worried about ALCL in the future.
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    Wiki E/M ordering of each unique test - 2023

    Thank you!
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    Wiki E/M ordering of each unique test - 2023

    If my provider orders an xray (done in office) on the day of the encounter, he is billing for both PC & TC as the practice owns the equipment, can this be counted at as ordering unique test for this encounter only?
    • D.R.
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    • Replies: 2
    • Forum: E/M
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    Wiki Kenalog Units

    Thank you!!!!
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    Wiki Kenalog Units

    Is this enough info to determine units of J3301 to bill? I get so confused!!! My docs always document in cc's "injected steroid / local to each site, both arms (bilateral pronator, bilateral radial tunnel). 1.5 cc of 1:1 mix of Kenalog 40 & Lidocaine, Injected to each of 4 sites" Thanks
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    Wiki Breast reconstruction

    pt had TE placed on separate day of mastectomy. Months later provider is now doing TE exchange to perm implant. Provider wants to submit 19380 RT / 19342 RT / 11970 RT / 15771/ 15772 x3. My opinion is we should only be submitting 11970 RT / 15771 / 15772 x3. Would appreciate thoughts please...
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    Wiki Dog ear excision

    I am seeing many different answers regarding excision of dog ear. KZA states if 2nd stage breast reconstruction, dog ear excision included. Okthat makes sense but what if it is not 2nd stage breast recon. I am finding many different opinions. I have seen use 1140x codes w/ intermediate...
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    Wiki Prolene mesh for abdominal perineal defect recon

    Hi all! Need help regarding what code to use for the prolene mesh used to reconstruct the abdominoperineal defect. My provider wants to use 49568 but there is no hernia. Would appreciate your input please. Thanks Pre-Op Diagnosis : Rectal cancer Post-Op Diagnosis : Same VERTICAL RECTUS...
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    Wiki Coding book

    Our company is offering to buy us our books this year and I would appreciate everyone's opinion on the best supplemental coding book for reconstructive plastics. TIA!! :)
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    Wiki 62252 in office setting

    not very familiar with this but hoping someone has some advice. Est pt coming into office w/ neuro provider for follow up. Pt had shunt placed back in 2016 for normal pressure hydrocephalus. No issues until recently with increased weakness, falls, gait & mobility issues. Medicare is...
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    Wiki 29848 ?

    Thank you it certainly does 😊
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    Wiki 29848 ?

    Need another opinion please. 29848 or 64721. Provider is requesting 29848 be submitted. I feel just because the scope is inserted at the very end doesn't make it endoscopic, The approach was open. Thoughts please ....... The transverse incision at the proximal wrist crease...
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    Wiki 15004 w/ tissue tx

    Thanks so much for your help!
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    Wiki 15004 w/ tissue tx

    Thanks so much. So basically when they are prepping/or debriding the recipient site of the ATT they should only be billing for the tissue tx correct?
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    Wiki Breast Recon

    Thank you!!
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    Wiki 15004 w/ tissue tx

    Can surg prep codes 15002-15005 be used with tissue tx codes 14000-14350? My providers want to bill for debridement along with the ATT codes but I believe debridement is included.
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    Wiki Breast Recon

    Please help!! I don't why I get so confused w/ plastics & breast px's. I feel the more I look into it the more confused I get. Should I use 19380 for right breast or 11970? This is what I have now 19318 - LT 19380 -RT 13101 - 59 36590 15771 - RT 15772 x3 - RT Thanks!! PREOPERATIVE...
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    Wiki 19380 or 15771

    Thank you it certainly does!!
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    Wiki 19380 or 15771

    What is everyone using for bilateral revision of reconstructed breast by means of lipo/fat grafting only? 19380 or 15771?? TIA
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    Wiki Trephination

    Would appreciate help on this. It seems to me the px was done to promote healing. I feel the trephination codes 611xx are for more extensive px(s). Would you use unlisted 21299 (craniofacial) ?? And if so what could be used as a comparison code? The physician suggested surgical prep &...
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    Wiki 19342 & 19371

    Thank you so much. For some reason I really struggle with breast procedures. I have a hard time finding resources that will answer my questions relating to the plastics/reconstruction portion of these surgeries, post mastectomy. Maybe I am searching in the wrong places but the info I find is...
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    Wiki 19342 & 19371

    Can 19342 & 19371 be billed together when performed on the same breast? Procedure(s): Bilateral exchange of breast implants and right breast capsulectomy Indications: This is a 67 yo female s/p prior bilateral skin sparing mastectomy with saline implant reconstruction. She has been followed...
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    Wiki 64450 with breast reconstruction

    My plastic surgeon is performing a bilateral breast recon w/ TE replacement. He wants to bill for bilateral nerve blocks of the pectoralis major. Wouldn't this be included with the primary px? What if the blocks are used for post op pain management and not a supplemental/intraoperative...
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    Wiki Shoulder scope ORIF

    Thanks! Much appreciated
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    Wiki Shoulder scope ORIF

    Hoping someone can help. I am confusion with the scope portion of this surgery. As of now the only thing I am sure of is 23430. Your help would be appreciated Diagnostic arthroscopy was performed in the standard fashion. An anterior portal in the rotator interval was placed using an outside...
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    Wiki Microtia repair - The physician is grafting cartilage

    What can be used for a comparison code for 69399?
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    Wiki ear reconstruction help

    Would appreciate everyone's opinion on this. I have a hard time with recon plastics. Not much experience. Please let me know what you all think. Also, the doctor gave me an unlisted for sculpting of cartilage frame work. Would that even be billable? if so not sure what to use as comparison...
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    Wiki plastics - mesh

    Suggestions please. The doc gave me 15734 x 2, 49568, 13101 & 13102. I don't believe the 49568 should be used for this mesh and would you say that the note supports the use of 59 on the complex closure codes which is included w/ 15734? I would think it would due to the radical resection that...
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    Wiki shoulder scope

    Thanks so much!
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    Wiki shoulder scope

    Need opinions. Now working for new Ortho practice & their dictation is different than I am used to seeing. I would really appreciate if I get another opinion re: codes on this op report. I might just be reading it over to many times and doubting myself. But as I said, I am so used to the...
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    Wiki 29807 & 29806

    2nd opinion needed on this please. Doc wants both 29807 & 29806 billed, what are your thoughts? Thanks in advance PREOPERATIVE DIAGNOSIS: Left shoulder instability Bankart superior labral tear OPERATION PERFORMED: Left shoulder arthroscopic extensive glenohumeral debridement, labral repair...
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    Wiki excision tumor/prox femoral

    My doc gave me this op note. I'm curious to see what you guys can come up with for codes. Preop DX: Impending pathologic Fx, LT proximal femur and hip, metastatic lesion Posterolateral incision was made, extended somewhat distally to allow for proximal femoral resection. This incision was...
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    Wiki need it in writing

    I need help, I know the answers but my doc wants in writing. He doesn't want to here it from me. so I hope somebody can tell me where to find it. 1) Is it ok to bill fx care if the pt is only seen once and then pt is prn'd ? 2) If there is a question of a fx, but the doc is providing the same...
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    Wiki Consultations within orthpedic practice

    i also work in a large ortho practice which all physicians have the same TIN. Many of our docs have sub-specialities. It is ok to bill consults from one of your docs to another. we do this quite often. just remember that if the doc that has already billed for fx care ie. ankle fx, then refers...
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    Wiki Arthroscopic Biceps Tenodesis

    The New Code Is 29828 For Bicep Tenodesis
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    Wiki Acl W/graft

    which code(s) are used for an ACL reconstruction,allograft bone-tendon-bone? also if it is an ACL w/autograft is it appropriate to use 29888 w/ 20902? hope someone can help. thanks.
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