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    Wiki Humana Mod -79 Denial

    Hi, I have noticed denials from Humana on procedures billed with mod -79 performed during the global of another procedure. Commonly seen on cataract surgery done on the opposite eye during the global period of the first eye. Practice is also billing with laterality mods. For example, first...
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    Wiki Xray cpt codes

    Chap 9 Radiology Services NCCI Policy Manual for CMS (revision date 1/1/2022): 17. CPT codes 72081-72084 describe radiologic examination of the entire spine, the codes differing based on the number of views. The other codes in the CPT code range 72020-72120 describe radiologic examination of...
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    Wiki Authorization Denials, Surgery

    Curious- Has anyone had surgery auth denials for final coding not being what was anticipated and auth'd prior to surgery that they've appealed successfully? Example: Surgery paperwork may states "Knee arthroscopy, diagnostic, meniscectomy" CPTs: 29870, 29881 called on/submitted for surgery...
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    Wiki Surgery Auths

    Curious- Has anyone had surgery auth denials for final coding not being what was anticipated and auth'd prior to surgery that they've appealed successfully? Example: Surgery paperwork may states "Knee arthroscopy, diagnostic, meniscectomy" CPTs: 29870, 29881 called on/submitted for surgery...
    • LaurenBrooke
    • Thread
    • appeals authorization billing pre-authorization surgery surgery prior auths
    • Replies: 9
    • Forum: Orthopaedics
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    Wiki Extensor Retinaculum Lengthening

    Provider performed lengthening of the extensor retinaculum overlying the fourth dorsal compartment following excision of extensor tendon intrasubstance ganglion cyst from dorsal hand. Although the cyst had been addressed, it was felt appropriate to slightly lengthen the extensor retinaculum...
    • LaurenBrooke
    • Thread
    • hand ligament lengthening ortho specialty coding retinaculum surgery wrist
    • Replies: 1
    • Forum: Orthopaedics
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    Wiki Insight: Superior Capsular Reconstruction & Rotator Cuff Repair

    -I have read the article and do understand where it is coming from, but based on a March 2018 forum post you replied to you have stated: "Unfortunately you don't give a lot of detail or information, so I am "assuming/guessing" that this is a shoulder surgery case. As such, the "superior...
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    Wiki Use of CPT 15777

    Thanks so much for this. I have sent this along as well. I appreciate you confirming the i.e./e.g.
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    Wiki Insight: Superior Capsular Reconstruction & Rotator Cuff Repair

    In patients with chronic rotator cuff disease, loss of the glenohumeral force couple, generated by the rotator cuff, results in superior subluxation of the humeral “head” and attenuation of tendon and joint capsule. Tissue degeneration also results in a high risk of failure when using more...
    • LaurenBrooke
    • Thread
    • alan pechacek m.d. orthocoderpgu orthopedic surgery rcr scr
    • Replies: 2
    • Forum: Orthopaedics
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    Wiki Use of CPT 15777

    CPT 15777: Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (List separately in addition to code for primary procedure) Within the notes for this code it states when using a biological implant for soft tissue reinforcement in areas...
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    Wiki Use of CPT 15777

    CPT 15777: Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (List separately in addition to code for primary procedure) Within the notes for this code it states when using a biological implant for soft tissue reinforcement in areas...
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    Wiki Cpc-a

    I am seeking a full time Medical Coding (outpatient) job. I am recently certified through AAPC and willing to relocate! Please contact me at: lbrookebeasley@gmail.com
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