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    Wiki Haglund's Deformity

    I usually use cpt code 28118 for Haglund's deformity on the calcaneaus, if more extensive like more amount of bone is taken then I use 28120. Dr. wants to use cpt code 28120. Any thoughts on this one? The operative extremity was exsanguinated followed by inflation of the tourniquet to 275...
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    Wiki Release of 6th dorsal compartment of right wrist

    This was the only thing that was performed. I went with 25295 and the dx was -M65.131 other infective synovitis. This was the closest code that I could find for this surgery and the codes needed to be submitted immediately. Patient did not have RA. Thanks for chiming in.
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    Wiki Release of 6th dorsal compartment of right wrist

    I have a surgery for the release of the 6th compartment extensor tendon, which is on the side of the small digit. Cannot use cpt code 25000 because that is for the 1st compartment on the other side of the wrist. Below is the part of the surgery. What about 25295? Below is the definition of...
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    Wiki antibiotic hip spacer

    The patient had no prosthesis. This is his original parts and has developed septic arthritis. Documentation states: Mixed 2g of vancomycin & 2.4 g tobromycin into 1 batch of cement this was placed to the acetabulum from the medial defect onto the cement with a size 3 high offset Summit...
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    Wiki antibiotic hip spacer

    The dr. places an antibiotic spacer in the shape of a cup & head (depuy summit cemented size 3 high offset with a +5 32 head with postalac cup.) I was thinking of using cpt code 27030. Dr. wants to use 27125 but this is not an actual prosthesis. Any thoughts on this one? Thanks,
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    Wiki cpt codes 27216 & 27217

    They paid the left side but will not pay the right side. Per Medicaid's notes, "CPT code 27216 can only bill for a quantity of 1."
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    Wiki cpt codes 27216 & 27217

    This State's Medicaid wants 2 lines- 1 frequency per line and that is how it was coded. Thanks,
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    CPC, COSC

    CPC, COSC
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    Wiki cpt codes 27216 & 27217

    They have said no modifier 50 and they will not take the G code. From what I found out it seems as though we can just code this once with no modifier if it was performed on both sides. My other payors I can put a 50 modifier on these codes. Thanks,
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    Wiki cpt codes 27216 & 27217

    So, cpt code 27216 is getting denied for medicaid and a few other insurances when I code this twice for LT & RT. We only use the G code for Medicare or Medicare supplements. I have been told by one coder that 27216 and 27217 can only be used once regardless of Lt & RT being fixed. Then another...
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    Wiki Slipped Femoral epiphysis 27176

    Any coders out there in orthopedics that would be able to help on this one? Thanks,
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    Wiki Slipped Femoral epiphysis 27176

    Okay I need any other ortho coders to help on this one. So, my Dr. fixed the Left and the Right side for SCFE-27176. MUE's are 1 & MAI of "2" cannot use a modifier to override the daily limit for the CPT code. This is AL. MCD which only wants LT or RT modifiers, not 50. Any suggestions on coding...
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    Wiki COSC exam in person

    When I took it there was plenty spine surgeries but maybe this changes year to year. I passed but time was my biggest hurdle.
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    Wiki COSC exam in person

    I took the COSC exam a few years ago and you can bring in Vol.I and II. I wish you all the best.
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    Wiki ortho coding

    Would anyone know if we can code cpt 24220 -Injection procedure for elbow arthrography with cpt code- 24538 pinning of supracondylar fracture. These two do not bundle but are being performed in the same area. I am not sure if insurance would look at 24220 as being inclusive. I have never run...
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    Wiki Hammertoe, Tendon transfer, Exc. of bones

    Anyone in ortho that is experienced in the foot area, please chime in. 1. Application of Stress for Joint Radiography of Left Foot 77071 2. Left Fourth Hammertoe Repair 28285-T3 3. Left Fourth Superficial Transfer of Extensor Hallucis Brevis to Longus 27691-LT ( this one does not bundle but I...
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    CPC, COSC

    CPC, COSC
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    Wiki 27303 coded with 20702 & 20703

    Okay so the patient had a open femur shaft fracture from a gunshot. Patient developed an intercalary defect where the fracture is. In the original surgery, Dr. repaired the nonunion without graft 27470 with a partial excision/diaphysectomy of the femur 27360. Dr. inserted a nonabsorbable...
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    Wiki 27829 with 27828

    Thanks for always jumping in to help. I appreciate your feed back.
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    Wiki 27303 coded with 20702 & 20703

    Okay I have the code 27303 which the Dr. wants coded. Also, wants to code 20702 & 20703. The problem is cpt code 27303 is not one listed as a qualifying code to go with 20702, 20703. Dr. did take out the spacer intramedullary though. Any thoughts on this case? Thanks,
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    Wiki 27829 with 27828

    Update, I decided to not code the 27829. Thanks for your help.
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    Wiki 27829 with 27828

    Thank you both, I may append the XU modifier and follow this one to see if it gets denied. I will come back to update this one.
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    Wiki 27829 & 27828

    Has anyone ever coded these two together? They have separate diagnoses but they do bundle. Same ankle being worked on. Pilon fracture and a sydesmosis sprain. Thanks,
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    Wiki 27829 with 27828

    Has anyone ever coded 27829 & 27828 together for the same ankle? No separate incisions were made. After the Pilon fracture was worked on a clamp was placed from the fibula to the tibia to gain reduction of the sydesmosis. Then two Sydesmosis screws were placed through the plate acheiving...
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    Wiki Total Thyroidectomy with only 1 lymph node removed

    How do you code a total thyroidectomy with only one deep cervical lymph node being removed that is malignant? I would think the correct code would be 60240 because Under 60252 in encoder it states: Representing more than one lymph node being removed. The physician removes a malignant...
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    Wiki Dr. Alan Pechacek for Ortho

    I am so sorry to hear of his loss. What a great mentor he was. Thanks for answering this to confirm his passing.
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    Wiki Dr. Alan Pechacek for Ortho

    I have really learned a lot from reading the articles that Dr. Pechacek has posted in the past. I just read an obituary for this name and if he has passed away would anyone be able to chime in on this? I continue to look for his input and can't seem to find anything lately that he has written...
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    Wiki COSC Exam

    Congratulations to you. That is awesome. The only way most people could make the time is to not even read the actual surgery report and just read the titles which is not a good idea.
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    Wiki COSC Exam

    Congratulations to you. I have to agree time needs to be extended for sure. I had 5 books to go through for this exam.
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    Wiki COSC Exam

    There was not a whole lot of E/M. I found the biggest herdle was time. The other herdle for me was spine, since I do not code spinal surgeries. If I had to pick the #1 problem with the test, it would be time.I wish you all the best on your test.
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    Wiki Trigger point injection

    20605 is injection into a joint or bursa. 20552 is what you would want if it is a trigger point injection into 1 or 2 muscles. If 3 or more you would code 20553. Remember that it goes by number of muscles not injections. Also if Flouroscopy was used remember to code that also.
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    Wiki A4 PULLEY RELEASE

    Would anyone know a code for an A4 Pulley release for adhesions. 26055 is for the A1 pulley. Also this patient did not have a trigger finger which makes this a little trickier. Dr. just made and incision to see if the FDS repair performed a while back was still in place. The repair was still in...
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    Wiki COSC Exam

    I wanted to post this for anyone who is studying or thinking of getting their certification in Orthopedics. I took the COSC exam around 3 weeks ago and was very Blessed to have passed it. I would encourage anyone who wants this certification to purchase the the online exam prep, the COSC study...
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    Wiki Arthrotomy with Lateral and medial retinacular release

    Has there ever been a code for the medial retinacular realease? 27425 is what is used for the lateral retinacular release, but would this cover both? Dr. is cleaning out adhesions and contractures in the patella area and is releasing both sides. No reconstruction is being performed. Any...
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    Wiki Sympathetic Nerve injection

    Hello, Has anyone ever coded 93740 to measure temperature during the Lumar sympathetic nerve injection procedure(64520). This would be on the Physician side, not the facility side. Thanks,
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    Wiki code 27245 vs 27506

    27245 Is located at the Hip for Intertrochanteric, Peritrochanteric or Subtrochanteric. 27506 is farther down the femure(shaft area) falls under the knee section. Usually it will say Gamma Nail, Trochanteric nail, etc. I hope this helps. Thanks,
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    Wiki Modifiers for unlisted codes

    Okay thank you for explaining this more.
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    Wiki Modifiers for unlisted codes

    Thank you for this information, I will go look into this more. What about the global modifiers to alert the insurance that the patient is coming back for a procedure in the global period. Such as: 58, 78,79?
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    Wiki Modifiers for unlisted codes

    The CPT code book conflicts with instructions from CMS regarding the use of modifiers with unlisted codes. The CPT book indicates that a modifier should not be appended to unlisted codes since there is no need to alter the definition of an unlisted code because the code does not describe any...
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    Wiki COSC EXAM

    Has anyone used the COSC training course? I have the practice exam and the study guide already, which is just about 24 practice cases. This is supposed to give you more to study. Please let me know thoughts if this helped you for the exam. Thanks,
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    Wiki ED to Inpatient then transferred on same day

    I code for the Physician side, not the facility side. So, for us we would still code the ER visit with any procedure that was performed, 99281 - 99285. Example- 99282-57(decision for surgery, 90 day code)An evaluation and management service that resulted in the initial decision to perform the...
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    Wiki COSC EXAM

    Could anyone actually tell me, that has taken the COSC exam, about how many spinal surgery questions are on it? I am getting conflicting information, some say not many while others say a lot. We are only given a total of 3 spinal questions between the study guide and the practice exam. Thanks...
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    Wiki COSC exam takers, Fracture CPT codes Vs. Arthroplasty codes

    0 Today at 8:23 AM This is for anyone who has taken the COSC exam to answer, please. So, when I get surgeries that the Dr. performs an arthroplasty for a fracture. The way we code these is, if it is a fracture even though the Dr. states arthroplasty we code as a fracture repair. Ex: Left radial...
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    Wiki Thinking about taking the COSC exam

    CPT Professional book is what I use and will be bringing that with me to test. I will also use my ICD 10 book. I am thinking about purchasing the some others also. Thanks,
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    Wiki Thinking about taking the COSC exam

    Thank you
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    Wiki Modifiers

    Would anyone know if the modifier XP is a pricing or payment modifier? I have a list of categories and XP is not listed in any category. Thanks,
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    Wiki Flexor Digitorum Profundus tendon in the hand

    My question is if Dr. is repairing a Flexor Digitorum Profundus tendon not in zone 2, should we code 26350 or 26370. 26350 is repair of flexor tendon, not in zone 2 and 26370 is repair of advancement of profundus tendon with intact superficialis tendon. One states Flexor tendon and the other...
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    Wiki EXTENSOR TENDON REALIGNMENT AND TRANSFER

    Has anyone has ever coded 26437- Realignment of extesor tendons in 4 fingers and 26498 -transfer of extensor tendon in the same 4 fingers? Procedure is: Realignment of the common extensor tendons to the index, long, ring, and little digit by soft tissue including a transfter of the lumbrical...
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    Wiki Specialty exams

    I am studying for the Ortho exam (COSC). In the real world for Ortho there are many codes that bundle. So in my mind I would think we would have to be able to check for bundling on the exam some type of way. Especially if one question asks, do I need to append any modifiers and 59 is one of the...
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    Wiki Thinking about taking the COSC exam

    If I may ask for those who have taken this exam, how did you check for CCI edits during the test to know if you need a 59 modifier on any cpt codes? Thanks,
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