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    Wiki 52344 Bundles??

    Hi All, My physician performed a ureteral dilation, lithotripsy and a stent placement. It looks like 52344 bundles into 52356, you can use a 59 to break the bundle. My question is what when is it acceptable to use the 59? Is it only when performed on different sides??? Here is a description...
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    Wiki 52356

    I have a question regarding the new code for lithotripsy and stent placement. Sometimes our docs will perform the lithotripsy and then use a basket to extract the fragments. The codes 52353 and 52352 use to bundle, so I could only code with 52353. But now with the new code of 52356, it is not...
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    Wiki Stent Reposition through Stoma, Help!

    I'm not having any luck with this, I hope someone out there can help me. Thanks!! PREOPERATIVE DIAGNOSIS: Left ureteral stent misplacement POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE: Bilateral retrograde pyelograms, re-positioning of left ureteral stent EBL: 0cc Specimens: None INDICATIONS...
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    Wiki Perineal Incisional Hernia Repair???

    I need some help with this. Doc did a perineal incisional hernia repair 1 year after patient underwent a abdominoperineal resection. Here is the op note. The hospital coder coded it as 49560/49568, but I'm not sure about that since it wasn't an abdominal hernia???? Any thoughts would be...
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    Wiki Laser Resection of Ureteral Tumor and Ablation

    I'm fairly new to Urology coding and I'm not sure on this one. Doc describes it as laser resection of ureteral tumor and ablation. It looks like he took several biopsies and then lasered the remaining tumor. I cannot find a code for laser of tumor in the ureter. Here is part of the op note...
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    Wiki Subcutaneous Exploration, Neep Help Please

    I have attached a op report I need help coding. Doctor was to repair a ventral hernia, however when she got in there there was none. She explored then closed with a layered closure. It doesn't look like she debrided tissue. Is there a code I can use for exploration? Should I just code for...
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    Wiki Umbilical vs Ventral Repair

    I'm hoping someone could lead me in the right direction. One of my docs performed a supraumbilical hernia repair, I was always told to code as a ventral hernia (i.e. 49560), however the hospital coder has coded this procedure as an umbilical hernia (49585). I asked her about it and she emailed...
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    Wiki Post Op visit after positive margins on lumpectomy?

    We had a Medicare patient with a diagnosis of breast cancer go in for a lumpectomy, upon receiving the pathology report several days later, the patient's margins were positive and had to be scheduled for a return to the operating room. My question, can we charge for a office visit with a 24...
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    Wiki Subtotal Colectomy with ileostomy - Help

    Here is the op report. Thanks for your help! Dx: Bowel Perforation Operations Performed: 1) Exploratory Laparotomy, 2) Subtotal Colectomy Operative Findings: THere was a perforation of the transverse colon at the splenic flexure with facal peritonits. There was a ferforation of the...
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    Wiki 11046 Add-on, Medicare Limit?

    My doc performed a large debridement on a patient into the muscle/fascia. The area was over 600 sq cm. I billed Medicare using 11043 and 11046 x34. They are denying this as they state "the number of units of service exceeds our acceptable maximum". I have in the past billed commercial...
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    Wiki Intraoperative Help by General Surgeon to a OB/GYN

    Hi All, I need help with this scenario. My doc, who is a general surgeon, was called into a surgery by an OB/GYN who was performing a hysterectomy and ran across extensive adhesions. The OB/GYN needed our doc to handle a small bowel resection, he did the resection and anastomosis along with...
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    Wiki Debridement Question

    I need help on this op report. Such a large area, I'm not sure if I'm figuring out this correctly. Preoperative/Postoperative Dx: Epidermal necrosis, Right Thigh Procedure Performed: Debridement, Right Thigh The patient was placed supine on the operating table, and the right leg was...
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    Wiki Excision of Lesion on Colostomy Site

    I'm having a hard time trying to figure out how to code this procedure. The patient has a colostomy and the doctor excised a >1 cm lesion from the colostomy site. My first thought was 1140X or 1160X depending on the patholoy outcome. However, Doctor states this was not an excision of skin, it...
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    Wiki Help with coding Endovascular AAA Repair

    Need help on this, we don't do too many of these and I seen to struggle when we do. What I have is 34812-50, 34803, 34825, 75952-26. I'm I on the right track? Am I missing something? Here is the op report. Dx: AAA Operation performed: Endovascular stent graft repair abdominal aortic...
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    Wiki Colectomy and ileostomy

    I'm not sure about this, it probably is really easy but I'm having a brain freeze. My doc took a patient back to the OR two days after a lap partial colectomy w/anastomosis (44204). The second surgery consisted of a exploratory lap, transverse colectomy, and ileostomy with complex debridement...
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    Wiki Debridement & Excision Coding Help

    Hi All, I need help with the procedure. I'm thinking 11042 is all I'll be able to code. The op report is here: Diagnosis: Necrotizing fasciitis of the right lower extremity Procedure: Right lower extermity debridement and excision of devitalized tissue with pulsavac irrigation...
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    Wiki Bypass graft with cryoperserved saphenous vein

    Surgeon performed Left Femoral Anterior Tibial bypass graft using cryopreserved vein. Should I code this 35566 (vein) or 35666 (other than vein). I'm inclined to choose the 35666 other than vein, but it isn't a synthetic graft it is a donor graft. Has anyone coded this before? Thanks, Lori
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    Wiki Lap Excision of an infarcted appendiceal epiploica

    I'm not sure how to code this. Doctor performed a dx laparoscopy with a laparoscopic exision of the infarcted appendiceal epiploica. He states that "after careful examination revealed an appendiceal epiplocia on the top of the descending colon. The appendiceal epiploica was grasped by one...
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    Wiki Evacuation of Hematoma

    :confused: How would you bill this? This patient needed to go back to the OR for a evacuation of a hematoma after a mastectomy. She developed a large tense hematoma that was painful and causing local skin compromise. Doctor states incision reopened and the clot evacuated.......drain...
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    Wiki Lap Chole - 47563

    I've been coding many lap choles with grams through the years (47563), but my administrator heard of another clinic who codes these using 47563 as well as 74300. I can't find anything regarding this, have I been doing this wrong? Isn't 74300 included in 47563? Thanks! :o
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    Wiki Cpt 36589 in Global Period

    I'm trying to bill Medicare for a permacath removal that was put in almost two years ago by a different doc. The trouble is the patient had an av fistula put in less than 90 days ago by our doc and the claim denied as it is in the global period. The reason the permacath was removed is because...
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