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  1. S

    Wiki IVUS 92978 discontinued?

    Hi, Looking for thoughts on how this is coded? IVUS catheter was placed in the proximal LAD and unable to be advanced due to calcium & angulation. No interpretation was made. Would the IVUS be coded with mod 74 or not coded? Coding for a facility. The cath lab coded the IVUS catheter C1753...
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    Wiki Propel Stent

    Hello, Could someone clarify the coding for the propel stent S1091 for a hospital. If a FESS is done, total ethmoidectomy with frontal & sphenoidotomy with tissue removal and maxillary antrostomy with tissue removal. Also a septoplasty & turbinoplasty. Propel stents were placed in the...
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    Wiki Diaphragmatic Hernia repair

    Thoughts on a laparoscopic and thoracoscopic repair of a diaphragmatic hernia with the reduction of the liver and small intestines. "The liver an small intestine were reduced into the abdominal cavity and the diaphragm was closed with sutures and mesh". Is this coded with CPT 43282 or CPT 49659...
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    Wiki Simple Mastectomy with removal of Ruptured Implant

    If a surgeon performs a simple mastectomy, 19301, and also removes a ruptured implant, 19330. Would you code only the simple mastectomy or both procedures? My thinking is only the mastectomy. A different surgeon replaced the implant at the same session, 19340, and also did the closer, would...
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    Wiki D&C and MVA

    Can CPT codes 59840 & 58941 be coded together on the same day? Don’t see any edits. Tried a MVA at bedside but was stopped as patient couldn’t tolerate. Later the same day patient brought to OR for a D&C by a different physician. Thinking of 59841-74 & 59840. Coding the facility. Thanks...
    • suec
    • Thread
    • Replies: 3
    • Forum: OB/GYN
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    Wiki Mastectomy with possible lymph node excision

    Has anyone come across a situation where the surgeon did a mastectomy, 19303. Methylene blue was injected, 38900 and was going to excise axillary sentinel lymph node but couldn't find the nodes. The mastectomy specimen was inspected and several nodes were within the axillary tail. Can we code...
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    Wiki Breast clip insertion and removal

    A breast localization device was implanted by mammographies guidance, there was an issue and the clip was removed a few minutes later. CPT code 19281-RT. Do you need to add modifier 74 because the clip was removed. I don’t think so but we have a disagree among coders. thanks
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    Wiki KX modifier

    Can someone explain the KX modifier for injections? Seems Medicare wants a KX modifier appended for all diagnostic injections (CPT 64633-64636 & 64490-64495) How does a hospital coder know if it is a diagnostic or therapeutic injection.
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    Wiki Botox Injections 64615 & 64644

    Just curious, does anyone know why 64615 ( botox injection for migraine) and 64644 (botox injection extremity, in this case lower extremity) can't be coded together? Dx codes of migraine and spasticity. I know the CPT book notes these can't be coded together but was wondering why? The patient...
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    Wiki Hysteroscopy discontinued

    Hello, any thoughts would be helpful. Patient in hospital setting, was scheduled for pelvic exam under anesthesia and hysteroscopy d&C, polypectomy, possible myosure. The exam under anesthesia was done. The cervix was dilated 3 times with different size hegar dilators but the hysteroscope...
    • suec
    • Thread
    • Replies: 2
    • Forum: OB/GYN
  11. S

    Wiki Colonoscopy screening Modifier

    If a patient comes in for a screening colonoscopy no polyps or biopsies are done. Non Medicare payer - we coded Z1211 with 45378. Is modifier 33 added to the CPT code? Is the modifier added to show this wasn't a diagnostic exam because there is no "screening" CPT code like there is for...
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    Wiki Breast injection with fat from abdomen

    Has anyone come across this scenario: doing a revision of a reconstructed breast, fat injection into breast and revision of abdominal scars from donor site. The abdominal scar sites were corrected by suction assisted liposuction. But then they used the fat harvested from the liposuction and...
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    Wiki Dialysis

    Have a scenario, patient had their AV fistula declotted in the hospital as outpatient service and then went to dialysis in the hospital. Coded 36905 & 93935. Does anyone know what modifier is needed on CPT 93935? This is a Medicare Managed care plan. Tried V7 but the claim is not being...
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    Wiki Cryotherapy of eyelashes 67825

    So many changes over the years, is this coded per eye, per eyelash or per procedure? Example: if the procedure was done on the upper and lower of right eyelashes and the left upper eyelash. What modifiers should be used. Modifier 50, E modifiers, Lt & RT, XS. Getting a Medicare MUE that...
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    Wiki flap vaginoplasty

    Could use help/opinions on how this should be coded: 58999/57106/57335. ( don't think is this correct as it is intersex) Patient has persistent cloaca with previous repair. The procedure: examining the external perineum, there was a bar of tissue where the perineal body had been reconstructed...
    • suec
    • Thread
    • Replies: 2
    • Forum: OB/GYN
  16. S

    Wiki Conjunctiva biopsy & cryotherapy of eyelashes

    Hello, Could use an opinion with these two procedures. Procedure performed is a biopsy of conjunctiva for conjunctival scarring and cryotherapy of eyelashes for trichiasis. Coded 68100-LT for the conjunctival biopsy of left lower lid and 68725-50 for the cryotherapy of lashes. ( left upper &...
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    Wiki Modifier on Pacemaker Upgrade

    Is anyone using KX modifier on CPT 33229? PPM being upgraded to BiVen Pacemaker?
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    Wiki KX modifier

    Is KX modifier being used on CPT 33229? PPM being upgraded to BiVen Pacemaker?
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    Wiki Removal of Intralenticular Foreign Body

    Can someone explain where the intralenticular area is in the eye? Thinking it is intraocular? Scenario: person hammering a nail and part of the nail entered the eye... diagnosis is intralenticular FB and traumatic cataract. Procedure: Cataract extraction with IOL. Halfway through the creation...
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    Wiki Lateral Intercostal Artery Perforator Flap

    Wondering if anyone has code this type of breast reconstruction? Thinking of coding with CPT code 19364. Thoughts? Patient had lumpectomy and radiation but no prior reconstruction so I don't believe 19380 is correct. Thank you.
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    Wiki Injection for Subglottis stenosis

    Hi, Steroid injection was done for subglottis stenosis via direct laryngoscopy. Been reading the correct CPT code is 31570 or 31571. (injection into the vocal cords) Can someone explain why we would use these codes and not 31599? Thank you very much
  22. S

    Wiki placement of spinal cord stimulator after lead trial

    Hello, Can someone clarify the use or not use of modifier 58 on CPT 63685 for facility coding. The procedure: trial leads are placed previously & attached to a external generator. Later a permanent generator is placed and attached to the previously implanted leads. We coded 63685. It was...
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    Wiki Laparoscopic Hysterectomy with B/L salpingo-oophorectomy, resection of mass small bowel, tumor reductive surgery

    The procedure was a Laparoscopic Hysterectomy with B/L salpingo-oophorectomy, resection of mass small bowel, tumor reductive surgery. I would code with 58575 but they did not perform a omentectomy? Can i still use 58575 with modifier 52? (coding for a facility) Or should we use 58571 &...
    • suec
    • Thread
    • Replies: 4
    • Forum: OB/GYN
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    Wiki Cryotherapy of Lashes & Conjunctival Biopsy

    Hello, Could use an opinion as to why the payor has denied the code 68100? Coded 68725-50 and 68100-LT, know the cryotherapy is per procedure but they paid for the bilateral procedure but denied the conjunctival biopsy which I don't understand. Can someone explain? Procedure: cryotherapy...
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    Wiki Postpartum D&C

    Hello, Could use some help as my OB coding is not strong. Have a situation were the patient delivered a healthy baby and is coming back 13 weeks later to the hospital for a D&C for retained products of conception. Coded CPT 59160 but it's being denied. Payor is requesting 58120. They are...
    • suec
    • Thread
    • Replies: 4
    • Forum: OB/GYN
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    Wiki Eustachian Tuboplasty with Sinuplasty

    Morning, Can someone explain the NCCI edit am getting with 31296-50, 31295-50 with 69706? Don't understand why am getting an edit stating: 69706 is not allowed with 31295 & 31296. CPT book notes say 69705 can't be used in conjunction with 31231 & 92511. CPT code 69705 is new for 2021...
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    Wiki Sigmoidoscopy, done twice

    Hello, Could use some advice on the modifiers, believe the CPT are correct. Patient scheduled for a colonoscopy on 2/21, scope could only be advanced to rectum due to mass. CPT code 45330 per the decision tree. Patient scheduled for a flexible sigmoidoscopy the next day, 2/22 by a different...
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    Wiki Suction Dilation & Curettage after medical termination of pregnancy

    Hello, could someone clarify if my thinking is correct? The patient had an elective abortion. Had excessive bleeding after the procedure and had a suction dilation and curettage procedure was done two weeks later for the retained products of conception. Was coding this as 58912. My thinking...
    • suec
    • Thread
    • Replies: 3
    • Forum: OB/GYN
  29. S

    Wiki Botox Injections

    Does anyone know why the CPT book states 64615 can't be coded with 64646? Trying to code CPT 64615 for migraines and CPT 64646 for spasticity. Thanks for clarifying!
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    Wiki DBS pocket revision

    If the skin is thinning at the site of the DBS and the pocket is enlarged and made deeper. The same generator & electrodes are returned to the "revised" pocket. Is this coded with 61888? There is device code edit. Or would you code a debridement or unlisted? " used plasma blade to perform a...
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    Wiki Total Hip replacment

    If a person had a hip bone decompression for AVN and years later has a total hip replacement. Is this considered a conversion or a new insertion. 27132 or 27130. A hip bone decompression is not an open procedure but a skin incision is made to insert the instruments. Thoughts?
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    Wiki Percutaneous guided tenotomy of shoulder

    U/S guided tenotomy of the shoulder using a TX-Bone device. For this procedure are people using 23405 or 23929? Approval received for CPT 23405. This is an open procedure. Are people using 23929?
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    Wiki Bilateral Zygomaticomaxillary

    These op have me confused. Operation was: ORIF for zygomaticomaxillary & nasomaxillary fractures bilaterally. Coded with 21422. Is CPT 21422 a bilateral procedure? If done on both sides is it reported with 50,L&R modifiers or is correct to use 21423. Or am I not in the correct code series...
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    Wiki EGD with control of bleeding

    An EGD with control of bleeding done for prophylactic reason. Non-bleeding angioectasias, iron deficiency anemia unspecified and melena. Is it correct to code CPT 43255? Having an issue with medical necessity diagnosis. Thanks
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    Wiki Drug-Induced Sleep Endoscopy

    See other threads concerning this procedure and could use help to resolve coding discussion. A drug-induced sleep endoscopy was done with a b/l tonsillectomy. Diagnosis are hypertrophy of tonsils and OSA. Drug induced sleep endoscopy was done to identify the level of collapse. Procedure: The...
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    Wiki post-operative bleeding ear

    Does anyone have another suggestion? Can't find a CPT accept for the unlisted code 69799. Pt. had a tympanoplasty with mastoidectomy, radical with ossicular chain reconstruction. Post-op there was auricular bleeding. Pt. went back to op room the same day and the bleeding was controlled with...
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    Wiki foot surgery

    Can someone explain or advise if this is coded correctly. CPT 23808 was denied as a subset to 28285 & 28270. Incision was made at the 2nd toe, and the following procedures were done: a MTP capsulotomy & tenorrhaphy (28270) A metatarsal shortening osteotomy 28308 and a hammertoe correction...
  38. S

    Wiki R breast augmentation & L breast reduction.

    Could use help we are coding this correctly. Cosmetic procedure for breast asymmetry. , R breast augmentation with implant. CPT 19325. L breast reduction with implant. CPT 19318. Questioning if 19318 includes the implant. Can someone confirm this is correct? Thanks
  39. S

    Wiki NobleStitch for PFO Closure

    Has anyone code a PFO closure using the Noble Stitch technique? The closure is closed with stitches instead of an implant. CPT 93580 is PFO closure with an implant. Thinking of CPT 93799. Thank you. Buttercup
  40. S

    Wiki Lap occlusion of Fallopian tubes, right side only

    Hello, new to ob/gyn coding and this has me stumped. CPT 58671 is a bilateral code. If only the right fallopian tube is occluded via band is it coded as 58671-RT. Does it matter if the payor is Medicare or Commerical? Coding for a facility and not a physicians office. Thank you.
    • suec
    • Thread
    • Replies: 0
    • Forum: OB/GYN
  41. S

    Wiki Nasal Conformers/Nostril Sizers/Plastic Tubes

    Need help with something new we are seeing in the hospital setting. After a cleft lip/palate repair the patients are coming to the hospital, because of their age, to have the nostril sizers/stents or tubes upsized. Is there a code for this procedure? We have been using CPT code 30999. Don't...
  42. S

    Wiki Bronchoscopy thru Tracheostomy with EBUS

    Could use some help. Did a Diagnostic Bronchoscopy thru a tracheostomy tube, L&R mainstem bronchus & trachea viewed. EBUS was used to review the lesion. Thinking of 31615 but then EBUS can't be coded because there is no primary code. CPT 31622 is a bronchoscopy but not thru the tracheostomy...
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    Wiki Modifiers on Add-On code 36907

    Hi, I am new to this and could use some help. The hospital billed 36905 & 36907. Medicare is saying a modifier is needed on 36907. (OCE edit 40) Can some explain why we need a modifier on the add-on code when the CPT book indicates they can be paired together? Thank You
  44. S

    Wiki Screening Colonoscopy discontinued

    With the 2015 changes, looking for opinions on how this should be coded from a hospital perspective. Medicare patient came in for a screening colonoscopy. (intent was to reach the cecum - would have coded G0121) The scope was not advanced pass the splenic flexure, procedure stopped. The new...
  45. S

    Wiki fibrin glue injected into cervical pseudomeningocele

    Hello, I could use some help with coding this procedure. The procedure was done in the IVR suite. The cervical pseudomeningocele, created from a recent cervical fusion, was injected with fibrin glue sealant as an alernative to open surgery of repair of the durototmy. Does anyone know the cpt...
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    Wiki Injection of Fibrin Glue into Pseudomeningocele

    Hello, I could use some help with coding this procedure. The procedure was done in the IVR suite. The cervical pseudomeningocele, created from a recent cervical fusion, was injected with fibrin glue sealant as an alernative to open surgery of repair of the durototmy. Does anyone know the...
  47. S

    Wiki Cardiac Help

    Pt is already known to have a stenosis in the LAD & Circumflex. Stent placed in LAD. An IVUS of the Circumflex was going to be attempted. The left system was engaged and an angiogram was done. Can I code the angiogram of the Circumflex (93454-59) or is that considered part of the IVUS...
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