Search results

  1. D

    Wiki 52281-52?

    I'd code 52281, he still did it. Just had to cut it short do to patient becoming hypotensive, 51610 is inclusive to 52281.
  2. D

    Wiki Cystotomy for Bladder Tumor Resection?

    I see 51530 + 38770.
  3. D

    Wiki Calculus Removal Same side

    Yes: Per new guidelines, Placement of additional accesses, if needed, into the kidney, and removal of stones through other approaches (eg, open or retrograde) may be reported separately, if performed.
  4. D

    Wiki 55706?

    I see 52351 + 55700 + 76942.26
  5. D

    Wiki Thulium laser incision of parapelvic cyst

    I agree with 52354 in this context.
  6. D

    Wiki 44385 with 52000?

    I'd stick with 44385 only, would be double dipping to use 52000 + 44385.
  7. D

    Wiki Bladder Mobilization

    If OPEN 49000, If Laparscopic 49320. No need to go unlisted.
  8. D

    Wiki 2.0 cm bladder tumor 52234 vs. 52235

    52234
  9. D

    Wiki 52330 cystourethroscopy with manipulation of stone

    I see 52332 + 74420.26 only.
  10. D

    Wiki Cystoscopy with Litholopaxy; vaporization of the prostate 52318/52648??

    This looks like the patient had a prior TUPR. I'd use 52630 in place of 52648. Keep 52318, no mod 22. Description states complex. 52630 52318
  11. D

    Wiki URETHRAL POLYPECTOMY

    review code range 53200,53260,53265,53270,53275.
  12. D

    Wiki Removal of vaginal mesh that has migrated into the urinary bladder

    Only code 57426, closure of bladder would be integral. Lay description states The physician revises or removes a previously placed prosthetic vaginal graft via a laparoscopic approach. Through small stab incisions in the umbilicus and/or abdomen, a fiberoptic laparoscope and trocars are inserted...
  13. D

    Wiki Codes 51050 and 51040

    Only code 51050, Lay description states insertion of drain tube at the end of procedure. This would be integral in this context. The physician makes an incision in the bladder to remove a calculus. To access the bladder, the physician makes an incision in the skin of the lower abdomen and...
  14. D

    Wiki prostatic urethral cpt code

    I see 52224.
  15. D

    Wiki Neurostimulator Replacement and Insertion

    I see 64561 and 64590 for the PB side.
  16. D

    Question 2 visits on one day--what modifiers should be used in physician's office?

    Modifier 25 Example 992xxx.25 11042 Second visit for fall 992xxx.25 If you see a patient in separate settings on the same date of service, you should not add the time together, even if you were accustomed to billing that way for years. Instead, you can report two separate E/M codes with...
  17. D

    Wiki Modifier -33

    I'm a 59er, but my higher up likes to use these X modifiers. To me, same difference. But XS could work.
  18. D

    Wiki 52005?

    I would code 50590.LT only. No modifier 22, that wire may be a indication he did 52005. Which would lead to a query for an addendum for insertion of a cath into this area to support 52005. But with this documentation, there's not enough to support 52005. Hope this helps Regards,
  19. D

    Wiki 52005?

    50590.LT only. I would just inform the provider CPT 76000 + 52005/52000 is inclusive per CCI edit. The patient was brought into the OR and placed in dorsal lithotomy position on the lithotripsy table. I then performed cystoscopy 52000 with the rigid scope and noted a normal urethra and bladder...
  20. D

    Wiki Modifier -33

    Interesting. Alot of commercial follow Medicare, so you code just flip the 33 to PT, see if that clears the edit. I don't think you'll find a official source stating to apply modifier 33 in first position. Based on coding sequencing logic, 33 would be last position in this context. Since it's a...
  21. D

    Wiki Laser Ablation

    I'd use 52354.
  22. D

    Wiki Help with OP Note

    Hello, these are the codes. But looks like they’re attacking the same reason with all these codes. Based on CCI edit, CPT 50590 is primary to all these codes. I’m thinking just 50590.22.LT alone, Mod 22 for the complexity of this case. If you can justify each CPT mention below, then these are...
  23. D

    Wiki EGD REMOVAL OLD PEG TUBE REPLACE WITH TRIFUNNEL TUBE

    Hello, you can't code for the removal when your replacing the tube. I'm leaning toward just 43246. Intubation of the gastrointestinal tract (e.g., percutaneous placement of G-tube) includes subsequent non-endoscopic removal of the tube. CPT codes such as 43247 (Upper gastrointestinal endoscopic...
  24. D

    Wiki High Risk Screening Colonoscopy

    Hello, this is what there referencing. Personally, you both right. Colonoscopy are a little tricky because you have the SCREENING VS DIAGNOSTIC element to the coding. Some payors just need Z86.010 alone to get paid on HIGH RISK. Even though I think coding instructs that it can't be billed alone...
  25. D

    Wiki Modifier -33

    This may help.
  26. D

    Wiki EUS

    This may help.
  27. D

    Wiki EGD W/EUS w/FNA & gallbladder stent -What code should i use 43240/76000 or 43242/43266?

    My final code selection: 43999 (Compared to 43240) Hello- I’d code only unlisted code, 43242+43266 bundles into 43240. Since CPT 43240 is my comparison code, then I wouldn’t allow 43242+43266. CPT 43240 is a good code, but it’s for pseudocyst. Reason for the unlisted code. Hope this...
  28. D

    Wiki Umbilical hernia repair with incidental epigastric hernia repair

    Hello Looks like your covered with the new codes, and just need one code. See the description (s). Repair of anterior abdominal hernia(s) Regards,
  29. D

    Wiki CPT to use for excision of left breast mass

    I'd be looking at CPT 19120, and you can add CPT 76998 only if permanent images are obtained and saved,and an ultrasound report is entered into the medical record. regards,
  30. D

    Wiki PROCEDURE: Reopening of recent laparotomy, placement of percutaneous transhepatic cholecystostomy drain, repair of biliary anastomosis.

    One option is to use CPT 35840. I don't like this one. I'm leaning towards unlisted CPT 47999 Compared to 47900 + 47999 Compared to 47801. Effective 2024: We can use the same unlisted multiple times. Hope this helps. Regards,
  31. D

    Wiki dual stent insertion, same laterality

    Doesn't happen often, but I'd apply two CPT 52332. CPT 52332.LT + CPT 52332.76.LT + 74420.26, not to sure on the mod 76. Applying modifier 22 is another option, but personally I'd code it twice.
  32. D

    Wiki Interstim..I don't understand it!

    Hello, I'd remove CPT 76000. Since 64561 has imaging mention in the description. I'd apply modifier 59 to CPT 76000, as this is allowed with 64590 only. And to make it clear your applying it to 64590.
  33. D

    Wiki Surgeon called in to explore wound

    just intra-op consult
  34. D

    Wiki Robotic-assisted palliative gastric bypass.

    sounds like 43659 +S2900 compared to 43820 Gastrojejunostomy; without vagotomy
  35. D

    Wiki LAPAROSCOPIC HAND ASSISTED RIGHT HEMICOLECTOMY

    Looking for key terms I look for to determine if it’s Lap or Open, it’s not clear. But I’m learning towards OPEN. Definitely starts out Laparoscopic. I’d personally have to query the doctors. What is a LigaSure device for open surgery? The Ligasure device is an advanced surgical...
  36. D

    Wiki USE OF MODIFIER "SA"

    I'm in california, so we have U7 for P.A and SA for NPs.
  37. D

    Wiki Correct use of Modifier -52

    Everything is context. IR coding is a bit different, sounds like you will use 62270 with no modifier. Follow this rule for IR coding.
  38. D

    Wiki Co-Surgeons

    Yes- you'd need to query the provider, explain you can't bill Co-Surgery for the case because there both of the same specialty. Then request which one they want to be Primary surgeon, and if your in a teaching hospital. You'll need a qualifying statement on why a assistant was requried.
  39. D

    Wiki G-POEM PROCEDURES

    g-poem This is a g-poem for gastroparesis and that is an unlisted code of 43999 and create the fee comparable to 43800. vs 43497 is for achalasia and involves the esophagus.
  40. D

    Wiki Co-surgeon questions

    Key to CO-Surgeries, are they sharing components of the same procedure. If not, then you move on to split billing the case with their specific CPT on what they did. We have alot of ENT docs that split cases like this up, we bill each provider individually to what they did.
  41. D

    Wiki Modifier 33 on CPT 45378

    your logic is right, I'd just move on to the next questions. As long as you understand. This is what I have on file for my team.
  42. D

    Wiki ERCP ?

    yes
  43. D

    Wiki Laparoscopic revision of paraesophageal hernia repair with gastropexy

    You have 2 options, stick with 43281/43282. Or use unlisted. AHA clinic states to use 43281/43282 still for REDO-Revision.
  44. D

    Wiki Small Bowel Resection

    The title is misleading, looks like the doc is doing 43860
  45. D

    Wiki EUS with Biliary drainage CPT?

    your in the right direction with 43240, but you'll have to go unlisted here. We use 47999 compared to 47801 + 43259 for Choledochoduostomy + EUS.
  46. D

    Wiki Stigmata of recent bleeding and Adherent blood

    tricky question, yes and no. but if the O.P note states there doing 43255 or 45382 to treat this. I'd still code these CPT.
  47. D

    Wiki CPT 43254

    use only once, MUE is 1.
  48. D

    Wiki gastroenterology question

    minor surgical procedure
  49. D

    Wiki ERCP question ampullectomy

    I see the following 43274 43274 w/two stent placements 43254 resection w/a hot snare removal. A lift was performed, and a clip was placed. 74328.26 The documentation is kind of weak to support a EMR 43254, but I think that’s what they did. Otherwise you’d have to change 43254 to these codes...
  50. D

    Wiki G-tube change in clinic by NP/PA

    If the NP or PA is contract with your company, and providing services. They can bill 43762. More then likely the RN is not contracted to bill, if not. Then you'll have to not bill, we use a dummy code to track these services.
Top