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  1. M

    Wiki Skin Excision vs Lipoma Excision (114xx, 2155x)

    Hello Everyone: Can someone take a peek at this op note, path states path but not so sure about this op note. Can provider be giving credit for lipoma excision? if his op note states "fascial closure" although it does not mention subcutaneous. Also, if he cannot be giving credit for lipoma...
  2. M

    Wiki Excision 11400 or 25075

    Hello Everyone: I was wondering if someone can take a peek at this op note. The path states lipomas but don't his documentation supports 25075. Preoperative diagnosis: Multiple lipomas of the left forearm Postoperative diagnosis: Same Procedure: Excision of 2.5, 2.1, 1.5, 1.6, 1.1, 1.3...
  3. M

    Wiki Laparoscopic Inguinal Hernia Repair TAPP Technique

    Hello Everyone: Was wondering if someone can review the following op note Should this be more then 49650? Maybe additional code 15734? Preoperative diagnosis: Left inguinal hernia Postoperative diagnosis: Same Procedure: Laparoscopic left inguinal hernia repair with implantation of mesh...
  4. M

    Wiki Non tunneled central venomous catheter

    Hello Everyone: Not sure if this is where I would post this question but I figure I would try. I have a provider that code 36556, however not sure this is appropriate and what other code would be more appropriate. This is the brief note Time out performed: No (Emergent situation) Patient...
  5. M

    Wiki 47562 and 47563 (2023)

    Hello fellow coders: Was wondering if someone can take a peek at this note. I thought it would be 47563 but after reading an article from Karen Zupko Associates (Known as KZA) not sure if this is correct and perhaps it should be 47562. Op note is listed below and also the little clip from KZA...
  6. M

    Wiki 27279 WITH 20930 AND 20936

    Hello Everyone: Was wondering if any of your providers are trying to bill the combination above. I know you can't use the 20930 and 20936 with the 27279. My computer systems actually kicks the claim out for coding. But was wondering if there is maybe another code I should be using? Thanks in...
  7. M

    Wiki COLOVAGINAL FISTULA AND HARTMANN

    Hello Everyone: On the following op note, would you give credit for 44650 or 44661 or should the only thing to code be 44143 Preoperative diagnosis: Perforated diverticulitis with abscess and colovaginal fistula Postoperative diagnosis: Same Procedure: Hartmann's procedure, repair of...
  8. M

    Wiki COLOVAGINAL FISTULA AND HARTMANN

    Hello Everyone: On the following op note, would you give credit for 44650 or 44661 or should the only thing to code be 44143 Preoperative diagnosis: Perforated diverticulitis with abscess and colovaginal fistula Postoperative diagnosis: Same Procedure: Hartmann's procedure, repair of...
  9. M

    Wiki Jejunostomy Tube Removal Done as outpatient

    Hello Everyone: Cannot find a code for this procedure and I came across an article that this can/should be included in the E&M. But this patient had this done as an outpatient. Not sure if I should bill for an E&M or unlisted? but if unlisted what do you compare it to? The area and the...
  10. M

    Wiki 77066 and G0279 Medicare denied for NCD

    Hello Everyone: We billed for G0279/TC and 77066/TC with dx C50911. Patient is currently receiving treatment. The G0279/TC was paid but the 77066/TC denied for NCD. When reading the article states that it will reimbursed when patient has personal history of breast cancer. So, is it appropriate...
  11. M

    Wiki Breast Tissue Marker A4648 in an office setting POS 11

    Hello Everyone: We are fairly new to mammography coding so find some denial a little challenging. Was wondering if someone can tell me if they are billing the A4648 with 19083? and are you getting reimbursed (specifically by Medicare) We are noticing that our billing service is adjusting them...
  12. M

    Wiki Excision withouth pathlogy results

    Hello: I was wondering if any one has come across this situation. I have a provider that dictated an "excision of a cyst" there was no pathology pending or resulted. So I querry and he said "I removed but didn't send it to pathology" Is this billable? or not. Thanks for any clarification. MF
  13. M

    Wiki Electrocautery of sigmoid colon caused by OB-GYN

    Hello Everyone: Would someone be able to take a look at this op note and let me know what you think? I don't think this is 44604 maybe 49320? This was an outpatient so 44604 would not fly. FINDINGS: A small less than 1 cm surface adjacent to the rectosigmoid junction in the retroperitoneum on...
  14. M

    Wiki Hybrid Open and minimally invasive fusion

    Hello: Would someone be able to take a peek at this note? Not sure if all these codes are correct. The only path I have is this " Metastatic malignant neoplasm with epithelioid and sarcomatoid features to bone consistent with the patient's known high-grade urothelial carcinoma with sarcomatoid...
  15. M

    Wiki New to Radiology Coding

    Hello Everyone: I just have a quick question, I hope. I was asked to help code for some radiology services 77062/TC, 77065/TC 76642/TC (and other codes as well) To come up with a diagnosis code do you pull it from the radiology report? if so do you code from the Indication, Findings or...
  16. M

    Wiki Radiology Coding

    Hello Everyone: I just have a quick question, I hope. I was asked to help code for some radiology services 77062/TC, 77065/TC 76642/TC (and other codes as well) To come up with a diagnosis code do you pull it from the radiology report? if so do you code from the Indication, Findings or...
  17. M

    Wiki Rigid proctosigmoidoscopy

    Hello: I was wondering if someone can take a peek at this op note. I was thinking 45300 but this is repair?? Unlisted? if so what do I compare it to? Findings: Anterior rectal defect repaired with 2 layer closure, widely patent, tissues viable. No fecal spillage is noted. Negative leak test...
  18. M

    Wiki 2023 Hernia Repair Codes

    Hello Everyone: Was wondering if I can ask how are your providers documenting the size of the hernias. Are they mentioned it within the body of the op note? As part of the procedure title? I have one provider that it is listing it under findings: Findings: A very small, 5 mm defect amenable to...
  19. M

    Wiki Counting Level for Laminectomy 63047 and 63048

    Hello Everyone: Can someone help on this question. If a provider performed a L2-L3 and L4-L5 laminectomy Would that be 63047 1 unit and 63048 3 units? Perhaps someone can send me a diagram or picture? Greatly appreciated MF
  20. M

    Wiki Coding assistance Hemi-Laminotomy C7 63001? and T-1 thru T-3 laminectomies with T-3 Intradural Excision

    Hello Everyone: Was wondering if someone can shade some light on this op note. Not really sure of the codes. PROCEDURE PERFORMED: 1.C7 bilateral hemi-laminotomy, T1-T2 bilateral laminectomies and T3 bilateral hemi-laminotomy with excisional biopsy of intradural extramedullary spinal cord...
  21. M

    Wiki Small Bowel Subserosal Ecchymosis

    Hello Everyone: Was wondering if someone can assist with this question. OB-Gyn called one of my general surgeons to assist on a case. OB-Gyn billed for 49900 and we billed 44602. The 44602 was denied. Just wondering if there is another code we can bill or should we just be the assistant to the...
  22. M

    Wiki Return to the OR for Thrombolytic infusion catheter

    Hello Everyone: Was hoping someone can help with this issue. Patient had a 37211, 36247-51 and 75710-26-59 on 4/5. On the same day while patient was in recovery the catheter were abruptly pulled and retracted out. The sheath and the catheter were still inside her body, but I recommended...
  23. M

    Wiki Arthrodesis?

    Hello: Was wondering if someone can point out where the arthrodesis is within this op note? Should this be 63047, 63048 X2 PROCEDURE PERFORMED: 1- Decompressive bilateral laminectomy L3 and L4 with medial facetectomy ( L2-3, L3-4, L4-5) with foraminotomy L3, L4 and L5. 2- Left L4-L5 facet...
  24. M

    Wiki Laparoscopic converted to open sigmoid colectomy, splenic flexure takedown

    Hello Everyone: Was wondering if someone can take a peek at this note. I have asked provider to verify if this was truly a "convert to open" but not getting an answer :-( I do not see where he converted to an open sigmoid colectomy. I only see the laparoscopic approach Operative technique...
  25. M

    Wiki Laparoscopic Diverting Sigmoid Colostomy with Mucous fistula (no colon resection)

    Hello Everyone: Was wondering if someone can shade some light on this surgical case. I was thinking the 44188 but not sure what to do about the fistula. There is an old post that recommend 44144-52. But that was posted quite a few years back. Listed is the op note. Thanks for any...
  26. M

    Wiki Hemidiaphragm Biopsy at the same time of a right hemicolectomy (Laparoscopic)

    Hello Everyone: Has anyone ever billed for this type of biopsy?? All I'm coming up with is an unlisted 39999 but if I do that what do I compare this code?? Any thoughts or information would be greatly appreciated. Thanks Miriam Upon further inspection there appeared to be mucinous implants...
  27. M

    Wiki CPT 22630 VS 22633

    Hello: Hoping someone can clarify whether the following op note should be 22630 vs 22633. If someone can point out if provider did do the combination approach as described in cpt 22633. That would be great. I was thinking coding would be 22630 or 22633...
  28. M

    Wiki Open repair of right anterior tibial artery pseudoaneurysm using reversed right great saphenous vein interposition graft

    Hello Everyone: Can anyone guide me as to roughly what cpt code this should be? Looking in the "Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease cpt 35001-35152 but there is...
  29. M

    Wiki Billing for CPT 85060

    Good morning everyone: Is anyone billing for cpt 85060?? CPT 85060 According to CPT there needs to be a written report in order to bill 85060 (our setting is outpatient clinic) If the provider just says "reviewed peripheral smear and essentially patient has minimally elevated or decreased...
  30. M

    Wiki cheat sheet for radiation oncology and sample notes

    Hello fellow coders: Does anyone have a cheat sheet for cpt codes for radiation oncology? also looking for some sample notes to cover these cpt codes. For example I have a rad onc billing for 77301-26,77300-26 and 77338-26. The note states IMRT planning note but not sure how to take it apart to...
  31. M

    Wiki Surgery Complication

    Just want to double check. This is a complication on a Non-Medicare Patient. Surgeon had to repair a vascular injury to the right common iliac vein. Can I truly bill for this? CPT 37660?:confused: Thanks, MF
  32. M

    Wiki Groin Lymph Node Excision

    Hello Everyone, Just want to double check on this. My op states "A 5cm skin incision was made overlying the enlarged lymph node approx. 2cm above the groin crease. The incision was carried through the subcutaneous tissue and fat using a Bovie electrocautery until the lymph node was reached...
  33. M

    Wiki ultrasounds billing requirements

    Hello everyone, I was wondering if someone can give me some directions as far as when is it correct to bill out ultrasounds. We have patients who have ultrasound guided biopsies at our office all the time. We do not own the equipment and there is no seperate dictation/note to cover the...
  34. M

    Wiki Wound vac change during post op period

    Hello everyone, I was wondering if someone can clarify or stear me in the right direction. I have a patient who had a wound vac change during her post op period. Is this billable and what code should I really be using. 97605/97606/11040? Thanks in advance. MF
  35. M

    Wiki ICD-9 for H/O groin cyst

    Hello List, I have tried to find this diag but I'm having no luck. Can anyone help? please! TIA MF
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