Search results

  1. J

    Wiki Aetna - Complex Repairs w Exc of Benign lesion - Any Complex Repair

    Thank you very much for this information, it confirms what I thought but it's in writing (minus your name) to present to the provider. Have a great day :p
  2. J

    Wiki Aetna - Complex Repairs w Exc of Benign lesion - Any Complex Repair

    This has been a burr in my backside as well not only for Aetna but UHC. I'm still searching for specific documentation requirements and so far CMS, NGS J6-our mac, Aetna nor UHC have specific policies for documentation of "complex repair". There was another thread going that I'm following...
  3. J

    Wiki Modifier JW

    Definitely not a good idea, target on your back for sure.
  4. J

    Wiki Coding for complex excision of pilondial cyst disease with perianal fistulas, excision size of 12 x 9 x 2 cm

    Please help, coding scenario conundrum. It's been suggested 11772 - Excision of pilonidal cyst or sinus; complicated The code does not allow for co-surgery which is another issue in it's own. From what I can deduce, it's not a cyst rather it's secondary to prior cyst removal and development...
  5. J

    Wiki Modifier JW

    That's an interesting one, did the patient's guardian sign consent to have the vaccine prior to prep of the vaccine? My thought is since nothing was administered the guardian should be held liable for the medication. JW doesn't apply to Vaccines only administered drugs.
  6. J

    Wiki Medial collateral ligament lengthening & bone marrow venting

    Thank you so much for the additional info, it's the way I was leaning but wanted to make sure. Makes sense that majority of us with OCD need to vent every now and again lol, although I have CDO - it's alphabetized. Have a great weekend!
  7. J

    Wiki Medial collateral ligament lengthening & bone marrow venting

    Hello all. I'm a Compliance Coding Auditor and reviewing an OP note that has me perplexed. I found the above question from 12/7/2017 from "ironically" my previous co-worker - she's retired now. This has come up again recently, I don't see any replies, and the thread is from 2017 so 29879 I...
  8. J

    Wiki What would you say to someone considering becoming a medical coder?

    I would say don't get discouraged when you are credentialed and looking for a job without success. Just because you are credentialed doesn't give you a shoe in the door automatically for coding, unfortunately experience is preferred over credentials. I'm not trying to be disrespectful to anyone...
  9. J

    Wiki Coding for Regeneten Patch procedure during Rotator Cuff repair/reconstruction

    It's the Smith and Nephew website and I've corrected my original thread, I see where I stated incorrectly "23412 in addition to the Rotator Cuff repair/reconstruct code", when it should just be the open code for the RC repair. I added the URL however, you have to create an account to get to it...
  10. J

    Wiki Coding for Regeneten Patch procedure during Rotator Cuff repair/reconstruction

    I've read some older threads where coders have asked this question and replied just now however, I thought I would create a new thread post in case someone misses it. "The question was that surgeon's are performing a Patch graft procedure during a Rotator Cuff repair/reconstruction, how should...
  11. J

    Wiki Rotator Cuff repair w/allograft patch augmentation

    After deep research into this, I've discovered that IF arthroscopic the best case scenario and advice is to bill 29999 (Regeneten Path procedure, compare to 23412). 23412 is for OPEN procedure but the lay term describes the procedure to a "T". 17999 wouldn't be appropriate because it's not from...
  12. J

    Wiki Shoulder augmentation rotator cuff repair

    After deep research into this, I've discovered that IF arthroscopic the best case scenario and advice is to bill 29999 (Regeneten Path procedure, compare to 23412). 23412 is for OPEN procedure but the lay term describes the procedure to a "T". 17999 wouldn't be appropriate because it's not from...
  13. J

    Wiki Rotator cuff repair, Regeneten bioinductive allograft

    After deep research into this, I've discovered that IF arthroscopic the best case scenario and advice is to bill 29999 (Regeneten Path procedure, compare to 23412). 23412 is for OPEN procedure but the lay term describes the procedure to a "T". 17999 wouldn't be appropriate because it's not from...
  14. J

    Wiki HCPCS Code for Regeneten Bioinductive Patch

    After deep research into this, I've discovered that IF arthroscopic the best case scenario and advice is to bill 29999 (Regeneten Path procedure, compare to 23412). 23412 is for OPEN procedure but the lay term describes the procedure to a "T". 17999 wouldn't be appropriate because it's not from...
  15. J

    Wiki Shoulder-Rotator cuff procedures with allograft, any official guidance?

    After deep research into this, I've discovered that IF arthroscopic the best case scenario and advise is to bill 29999 (Regeneten Path procedure, compare to 23412). 23412 is for OPEN procedure but the lay term describes the procedure to a "T". 17999 wouldn't be appropriate because it's not from...
  16. J

    Wiki Anesthesia Physical Status Modifiers

    Lisa, I hope that you don't mind that I pick your brain a little further as I'm learning. Regarding to "concurrency" of cases that a anesthesiologist can supervise being a max of 4 per CMS, have you found any Commercial carriers that follow this same policy or that have their own? Jason
  17. J

    Wiki Anesthesia Physical Status Modifiers

    Lisa, Thank you very much! I've been to the ASA's site but couldn't locate what I needed until you sent me the link. This is extremely helpful and just what I needed :) I appreciate it! Best Regard, Jason
  18. J

    Wiki Anesthesia Physical Status Modifiers

    Hello, I'm a Compliance Coding Auditor for a large group practice with an ASC. I'm currently auditing the ASC's anesthesia and have come across a question I cannot find the answer to nor supporting documentation. >The Medicare Claims processing manual only mentions "time reporting", I see...
  19. J

    Wiki Documentation requirements for OPTOS

    Looking for advice on where to find medical record documentation requirements when billing for the OPTOS. The OPTOS is billed under the same CPT as Fundus Photography 92250 and is being used in most cases as an alternative to being dilated. I'm looking for documentation guidelines /...
  20. J

    Wiki Botox billing advice needed!

    Hello, I work for a Multispecialty Ophthalmology clinic and we have a Oculoplastic Surgeon who performs Botox Injections for functional reasons, but also cosmetic purposes. Currently we only bill for the Botox itself J0585. Here's a thought, if you are purely looking to do cosmetic botox and...
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