Spinal Surgery Coding Challenge: Tethered Cord Release & Dural Tag Removal

Question: My neurosurgeon released a tethered cord under the microscope, then excised a dural tag and sent it to pathology. Can we be reimbursed for both services, or are they inclusive?
Answer: The procedure removes adhesions (tags) from the dura to correct any neurological deficits. Physicians often remove a specimen to send for lab review, but […]

Related articles:

  1. Take Our Multi-Level Spinal Surgery Coding Challenge AUDIO TRAINING EVENT: Receive Optimum Reimbursement for Spinal Co-Surgeries,…
  2. Watch Your Back: Bust These 5 Spinal Instrumentation Myths Same-session arthrodesis errors? Read on to discover where you…
  3. Coding Challenge: Foot Foreign Body Removal Vs. Soft-Tissue FBRQuestion: Our physician performed a foreign-body removal (FBR) on a…
Read More »

Laceration Repair Documentation Checklist

Sew Up Laceration Repair Coding With These 8 Elements
Unless you want to grapple with denials, the procedure notes that support your physicians’ laceration repair claims should contain these 8 elements. How do the physicians in your practice measure up?
• location
• length
AUDIO EXTRA: Secrets to optimal reimbursement for lesion excision, repair.
• layers
[…]

Related articles:

  1. ED Coder’s Toolkit: Wound Repair Documentation Acronym ‘LLLDTEAR’ ensures you’ve got every element. Coders and…
  2. Simple Laceration Repair Code or E/M Code? Answer Could Cost Hundreds Not recognizing a laceration repair that’s included in an…
  3. Multi-Laceration Repair Coding Case StudiesDo you know when to code repairs that occur in…
Read More »

ICD-9 2010: More Coding Options for Brain Injury

Check out V80.01 and V80.09 for special screenings.
The newest edition of ICD-9 changes goes into effect Oct. 1, so adjust your system to reflect some new diagnosis codes for special neurological screenings — and one that’s about to become invalid — to be sure your claims stay on par.
Extend ‘Other Conditions’ Dx From 348.8 to 348.89
Diagnosis 348.8 (Other conditions […]

Related articles:

  1. Which PET Code Is Best for Brain Images? Question: Which CPT code is appropriate for PET performed…
  2. Master Internal Hemorrhoid Excision With 3 Coding OptionsDon’t fall victim to the 46934 coding pitfall, especially in…
  3. Coding Challenge: Prior Cancerous Biopsy, But No Residual Tumor Question: We received a mastectomy specimen based on a…
Read More »

Medicare Will Pay for Some Telehealth Services: The Lowdown on How to Report Them

If you’re confused about whether Medicare covers telehealth services, look no further. CMS recently released a MLN Matters fact sheet on the topic that can help guide the way.
Keep in mind: CMS notes that Medicare beneficiaries “are eligible for telehealth services only if they are presented from an originating sitelocated in a rural health professional shortage area or in a county outside of a […]

Related articles:

  1. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open…
  2. 2009 Reimbursement Lowdown for PT, OT & SLP Services SLPs: Watch out for this MBS reimbursement cut. Happy…
  3. Break Down Outpatient ESRD Into These G-Code Mirroring Cat I Codes We tell you the inpatient dialysis codes that trigger…
Read More »

Shave Duplicate Lesion Excision Denials

Question: Our dermatologist shaved three epidermal lesions that the patient chose not to have submitted to pathology: a 0.4 cm lesion from the patient’s chest, a 0.3 lesion from the patient’s back, and a 0.2 lesion from the patient’s stomach. Will I need to include modifiers?
Answer: Because CPT classifies the shaves with the same anatomic […]

Related articles:

  1. Shave or Excision?Sharpen your lesion coding prowess with this tip from John…
  2. Prevent ‘Duplicate’ Chest X-Ray Denials With Modifiers 59 and 76 Keep 71010 troubles at bay with this helpful time-stamp…
  3. Lesion Excision Coding Challenge: 2 Lesions, 1 CutQuestion: Our nonphysician practitioner (NPP) discovers a pair of benign…
Read More »

Solve Op Note Mysteries With This Fracture Glossary

CPT code selection is easier if you know your fracture anatomy. Illustrations included!
Fractures are defined as a disruption in the integrity of a living bone, bone marrow, periosteum, and adjacent soft tissues. Fractures occur when a bone cannot withstand outside forces, the integrity of the bone has been lost, and the bone structure fails. Fracture […]

Related articles:

  1. Coder’s Anatomy: Greenstick Fracture Greenstick Fracture: This type of fracture is usually found…
  2. Orthopedic Coder’s ICD-9 Update: New Radius, Ulna Torus Fracture CodesCome Oct. 1, you’ll no longer will you look to…
  3. Weber B Fracture Repair: 27786, 27788 or 27792?Question: Which CPT and ICD-9 codes should we report when…
Read More »

Sort Out This ER, Then Assumed Care Scenario

Question: My orthopedist treated a patient who was first seen in the ER for an open fracture with laceration overlying the distal finger phalanx. The ER physician sutured the wound. When the patient arrives in our office, the orthopedist does an E/M service and assumes the care of the wound in addition to the fracture […]

Related articles:

  1. Weber B Fracture Repair: 27786, 27788 or 27792?Question: Which CPT and ICD-9 codes should we report when…
  2. Sort Out Your Globals With This Quick PFS Tour Our global period crash course puts you on top…
  3. Audit Alert: Wound CareCarriers auditing wound care claims are most likely to check…
Read More »

IVR & Modifier 22: Obesity Isn’t Automatic Support

It takes extra work to perform interventional radiology procedures on morbidly obese patients, so why not append modifier 22 to any obese patient’s claim and get paid more, right?
Wrong: The fact that the patient is obese is not enough reason to append modifier 22. Payers reason that the “easy” and “hard” procedures will average out […]

Related articles:

  1. Modifier 22 Moves for Ob-Gyn CodersThis U/S tactic will save you time — and add money…
  2. Medical Coder’s Modifier 25 Checklist Append 25 with the greatest of ease … Appending…
  3. Modifier 57 Alone Should Preclude the Need for 25 Medicare carriers don’t require you to append both modifiers….
Read More »

Urology Coding Challenge: Gold Seed Marker Placement Plus TRUS

Question: How should I report the placement of gold seed markers and a TRUS done in the office setting?
Answer: First, you should report 55876 (Placement of interstitial device[s] for radiation therapy guidance [e.g., fiducial markers, dosimeter], prostate [via needle, any approach], single or multiple) for the gold seed marker placement. If the urologist also examined […]

Related articles:

  1. Focus on Method to Ensure Proper Stereotactic Breast Biopsy CodingWatch out for the 77031 pitfall if the radiologist participates…
  2. Coding Ovarian Cyst Removal: Are You Making These 4 Mistakes?Here’s how you could potentially add $184 to your bottom…
  3. Where Anesthesia Coders Go Wrong With CS Cath Placement   Your doc needs to do this to get…
Read More »
Share on facebook
Share on twitter
Share on linkedin
Share on whatsapp

Most Popular: