Orthopedic Coding Alert
Medicare Physician Fee Schedule:
Check Out These 4 MPFS Proposals for 2024
Rules on SDoH, telehealth highlight proposal. Even though the COVID-19 public health emer... Read more
Check Out These 4 MPFS Proposals for 2024
Rules on SDoH, telehealth highlight proposal. Even though the COVID-19 public health emer... Read more
Surgery:
Scope Out These Knee Arthroscopy Tips for Optimal Coding
Do you know how the provider decided the patient needed arthroscopy? When a patient has a... Read more
Scope Out These Knee Arthroscopy Tips for Optimal Coding
Do you know how the provider decided the patient needed arthroscopy? When a patient has a... Read more
Check Out This 3-Visit Arthroscopy Tx Course
To get a more complete picture of how a knee arthroscopy scenario might play out, take a l... Read more
To get a more complete picture of how a knee arthroscopy scenario might play out, take a l... Read more
Surgery:
Technique, Approach Smarts Vital to Coding Spinal Fusion Correctly
Do you know which approach your surgeon used during the fusion? Patients requiring spin... Read more
Technique, Approach Smarts Vital to Coding Spinal Fusion Correctly
Do you know which approach your surgeon used during the fusion? Patients requiring spin... Read more
Reader Questions:
Report This Code for Myotonic Atrophica
Question: Encounter notes indicate that the provider treated a patient with myotonic... Read more
Report This Code for Myotonic Atrophica
Question: Encounter notes indicate that the provider treated a patient with myotonic... Read more
Reader Questions:
Zero In on Surgery’s Purpose for Code Choice
Question: When the surgeon performs a surgical arthroscopy of the subtalar joint, how... Read more
Zero In on Surgery’s Purpose for Code Choice
Question: When the surgeon performs a surgical arthroscopy of the subtalar joint, how... Read more
Reader Questions:
MRA and MRI Are Different; Here’s How
Question: Encounter notes indicate the provider ordered a magnetic resonance angiogra... Read more
MRA and MRI Are Different; Here’s How
Question: Encounter notes indicate the provider ordered a magnetic resonance angiogra... Read more
Reader Questions:
Take a Closer Look Before Coding for Castings
Question: We have a physician who is a foot and ankle specialist. They have been sen... Read more
Take a Closer Look Before Coding for Castings
Question: We have a physician who is a foot and ankle specialist. They have been sen... Read more
You Be the Coder:
Coding Elbow Arthroplasty Revision
Question: A patient who had a right elbow arthroplasty for displaced simple supracondylar... Read more
Coding Elbow Arthroplasty Revision
Question: A patient who had a right elbow arthroplasty for displaced simple supracondylar... Read more
NCCI Edits:
Look Out: This 3rd Quarter Edit Will Cause Confusion
CMS made a mistake, but clarification won't happen right away. If your practice performs ... Read more
Look Out: This 3rd Quarter Edit Will Cause Confusion
CMS made a mistake, but clarification won't happen right away. If your practice performs ... Read more
Surgery:
Level Up to Master Cervical Arthrodesis Coding
If it's below C2, arthrodesis coding gets complicated. In an orthopedic practice, patient... Read more
Level Up to Master Cervical Arthrodesis Coding
If it's below C2, arthrodesis coding gets complicated. In an orthopedic practice, patient... Read more
MIPS Reporting:
Smaller Practices Benefit From These MIPS Tips
Here's why you should bookmark CMS MIPS tools. When submitting measures for the Merit-Ba... Read more
Smaller Practices Benefit From These MIPS Tips
Here's why you should bookmark CMS MIPS tools. When submitting measures for the Merit-Ba... Read more
Reader Questions:
Remember Drug Supply for These CT Injections
Question: After a level-three evaluation and management (E/M) service for an establis... Read more
Remember Drug Supply for These CT Injections
Question: After a level-three evaluation and management (E/M) service for an establis... Read more
Reader Questions:
Get Coding Straight for Closed/Open Rib Fx Coding
Question: When a patient reports to the office for treatment of broken ribs, is there... Read more
Get Coding Straight for Closed/Open Rib Fx Coding
Question: When a patient reports to the office for treatment of broken ribs, is there... Read more
Reader Questions:
Flat Feet Dx Depends on Congenital/Acquired Question
Question: My provider is treating a dancer who has pes planovalgus. The surgeon state... Read more
Flat Feet Dx Depends on Congenital/Acquired Question
Question: My provider is treating a dancer who has pes planovalgus. The surgeon state... Read more
You Be the Coder:
Arthrodesis for Scoliosis Patient
Question: A 14-year-old patient presents with well-compensated double curve pattern a... Read more
Arthrodesis for Scoliosis Patient
Question: A 14-year-old patient presents with well-compensated double curve pattern a... Read more
ICD-10 2024:
Update Adds to Osteoporosis Dx Options
Desmoid tumor? There's a code for that in 2024. Summertime is known for cookouts, pool pa... Read more
Update Adds to Osteoporosis Dx Options
Desmoid tumor? There's a code for that in 2024. Summertime is known for cookouts, pool pa... Read more
Shoulder Surgery:
Scope Reason for Procedure to Use These Codes Correctly
Some require debridement; others call for surgery past debridement. When a patient repo... Read more
Scope Reason for Procedure to Use These Codes Correctly
Some require debridement; others call for surgery past debridement. When a patient repo... Read more
Clip And Save:
Remember to Include These Services in Shoulder Scopes
The global surgical package for these surgeries is large. When the orthopedist performs a... Read more
Remember to Include These Services in Shoulder Scopes
The global surgical package for these surgeries is large. When the orthopedist performs a... Read more
AI Learning:
Use CPT® Appendix S to Aid AI Understanding
Appendix S sheds light on AI nuances. The CPT® code book always contains an overwhelmi... Read more
Use CPT® Appendix S to Aid AI Understanding
Appendix S sheds light on AI nuances. The CPT® code book always contains an overwhelmi... Read more
You Be the Coder:
Multiple Finger Fractures
Question: Encounter notes indicate the orthopedist performed two surgeries: closed treatme... Read more
Multiple Finger Fractures
Question: Encounter notes indicate the orthopedist performed two surgeries: closed treatme... Read more
Reader Questions:
Modifier 52-Injection Claim Getting Denied? Try This Instead
Question: Our providers commonly perform lumbar sympathetic plexus blocks via single injec... Read more
Modifier 52-Injection Claim Getting Denied? Try This Instead
Question: Our providers commonly perform lumbar sympathetic plexus blocks via single injec... Read more
Reader Questions:
Use Dx Code Trio for This Laminectomy Patient
Question: A new patient presents with cervical spinal stenosis at C5-C6 and degenerative d... Read more
Use Dx Code Trio for This Laminectomy Patient
Question: A new patient presents with cervical spinal stenosis at C5-C6 and degenerative d... Read more
Reader Questions:
I.D. Anatomical Site for Compression Syndrome
Question: Encounter notes indicate that a patient suffers from anterior spinal artery comp... Read more
I.D. Anatomical Site for Compression Syndrome
Question: Encounter notes indicate that a patient suffers from anterior spinal artery comp... Read more
Surgical Coding:
Gear Up for ACL/PCL Repairs With Surgical Smarts
Do you know which injury is more common: ACL or PCL tear? Patients reporting to the ortho... Read more
Gear Up for ACL/PCL Repairs With Surgical Smarts
Do you know which injury is more common: ACL or PCL tear? Patients reporting to the ortho... Read more
Case Study Corner:
Connect This Lisfranc Dislocation Case
Do you know where Lisfranc joint resides? If a patient suffers from foot trauma as the f... Read more
Connect This Lisfranc Dislocation Case
Do you know where Lisfranc joint resides? If a patient suffers from foot trauma as the f... Read more
ICD-10 Coding:
Get Back to Basics for Cervical Disc Disorder Dx
‘Other' cervical disc disorders call for M50.8-. Patients reporting to the practice w... Read more
Get Back to Basics for Cervical Disc Disorder Dx
‘Other' cervical disc disorders call for M50.8-. Patients reporting to the practice w... Read more
Reader Questions:
Anatomy Matters With Palindromic Rheumatism Dx
Question: Encounter notes indicate that a patient suffered from ‘palindromic rheuma... Read more
Anatomy Matters With Palindromic Rheumatism Dx
Question: Encounter notes indicate that a patient suffered from ‘palindromic rheuma... Read more
Reader Questions:
Choose This Code Pair for Ankle/Toe Loose Bodies
Question: Notes indicate that the surgeon performed a level-four office evaluation an... Read more
Choose This Code Pair for Ankle/Toe Loose Bodies
Question: Notes indicate that the surgeon performed a level-four office evaluation an... Read more
Reader Questions:
Get Signature Post-Addendum
Question: If a healthcare practitioner makes an addendum to a patient's medical recor... Read more
Get Signature Post-Addendum
Question: If a healthcare practitioner makes an addendum to a patient's medical recor... Read more
Reader Questions:
Report All Breaches Big and Small
Question: We uncovered a small data breach in our practice that impacted about 225 pa... Read more
Report All Breaches Big and Small
Question: We uncovered a small data breach in our practice that impacted about 225 pa... Read more
You Be the Coder:
Multiple Finger Fractures
Question: Encounter notes indicate the orthopedist performed two surgeries: closed tr... Read more
Multiple Finger Fractures
Question: Encounter notes indicate the orthopedist performed two surgeries: closed tr... Read more
E/M Coding:
Experts Weigh Challenges of 2023 Inpatient/Hospital Codes
Revised E/M codes are making payers, coders adjust. As a coder, you have had to deal with... Read more
Experts Weigh Challenges of 2023 Inpatient/Hospital Codes
Revised E/M codes are making payers, coders adjust. As a coder, you have had to deal with... Read more
Compliance:
Reduce Denials With Thorough Documentation
Lack of documentation leading cause of claims headaches. Denials are a part of coding; b... Read more
Reduce Denials With Thorough Documentation
Lack of documentation leading cause of claims headaches. Denials are a part of coding; b... Read more
Surgery:
Count Vertebrae, Code Vertebroplasty/Vertebral Augmentation Correctly
Here's why code choice is affected by vertebral count. When a patient needs percutaneous ... Read more
Count Vertebrae, Code Vertebroplasty/Vertebral Augmentation Correctly
Here's why code choice is affected by vertebral count. When a patient needs percutaneous ... Read more
Reader Questions:
Look to Code Trio for This Ankle Repair
Question: The orthopedist performs repair of a disrupted ankle ligament. I'm seeing a few ... Read more
Look to Code Trio for This Ankle Repair
Question: The orthopedist performs repair of a disrupted ankle ligament. I'm seeing a few ... Read more
Reader Questions:
Use T Code for This Arthrodesis Type
Question: The provider performs minimally invasive percutaneous arthrodesis of the sacroil... Read more
Use T Code for This Arthrodesis Type
Question: The provider performs minimally invasive percutaneous arthrodesis of the sacroil... Read more
Reader Questions:
Use Multi-Site Dx Code for Some Skeletal Fluoroses
Question: Encounter notes indicate that the provider treated a patient with “skeletal fl... Read more
Use Multi-Site Dx Code for Some Skeletal Fluoroses
Question: Encounter notes indicate that the provider treated a patient with “skeletal fl... Read more
Reader Questions:
Explore Arthrotomy Code for Ankle Debridement
Question: Our podiatrist performed an ankle gutter debridement along with peroneal and pos... Read more
Explore Arthrotomy Code for Ankle Debridement
Question: Our podiatrist performed an ankle gutter debridement along with peroneal and pos... Read more
You Be the Coder:
Multiple Foot X-Rays and Dx Codes
Question: An established patient presents to the office complaining of pain in their right... Read more
Multiple Foot X-Rays and Dx Codes
Question: An established patient presents to the office complaining of pain in their right... Read more
Condition Spotlight:
Know Hip Dislocation Types for ICD-10, CPT® Success
Do you know how the surgeon typically diagnoses hip dislocations? When a patient di... Read more
Know Hip Dislocation Types for ICD-10, CPT® Success
Do you know how the surgeon typically diagnoses hip dislocations? When a patient di... Read more
Case Study Corner:
Try Your Hand at Coding This Spinal Deformity Surgery Scenario
Remember, there are anterior and posterior arthrodesis codes. In last month's issue of Or... Read more
Try Your Hand at Coding This Spinal Deformity Surgery Scenario
Remember, there are anterior and posterior arthrodesis codes. In last month's issue of Or... Read more
Compliance:
Get Hip to Post-PHE HIPAA World Before it Arrives
Here's how to ready your practice for PHE end times. The COVID-19 public health emergency... Read more
Get Hip to Post-PHE HIPAA World Before it Arrives
Here's how to ready your practice for PHE end times. The COVID-19 public health emergency... Read more
Reader Questions:
Modifiers LT/RT not Always the Answer
Question: Encounter notes indicate that the orthopedist performed an office evaluatio... Read more
Modifiers LT/RT not Always the Answer
Question: Encounter notes indicate that the orthopedist performed an office evaluatio... Read more
Reader Questions:
Separate Pre-Exam Shot, CT
Question: Encounter notes indicate that the provider performed injection for contrast... Read more
Separate Pre-Exam Shot, CT
Question: Encounter notes indicate that the provider performed injection for contrast... Read more
Reader Questions:
Head to These Codes for Specific Juvenile RA
Question: Encounter notes indicate that a patient suffers from pauciarticular juvenil... Read more
Head to These Codes for Specific Juvenile RA
Question: Encounter notes indicate that a patient suffers from pauciarticular juvenil... Read more
Reader Questions:
Look Around This Code’s Notes for Periarthritis Dx
Question: Encounter notes indicate that a patient suffers from “periarthritis NOS.â... Read more
Look Around This Code’s Notes for Periarthritis Dx
Question: Encounter notes indicate that a patient suffers from “periarthritis NOS.â... Read more
You Be the Coder:
Multiple Ganglion Cyst Injections
Question: Encounter notes indicate that the physician performed a level-three evaluat... Read more
Multiple Ganglion Cyst Injections
Question: Encounter notes indicate that the physician performed a level-three evaluat... Read more
Condition Spotlight:
Connect Dislocated Elbow Coding Dots for Full Coding Picture
Here's how your surgeon could diagnose a dislocated elbow. Patients reporting to your pra... Read more
Connect Dislocated Elbow Coding Dots for Full Coding Picture
Here's how your surgeon could diagnose a dislocated elbow. Patients reporting to your pra... Read more
Case Study Corner:
Test Yourself With These Foot Repair Scenarios
Tenolysis/tendon surgeries can test your coding ability. When orthopedic surgeons perform... Read more
Test Yourself With These Foot Repair Scenarios
Tenolysis/tendon surgeries can test your coding ability. When orthopedic surgeons perform... Read more
Surgery:
Code Spinal Deformity Arthrodesis With Specific Code Set
Proper coding depends on knowing how surgeon diagnosed deformity. There's typically a lot... Read more
Code Spinal Deformity Arthrodesis With Specific Code Set
Proper coding depends on knowing how surgeon diagnosed deformity. There's typically a lot... Read more
You Be the Coder:
Multi-Level Hemilaminectomies
Question: Encounter notes indicate that the surgeon performed hemilaminectomy on spin... Read more
Multi-Level Hemilaminectomies
Question: Encounter notes indicate that the surgeon performed hemilaminectomy on spin... Read more
Reader Questions:
PHE to End in May
Question: I read that there's been another extension to the public health emergency (... Read more
PHE to End in May
Question: I read that there's been another extension to the public health emergency (... Read more
Reader Questions:
Get More Info Before Coding Tenotomy
Question: Encounter notes indicate that the surgeon performed tenotomy of a patient's... Read more
Get More Info Before Coding Tenotomy
Question: Encounter notes indicate that the surgeon performed tenotomy of a patient's... Read more
Reader Questions:
Get Specific With Stress Fracture Dx
Question: Encounter notes indicate that the patient suffered from a “stress Fx RT a... Read more
Get Specific With Stress Fracture Dx
Question: Encounter notes indicate that the patient suffered from a “stress Fx RT a... Read more
Reader Questions:
Use This Guide to MDM Leveling With 1 Chronic Problem
Question: We have a patient with one chronic problem. It is not worsening, but it is ... Read more
Use This Guide to MDM Leveling With 1 Chronic Problem
Question: We have a patient with one chronic problem. It is not worsening, but it is ... Read more
Surgery:
Remember to Code for All Services Surrounding Radial/Ulnar Fx
Also, keep several modifiers handy to separate services. When a patient reports with an u... Read more
Remember to Code for All Services Surrounding Radial/Ulnar Fx
Also, keep several modifiers handy to separate services. When a patient reports with an u... Read more
Modifier Madness:
Use This Guide to Answer Surgical Modifier Questions
Surgical care only? Use this modifier. When your surgeon provides fracture care, there a... Read more
Use This Guide to Answer Surgical Modifier Questions
Surgical care only? Use this modifier. When your surgeon provides fracture care, there a... Read more
Surgery:
Don’t Miss Out: Code Disc Removals Separately
Also, these procedures could include other codeable services. In last month's issue of ... Read more
Don’t Miss Out: Code Disc Removals Separately
Also, these procedures could include other codeable services. In last month's issue of ... Read more
Reader Questions:
Count Segments, Then Code Arthrodesis
Question: Encounter notes indicate that on Monday, the surgeon provided a level-four ... Read more
Count Segments, Then Code Arthrodesis
Question: Encounter notes indicate that on Monday, the surgeon provided a level-four ... Read more
Reader Questions:
Bundle Biopsy Into Arthrotomy
Question: Encounter notes indicate that the orthopedic surgeon performed a right shou... Read more
Bundle Biopsy Into Arthrotomy
Question: Encounter notes indicate that the orthopedic surgeon performed a right shou... Read more
Reader Questions:
Leave Incident-To to the Side for This Patient Type
Question: A new patient came in and the nurse practitioner (NP) took the initial hist... Read more
Leave Incident-To to the Side for This Patient Type
Question: A new patient came in and the nurse practitioner (NP) took the initial hist... Read more
Reader Questions:
Final CF Doesn’t Change Much
Question: I remember that the Medicare Physician Fee Schedule (MPFS) final rule came ... Read more
Final CF Doesn’t Change Much
Question: I remember that the Medicare Physician Fee Schedule (MPFS) final rule came ... Read more
Reader Questions:
Count Foot, Toe X-Rays Separately
Question: Encounter notes indicate that the provider performed a two-view foot X-ray ... Read more
Count Foot, Toe X-Rays Separately
Question: Encounter notes indicate that the provider performed a two-view foot X-ray ... Read more
Reader Questions:
Descriptor Exceptions Exist for Talus Removals
Question: Do I document craterization of the talus and of the medial cuneiform with 2... Read more
Descriptor Exceptions Exist for Talus Removals
Question: Do I document craterization of the talus and of the medial cuneiform with 2... Read more
You Be the Coder:
Note Spinal Area on Schmorl’s Nodes Dx
Question: What are Schmorl's nodes, and how do I choose a diagnosis code for the cond... Read more
Note Spinal Area on Schmorl’s Nodes Dx
Question: What are Schmorl's nodes, and how do I choose a diagnosis code for the cond... Read more
Surgery:
Toe the Coding Line With Foot Tendon Repair/Tenolysis
Journey to this surgery will likely begin with E/M, imaging. When a patient reports to th... Read more
Toe the Coding Line With Foot Tendon Repair/Tenolysis
Journey to this surgery will likely begin with E/M, imaging. When a patient reports to th... Read more
Surgery:
Code Family Matters on Total Disc Arthroplasty
Here's when you'll need T codes to report these surgeries. Patients that report to your p... Read more
Code Family Matters on Total Disc Arthroplasty
Here's when you'll need T codes to report these surgeries. Patients that report to your p... Read more
Condition Spotlight:
Let Documentation Reign With Os Trigonum Coding
Notes must paint a clear picture of the patient's condition. Os trigonum syndrome most of... Read more
Let Documentation Reign With Os Trigonum Coding
Notes must paint a clear picture of the patient's condition. Os trigonum syndrome most of... Read more
Reader Question:
Connect Dislocation Coding to Graft Question
Question: The provider performed open treatment of a sternoclavicular dislocation. Ho... Read more
Connect Dislocation Coding to Graft Question
Question: The provider performed open treatment of a sternoclavicular dislocation. Ho... Read more
Reader Question:
Remember to Code Using New Observation Rules
Question: Encounter notes indicate that on Jan. 2, 2023, the provider performed initi... Read more
Remember to Code Using New Observation Rules
Question: Encounter notes indicate that on Jan. 2, 2023, the provider performed initi... Read more
Reader Question:
Go Deeper Into Code Book for Fuller Spine X-rays
Question: The provider performs a single-view X-ray of the spine that includes the entire ... Read more
Go Deeper Into Code Book for Fuller Spine X-rays
Question: The provider performs a single-view X-ray of the spine that includes the entire ... Read more
Reader Question:
Never Use 99211 As a Catch-All E/M
Question: Should I be reporting all services performed by a nurse, including those pr... Read more
Never Use 99211 As a Catch-All E/M
Question: Should I be reporting all services performed by a nurse, including those pr... Read more
Reader Question:
Rely on Combo Code for This Lumbago/Sciatica Dx
Question: Encounter notes indicate that a patient suffers from right-sided lumbago an... Read more
Rely on Combo Code for This Lumbago/Sciatica Dx
Question: Encounter notes indicate that a patient suffers from right-sided lumbago an... Read more
You Be the Coder:
Osteotomies in 2 Spinal Areas
Question: Encounter notes indicate that the orthopedist performed a spinal osteotomy ... Read more
Osteotomies in 2 Spinal Areas
Question: Encounter notes indicate that the orthopedist performed a spinal osteotomy ... Read more