Orthopedic Coding Alert

Correct Modifiers, Additional Codes Are Key in Overcoming Unique Conditions With THRs
Total hip replacements (THRs) are one of the most commonly performed orthopedic surg... Read more
CMS Memo Changes Rules for Diagnostic Coding
A new CMS policy that goes into effect Jan. 1, 2002, allows doctors to use either the si... Read more
Category III Codes May Lead to Reimbursement
In September 2001 the AMA introduced a series of temporary Category III, or emerging-techn... Read more
Anthrax Coding Report Free on Web
 Physicians and other healthcare professionals who provide services to any patients w... Read more
Reader Question:
Confirmatory Consultation
Question: Should I bill for a confirmatory consultation when a patient requests a second o... Read more
Reader Question:
Ankle Surgery
Question: Which codes should I use for arthroscopy and debridement of ankle: arthroscopic ... Read more
Reader Question:
After-Hours Coding
Question: A patient had to be taken into surgery late at night. According to the surgeon, ... Read more
Reader Question:
Bundled Procedures
Question: I've gotten a denial from Medicare saying that 63044 is bundled with 63... Read more
Reader Question:
Operating Microscope
Question: We are receiving denials for 69990 when billed with spine procedures. Is anyone ... Read more
Reader Question:
Knee Procedures
Question: How should I code a knee arthroscopy with chondroplasty and partial lateral meni... Read more
Reader Question:
CCI or AAOS?
Question: The surgeon performed a Bostrom procedure (27698, repair, secondary, disrupted... Read more
Reader Question:
Supply Billing
Question: Im having trouble getting paid for casting supplies (casting material, padding a... Read more
You Be the Coder:
Knee Surgery
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Few Changes to ICD-9 2002
Considering the many changes to CPT 2002, orthopedic coders may be relieved to know that... Read more
News Brief:
No Substantive CCI Edits for Orthopedics
The Correct Coding Initiative (CCI) version 7.3, which went into effect Oct. 1, 2001, cont... Read more
Reader Question:
Billing Medicare for Paperwork
Question: Does anyone bill Medicare for completion of paperwork such as renewal or updates... Read more
Reader Question:
Complex Wound Closure
Question: I have a patient who had multiple lacerations on his right and left fingers. Sho... Read more
Reader Question:
Post-RTC Infection
Question: A patient presents a postsurgery rotator cuff repair with a wound infection of t... Read more
Reader Question:
Excision of Heterotopic Calcification
Question: My physician did an excision of heterotopic calcification and removal foreign ... Read more
Reader Question:
Lateral and Posterior Fracture
Question: If a patient has a lateral and posterior fracture of the fibula, is this consi... Read more
Reader Question:
Billing for ESI Trays
Question: Our pain management specialist is now doing ESIs (epidural steroid injections) a... Read more
You Be the Coder:
ACL Bundling
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Claim Guidelines Vary:
Easing the Pain for IDET Reimbursement
Intradiscal Electrothermal Annuloplasty (IDET) is a minimally i... Read more
Analyze Options, Document When Selecting Analogous Codes
Choosing analogous codes to accompany claims for unlisted procedures, i.e., 2990... Read more
Reader Question:
Second Opinion
Question: If a patient is in the postoperative period for a diagnostic knee arthroscopy, c... Read more
Reader Question:
Lavage Irrigation
Question: What is the CPT code for lavage irrigation of the right knee joint? We used abou... Read more
Reader Question:
Depo-Medrol Billing
Question: Due to the unavailability of Celestone for injections, we are considering a sw... Read more
Reader Question:
Subsequent Surgery
Question: The surgeon performed arthroscopic knee surgery for a patient with symptomatic... Read more
Reader Question:
Juvenile Osteochondroses
Question: Does the term juvenile in juvenile osteochondrosis (732.x) refer to the physical... Read more
Reader Question:
Gore-Tex Cast Padding
Question: How should I handle billing and reimbursement for Gore-Tex cast padding? More an... Read more
Reader Question:
Discharge and Transfer Billing
Question: One of the surgeons in my practice insists that history and physical (H&P)... Read more
You Be the Coder:
Cast Replacement and Maceration
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Ease the Pain of Coding for Treatment of Osteoarthritic Patient
Many orthopedic practices see arthritic patients at various stages of their treatment... Read more
Multitrauma Patient:
RVUs and Modifiers Are Key to Securing Higher Payment
Orthopedists on call to their local emergency department (ED) are often required t... Read more
Reader Question:
Interval Closure
Question: How should I code for an arthroscopic rotator interval closure?Florida Subscribe... Read more
Reader Question:
S Codes for Thermal Shrinkage
Question: Why can I not use HCPCS code S2300 (arthroscopy, shoulder, surgical; with ther... Read more
Reader Question:
Medial Epicondyle Injection
Question: What is the appropriate CPT code for a medial epicondyle injection with a diagno... Read more
Reader Question:
Billing for Residents
Question: One of our orthopedists was on call at the ED, and the ED physician requested an... Read more
Reader Question:
ED Follow-Up
Question: I was on call at the ED and treated a patient there, then I saw that patient for... Read more
You Be the Coder:
Coding an In-Office Procedure
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Avoid Multiple Headaches When Coding Multiple Arthroscopic Shoulder Procedures
Orthopedic coders consistently cite coding for multiple arthroscopic shoulder procedures ... Read more
HCFA Adds New Codes for Casting Supplies
Obtaining reimbursement for cast and splint supplies has always been a challenge in or... Read more
CCI Changes to Orthopedics are Extensive but not Major
The Correct Coding Initiative (CCI) version 7.2, which went into effect on July 1, 2001,... Read more
News Brief:
HCFA Changes Name to CMS
The Health Care Financing Administration (HCFA), which administers Medicare and Medicaid p... Read more
Reader Question:
Assistant Surgeon
Question: We often use orthopedic residents from an area program, but when they arent avai... Read more
Reader Question:
Pin Removal With Scar Revision
Question: My doctor performed a removal of pins in the right hip with scar revision. This ... Read more
Reader Question:
History and Physical by PA
Question: Can I charge for a history and physical (H&P) done by our physicians assista... Read more
Reader Question:
E Codes
Question: What are E codes, and should I be using them? Nevada Subscriber  Ans... Read more
Reader Question:
Bone Graft
Question: My physician opened and prepared a graft site but then switched to synthetic bon... Read more
Reader Question:
Operative Report Alteration
Question: If my physician fails to mention a procedure in his operative report, can he cha... Read more
Reader Question:
Multiple Injections
Question: Im trying to bill 20550 for injections of multiple sites as separate line items ... Read more
Reader Question:
Synovectomy
Question: Our doctor performed an excision of a ganglion cyst (25111) and a synovectomy.... Read more
Reader Question:
Debridement
Question: Can I bill for debridement (11010) when billing for 25575? Insurance companies... Read more
You Be the Coder:
Arthroplasty
Test your coding knowledge.  Determine how you would code this situation before look... Read more
Unlisted Codes, Payer Education and Documentation Help Reimbursement for SED
Selective endoscopic diskectomy (SED) is a relatively new spinal procedure used to treat... Read more
Clarify Coding for Fracture Care
Fracture care is one of the most complicated procedures to code. Coders continually ques... Read more
Consult in ED
Question: Our orthopedic surgeons accept many calls to the emergency department (ED). Shou... Read more
Reader Question:
Multiple ORIF Procedures
"Question: I performed a combination of open reduction with internal fixation (ORIF) and c... Read more
Reader Question:
Partial Joint Arthroplasties
Question: My doctor did a knee arthrotomy with irrigation and debridement. She also replac... Read more
Reader Question:
DME Billing
Question: I have applied to a Medicare supplier for items like CAM walkers, case boots, bu... Read more
Reader Question:
Use 29909 Once for Multiple Arthroscopies
Question: One of our surgeons frequently performs multiple arthroscopic procedures on shou... Read more
Reader Question:
Untreated Medial Malleolar Fracture
Question: A patient has a chronic medial malleolar fracture and pronation of feet. This is... Read more
Reader Question:
Sliding Graft
Question: What is a sliding graft, and how should I code for it? My physician indicated th... Read more
Reader Question:
I&D Beyond Global
Question: A patient who was four weeks post-operative for a fasciotomy of the right elbow ... Read more
Reader Question:
Manipulation in the OR
Question: A patient had a total knee replacement 30 days ago, then returned to the operati... Read more
Reader Question:
Removal of Stimulator
Question: How should I code for the removal of an implanted bone stimulator? Delaware Subs... Read more
Reader Question:
ORIF of Ankle Fracture
Question: My orthopedic surgeon performed an open reduction with internal fixation (ORIF)... Read more
You Be the Coder:
Chondroplasty Bundling
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Avoid Fraud:
Stay Clear of Coding Pitfalls for Short-term Pain Pumps
While CPT has several codes for the placement of subcutaneous, long-term pain pumps, none ... Read more
Definitive Diagnosis Brings Correct Reimbursement for ED Ankle Fractures
When an orthopedist is called to the emergency department (ED) to treat an ankle injury, c... Read more
Reader Question:
ACL and Meniscectomy
Question: How should I code the following procedure? Arthroscopy of the right knee; Ant... Read more
Reader Question:
TKR During Arthroscopy Global
Question: A patient who had an arthroscopy on his left knee decided less than 90 days late... Read more
Reader Question:
Steroid Injection
Question: How do I code for a fluoroscopically guided, contrast-controlled right L4 trans... Read more
Reader Question:
Long Arm Splint
Question: How should we bill when the patient presents to us after going to an emergency r... Read more
Reader Question:
Ankle Fusion
Question: What is the most accurate way of coding an arthroscopic ankle fusion? Should I s... Read more
Reader Question:
Synovectomy
Question: Is it ever appropriate to bill for a 29875 with 29877 and 29874 ? I know these ... Read more
Reader Question:
Intraoperative X-rays
Question: How do I bill for intraoperative x-rays?New Jersey Subscriber Answer: Intraopera... Read more
Reader Question:
Radiographs
Question: What are the rules and guidelines for billing for radiographic interpretation (x... Read more
Reader Question:
Multiple Procedures
Question: One of our surgeons frequently performs the following multiple arthroscopic proc... Read more
You Be the Coder:
Two Injections
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Correct Modifiers are Key to Accurate Foot Care Coding
Coding accurately for services provided in the treatment of the foot requires careful plan... Read more
How to Use the 990xx Series Correctly to Get Reimbursed for Miscellaneous Services
Orthopedists sometimes need to report codes for miscellaneous procedures or supplies, so c... Read more
Clarification:
More on Marcaine
In the March 2001 issue of Orthopedic Coding Alert, we printed a reader question and answe... Read more
Reader Question:
ER Services
Question: When my physician sees patients in the emergency department (ED) should we alway... Read more
Reader Question:
Debridement
Question: What is considered limited debridement (29822) versus extensive (29823)?Arizona ... Read more
Reader Question:
Chondroplasty
Question: What compartments are referred to in arthroscopic chondroplasty of the knee (298... Read more
Reader Question:
Arthroscopic Surgery
Question: If a diagnostic arthroscopy (29870) is done on the medial compartment of the kne... Read more
You Be the Coder:
Arthroscopy
Question: My doctor performed 29877 (arthroscopy, knee, surgical; debridement/shaving of a... Read more
Know the Coding Options for Multiple Arthroscopic Knee Procedures to Boost Payment
Coding multiple arthroscopic knee surgeries where more than one procedure is performed in... Read more
Optimize Reimbursement for Thermal ACL Shrinkage With Comparative Codes and Thorough Documentation
Thermal anterior cruciate ligament (ACL) shrinkage is a new surgery that differs from trad... Read more
Clarification:
Acromioplasty
The February 2001 Orthopedic Coding Alert contained an error in a reader question on page ... Read more
Reader Question:
Botox Injection
Question: How do I code for the administration of Botox?New Jersey Subscriber Answer: The ... Read more
Reader Question:
Bilateral Lumbar Laminectomy
Question: How do I code for a bilateral lumbar laminectomy at L5-S1 (Level 5, Segment 1) w... Read more
Reader Question:
Lumbar Epidural Steroid Injection
Question: What is the correct CPT code for administering a lumbar epidural steroid injecti... Read more
Reader Question:
Conscious Sedation
Question: Our orthopedic surgeons perform many manipulations of dislocated total hip repla... Read more
Reader Question:
Injection Codes
Question: Is there a set of rules as to how many injections can be billed at the same time... Read more
Reader Question:
Fractures Without Castings
Question: What is the correct way to code for fractures that are treated without castings?... Read more
Reader Question:
Assistant Surgeon Fees
Question: When billing for assistant surgeons fees, should I charge full price for the a... Read more
Reader Question:
Removal of Exostosis
Question: How do I code for removal of exostosis on the hip? Texas Subscriber Answ... Read more
You Be the Coder:
Assisted Surgery
Question: My physician saw a patient, but he was not well practiced at the surgery the pat... Read more
Use Modifiers -57 and -25 to Optimize Office Visits that Lead to Surger
When an orthopedist decides that a patient needs an immediate or near-immediate surgical... Read more
Use Proper Documentation to Ensure Payment for Arthroscopic SLAP Repairs
Orthopedic coders often express frustration with coding for arthroscopic superior labrum a... Read more
News Brief:
HCFA Temporarily Suspends Part of CCI Version 6.3
HCFA has temporarily suspended many of the edits in version 6.3 of the national Correct Co... Read more
Letter Helps SLAP
The following letter to carriers describing the SLAP lesion repair and asking for reimburs... Read more
Reader Question:
Multiple Injuries
Question: I treated a patient for the following: 1. Fracture care of left hand original i... Read more
Reader Question:
Physiatrist
Question: My practice just hired a physiatrist and Im at a loss as how to bill for her ser... Read more
Reader Question:
Distal Tubercle Transfer
Question: One of our physicians performed a distal tubercle transfer medially (Elmslie-Tri... Read more
Reader Question:
Biopsy
Question: I am having trouble getting paid when a biopsy is done in the same operative ses... Read more
Reader Question:
Hemi-arthroplasty
Question: The patient underwent a hemi-arthroplasty for a fractured hip. He returned to th... Read more
Reader Question:
Removal of Exostosis
Question: How do I code for removal of exostosis on the hip? Utah Subscriber Answer: Use t... Read more
Reader Question:
Assistant Surgeon Fees
Question: When billing for assistant surgeons fees, should I charge full price for the ass... Read more
Reader Question:
Marcaine
Question: I am having difficulty getting paid for Marcaine. We use the unlisted HCPCS code... Read more
Reader Question:
HCFA Scrutinizes 99214
Question: I have heard that Medicare is taking a closer look at claims for 99214. Why is t... Read more
You Be the Coder:
Total Knee Replacement
Question: My surgeon is scheduling more bilateral total knee replacements (TKR), and we ha... Read more
Optimize Reimbursement for Core Decompression of the Hip
Core decompressions of the hip are a fairly common orthopedic procedure. Yet no CPT code... Read more
Use E codes Properly With the Diagnosis Code to Avoid Denials
Orthopedic coders sometimes use E codes (external causes of injury and poisoning) to enhan... Read more
News Alert:
HCFA Rejects Modifier -60
In Program Memorandum B-00-75, dated Dec. 21, 2000, HCFA announced that it will not reco... Read more
Correction:
Modifier -60 Not for Morbid Obesity
In the December 2000 issue of Orthopedic Coding Alert in the article Understand Significa... Read more
Reader Question:
Modifier -51
Question: I need help understanding when to use the -51 modifier. Weve been told to use it... Read more
Reader Question:
Workers Compensation Report
Question: Is it possible to bill for transcription costs for a workers compensation report... Read more
Reader Question:
Sports Physicals
Question: We are team physicians for a university and occasionally do sports physicals. Wh... Read more
Reader Question:
Arthroscope and Arthrotomy
Question: One of my physicians started to do a repair of a talar dome fracture through the... Read more
Reader Question:
Rotator Cuff Repair
Question: We recently had an audit of our surgical coding and were told that if a tendon i... Read more
Reader Question:
Acromioplasty and Acromionectomy
Question: One of our doctors performs rotator cuff decompressions that almost always inclu... Read more
You Be the Coder:
Cortisone Injection
Question: How do I code a fluoroscopic injection of cortisone into the hip joint under ane... Read more
Append Modifiers -78, -79 and -58 to Help Reimbursement During Global Surgical Periods
Several CPT surgical modifiers exist for related or unrelated procedures and returns to th... Read more
Know When Postoperative Complications are Unrelated to Original Surgery to Get Paid Separately for Routine Followup
With routine orthopedic surgeries like total hip (THR) and knee (TKR) replacements, pati... Read more
Reader Question:
Office Visit
Question: If a child is referred to me by his or her pediatrician for clubfoot and is in f... Read more
Reader Question:
Workers Compensation Updates
Question: What is the best way to deal with workers compensation carriers who require, aft... Read more
Reader Question:
Closed Reduction
Question: I need assistance in coding a closed reduction with percutaneous pinning of grea... Read more
Reader Question:
Arthroscopy
Question: Ive recently been told that when a partial claviculectomy is done arthroscopical... Read more
Reader Question:
Arthrocentesis
Question: How would you code this scenario? 1. The patient was seen as an orthopedic cons... Read more
Reader Question:
Musculotendinous Cuff
Question: We recently had an audit of our surgical coding and were told that if a tendon i... Read more
You Be the Coder:
Medial Retinaculum
Reviewed on May 20, 2015 Question: What is the correct code for an open repair of th... Read more
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