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Orthopedic Coding Alert

We've Got the Scoop on What You Need to Know About 2007's Revised Consult Codes
The new edition of CPT also cleans up graft language and introduces new -T- codes Coding ... Read more
Take Advantage of This Additional Consult Opportunity
Remember, you should report only one inpatient consultation per inpatient stay. If the sur... Read more
ICD-9 QUIZ:
Code the Story of Your Patient's Life
Can you find the diagnosis codes in this patient's history? Sometimes it may seem as if t... Read more
Nail Down E/M Rules to Select the Right Level Every Time
Is presurgical H&P part of global? The answer may surprise you The financial health o... Read more
Want to Make More Money? Experience Pays
Our second annual salary survey shows that experience, education and certification can hel... Read more
SALARIES
Picture of a $70,000+ Earner Our Coders- Salary Survey found that out of the 416 orthoped... Read more
READER QUESTION:
Determine Whether TP Was Available
Question: What are the rules on teaching physicians being present during surgical procedur... Read more
READER QUESTION:
Digital Block Bundles Into Toenail Excision
Question: Our foot surgeon performed a toenail excision and nail bed repair with a digital... Read more
READER QUESTION:
Use Healing Status to Select V Code
Question: Our patient had a hip replacement and returned one year later for a routine foll... Read more
YOU BE THE CODER:
How Should We Report Open Capsular Shift?
Question: Our surgeon performed an anterior reconstruction of the shoulder with a capsular... Read more
CPT 2007 to Debut New Distal Radial Fracture, Total Disk Arthroplasty Codes
You-ll also find new codes for some fluoro procedures If you-ve been looking for a more p... Read more
Keep Knee Surgery Payment Flowing With These Tips
Read policies carefully for OATS, mosaicplasty procedures Knee surgery remains one of the... Read more
Let This Chart Help You Select Accurate Knee Repair Codes
Match the site to the documentation and you-ll choose the right code every timeIf you have... Read more
NCCI Update ~ Expect Denials if You Bill Multiple Surgery Base Codes
Follow our experts- advice to save your claims from the denial pile Orthopedic practices ... Read more
Unhappy With Your Collections Rate? 7 Strategies Can Put You on the Road to Success
Collection agencies can be a great way to bring in the money -- if you can't collect ... Read more
Collections Checklist:
Remember These Criteria When Hiring a Collection Agency
Even with consistent adherence to collection procedures, orthopedic practices will often h... Read more
Reader Question ~ Look to 64470 for Facet Block
Question: Our physician administered a facet block via the patient's medial branch nerves,... Read more
Reader Question ~ Get Specific With Tissue Infections
Question: Our surgeon treated a soft-tissue infection on a patient's finger. Which diagnos... Read more
Reader Question ~ Avoid Modifier 50 for TPIs
Question: How should I report bilateral trigger point injections in three locations for a ... Read more
You Be the Coder ~ Don't Forget Ex-Fix Codes
Question: One of our physicians reduced an open tibia fracture, applied an external fixato... Read more
Op Report Examination:
If Hand Surgery Dissection Isn't 'Unusual,' Don't Append Modifier 22
Look for clues in the op note to signal the surgeon's extra workLittle-known fact: You can... Read more
News Briefs:
Expect Higher Reimbursement For G0289
You can look forward to $48 more in reimbursement when you report G0289 with your chondrop... Read more
Location, Depth Crucial For Foreign-Body Removal Coding
You can look forward to $48 more in reimbursement when you report G0289 with your chondrop... Read more
Solve Your Modifier 25 Mysteries at Long Last
Don't confuse a -0- global with no global Before you pull out your hair over modifier 25,... Read more
Don't Let Printing Errors Caused by the New CMS-1500 Form Foil Your Claims
Is your software ready to handle the changes? Now's the time to update your billing syste... Read more
Get up to Speed On The CMS-1500 Changes
Review the final version of the form onlineThe current CMS-1500 form will not be compatibl... Read more
Revel in How Easy It Is to Get An NPI Number
To save yourself time and effort, gather info before you start You don't need to pay som... Read more
Reader Questions:
Confirm Fracture Care Vs. Excision
Question: Our surgeon recently diagnosed and treated a left thumb accessory ossicle fractu... Read more
Reader Questions:
Remember Medicare's Post-Op Infection Rules
Question: We performed a total hip replacement (27130) and saw the patient three weeks lat... Read more
Reader Questions:
Decompression or Bony Lesion?
Question: One of our physicians performed a partial corpectomy at T-11 and a partial corpe... Read more
Reader Questions:
Don't Expect Payment for 20930
Question: My spine surgeon performed an anterior interbody fusion, posterior scoliosis cor... Read more
Reader Questions:
Get to Know Splinting/Strapping Differences
Question: What is the difference between splinting and strapping, and how can we determine... Read more
You Be the Coder:
Consider Graft Type for OCD Repair
Question: Our surgeon documented an open repair of an osteochondritis dissecans (OCD) lesi... Read more
NCCI Update:
Revisit Any 22630/22612 Claims You Submitted In the Last 6 Months
NCCI retroactively deletes PLIF/Interbody fusion bundle--and so should youSpine surgeons w... Read more
Steer Clear of 3 Orthopedic ICD-9 Coding Snags
The guidelines spell out the requirements for aftercare, V codesWhat should you do when yo... Read more
Correction:
3 Bones Count When You Bill 25215
Our June issue featured the reader question -Know Your Proximal Row Bones,- which stated t... Read more
Guest Columnist:
Jackie Miller, RHIA, CPC--Expert Answers to Your Top-5 Radiology Coding Questions
If you can't distinguish a spot film from a standard x-ray, read thisOrthopedic coders hav... Read more
Clip and Save:
Keep the Top-Billed Radiology Codes at Your Fingertips
Use this handy chart of the radiology codes orthopedic surgeons bill the mostWhether you-r... Read more
Follow the Keywords To Recognize OS Trigonum Codes
Warning:  ICD-9 doesn't include a diagnosis code for this condition If you c... Read more
READER QUESTIONS:
Avoid Faxing Consult Requests to Referrals
Question: We are a small orthopedic practice and we often refer patients to a local hand s... Read more
READER QUESTIONS:
CPT Includes Arthroscopic Tibial Repair Codes
Question: Our surgeon repaired a proximal tibial fracture using the scope. Is there a proc... Read more
READER QUESTIONS:
Apply 27418 for Fulkerson
Question: Our surgeon performed an anteromedial tibial tubercle transfer (Fulkerson proced... Read more
READER QUESTIONS:
Choose Unlisted for IIiopsoas Tendon
Question: Our surgeon performed an arthroscopic hip iliopsoas tendon release. Which code s... Read more
READER QUESTIONS:
Don't Forget E Codes for WC Patients
Question: We recently saw a workers- compensation patient who had traumatic neuritis of th... Read more
READER QUESTIONS:
Consider 29806 for Capsular Plication
Question: Our surgeon documented an arthroscopic capsular plication, but I cannot find a c... Read more
READER QUESTIONS:
Report Only 1 Primary Procedure pe Vertebroplasty
Question: Our surgeon performed vertebroplasty at multiple levels. How should we determine... Read more
READER QUESTIONS:
Determine Whether Bones Are Present for 26587
Question: Our surgeon documented excision of the digits for a patient whose diagnosis is b... Read more
You Be the Coder:
How Should We Report Ankle Mosaicplasty?
Question: Our surgeon documented -mosaicplasty reconstruction of talar dome right ankle by... Read more
We've Got the Answers to Your Top 3 Hip Coding Questions
Our editors have examined your queries, now we tackle the solutions If you-re puzzled by ... Read more
Correction:
Report 26356 for FPL Repair
In our March 2006 reader question -Include Volar Plate Repair in CPT 26370 - we advised th... Read more
Tackle the New-Versus- Established-Patient Puzzle
 Different locations, same physician? Use established patient codes When reporting m... Read more
Follow Orthopedic Acronyms to Decipher Operative Reports
Use these tips to better translate abbreviations into codes Do you know your APL from you... Read more
Let This Tool Guide You When You Encounter Acronyms
 If your surgeon's notes puzzle you, check this chart to decipher them  ... Read more
Reader Questions:
Include Disk Payment in 0091T
Question: Our surgeon performed a disk replacement using a Charite artificial disk. I am p... Read more
Reader Questions:
Look to G Code for Medicare Dermabond Repairs
Question: An elderly patient of ours presented with a 1.4-cm skin tear on his left thigh. ... Read more
Reader Questions:
Pinpoint Ulnar Impaction Syndrome Code
Question: Which diagnosis code should we assign for ulnar impaction syndrome of the wrist?... Read more
Reader Questions:
Report TKR Code Once When First Procedure Fails
Question: Our surgeon performed a total knee replacement, but after the glue hardened, the... Read more
Reader Questions:
Include Prescription Writing in E/M
Question: I recently attended a seminar in which the presenter said we can bill a particul... Read more
Reader Questions:
Use E/M Code for Patient-Generated Second Opinion
Question: I know that CPT deleted the confirmatory consult codes for billing second opin... Read more
Reader Questions:
Stick With 23472 for Reverse Shoulder Arthroplasty
Question: Which code should we report for a reverse total shoulder arthroplasty?Indiana Su... Read more
Reader Questions:
NCCI 12.2 Isn't Too Invasive
Question: Does the latest version of the NCCI hold any problematic edits for orthopedic su... Read more
You Be the Coder:
Report Unlisted for Cervical Vertebroplasty
Question: Which codes should we report when the surgeon performs cervical vertebroplasty?A... Read more
Nail Down Confusing Ankle-Fracture Lingo To Choose the Correct Code
Pinpoint which ankle or foot bone the patient fractured before you bill If you don't know... Read more
Let This Chart Help You Pinpoint Accurate Ankle-Fracture Codes
Match the fx site to the documentation and you-ll find the right code each timeIf you have... Read more
Limit 69990 to Once Per Session -- Not Per Level
Insurers that reimburse operating microscope are very finicky Before you assign 69990 eve... Read more
Coding Quiz:
Determine Your NPP Coding Know-How
Can you bill incident-to in the hospital? The answer may surprise you You might think you... Read more
Guest Column:
Annette Grady, CPC, CPC-H, CPC-P, OS: Avoid These Common ASC Coding Mistakes Or Face Denials
If you-re new to surgery center coding, make modifier SG your friend Any orthopedic coder... Read more
Will Your ASC Profit From Implant Services? You Decide
When you perform a procedure in an ASC, the surgeon's supplies are not separately reimburs... Read more
Lightning Round:
2 FAQs Can Help ASC Coders Collect
You-ve learned the basics, now master ASC CodingIf you code for an ambulatory surgical cen... Read more
Reader Questions:
Don't Forget Fluoro With Biopsy
Question: Our surgeon performed a disk biopsy at levels L5 and S1 using a Craig needle und... Read more
Reader Questions:
File Electronically and by Paper When Necessary
Question: We have difficulty filing paper claims for unlisted-procedure codes. Our payer s... Read more
Reader Questions:
Consider 27630 for Achilles Lesion Excision
Question: Our surgeon documented an excision for thickening of the Achilles tendon, and di... Read more
Reader Questions:
Don't Bill 99051 as Stand-Alone Code
Question: Regarding CPT 2006's introduction of 99051, I have three questions: 1. Shou... Read more
Reader Questions:
Look to 29862 for Arthroscopic Hip Repair
Question: Our surgeon treated a patient for femoral acetabular impingement with probable a... Read more
Reader Questions:
You May Be Able to Collect for VAC
Question: I-ve heard that we can now collect from Medicare for VAC therapy (as of 2006). U... Read more
You Be the Coder:
Should We Report Fluoro Per Site?
Question: We have a fluoroscopy machine in our office, and we bill 76000 when the surgeon ... Read more
New Diagnosis Codes Should Enhance Spine, Pain Claims
Increase specificity starting this October with the debut of several ICD-9 codes If y... Read more
Version 12.1 Update:
Spine Surgeons Await Cure For NCCI Woes
Angry about the new lumbar arthrodesis bundle? You-re not alone The latest major NCCI bun... Read more
Get to Know Common Facet Injection Coding Errors
Stop denials now by learning how to code injections properly If your orthopedic surgeons ... Read more
Guest Column:
Bill Mallon, MD: Know Your Anatomy, Clock Face to Code Shoulder Surgeries Properly
Can you bill acromioplasty or subscapularis separately? Read on to find out Shoulder surg... Read more
Make Your Code Selection for Rotator Cuff Repair a Snap With This Flow Chart
Step-by-step instructions make RCR coding a breeze If you-re looking for an easy way to d... Read more
Reader Questions:
Include Synovial Crystal Identification in Surgery
Question: Our surgeon uses polarization to identify crystals during total joint replacemen... Read more
Reader Questions:
Get Specifics When Billing Chronic Pain
Question: Which diagnosis code should I report for chronic pain?California SubscriberAnswe... Read more
Reader Questions:
Biceps Tenotomy May Require Unlisted
Question: Our physician performed a rotator cuff repair, subacromial decompression, limite... Read more
Reader Questions:
Use 1 Code for Deep and Superficial I&D
Question: Which codes should we report for an incision and drainage of a lumbar wound that... Read more
Reader Questions:
Adjacent X-Ray Sites Aren't Always Bundled
Question: If we perform a hand and wrist x-ray together, or a foot and ankle together, our... Read more
Reader Questions:
Look to 0074T for Online Consults
Question: I recently read that we can charge insurance for our physician's online consulta... Read more
Reader Questions:
Know Your Proximal Row Bones
Question: Our surgeon circled code 25215, but that code refers to all of the bones in the ... Read more
Reader Questions:
72196 Covers LS Spine MRI
Question: How should I code -MRI of LS spine and sacrum and coccyx-? My radiology tech doc... Read more
You Be the Coder:
Can We Report 2 E/Ms per Day?
Question: Our practice employs seven orthopedic surgeons, each of different specialty, suc... Read more
NCCI News:
Don't Expect Payment for Interbody Fusion With Posterolateral Fusion
Version 12.1 focuses on knee, spine and debridement claimsIf you have regularly reported 2... Read more
Check Anesthesia Type When You Code Dislocation Repair
Correct these common mistakes to fend off claim denials Because orthopedic surgeons f... Read more
Collect Accurate Payment For Spine Allograft Every Time
Have trouble choosing between 22851 and 20931?  We've got the answerIf conflicting in... Read more
You May Be Upcoding Trigger Finger Release
... and you may not even know it The next time your surgeon documents a trigger finge... Read more
Hand Surgery Cheat Sheet Can Lead You to the Right Codes
Learn these terms and you'll be able to link op report terms to proceduresIf you find it d... Read more
Guest Column:
Denise Paige, CPC--Ace Wrist Reconstruction Coding With 4 Quick Tips
Initial surgery or redo?  Confirm status before you submit your claim In the mul... Read more
READER QUESTIONS:
Don't Bother Looking for DEXA Interp Code
Question: At our clinic, x-ray technicians perform DEXA scans, and orthopedic surgeons int... Read more
READER QUESTIONS:
Check Restorative Status Before You Bill 29540
Question: Can we report 29540 for strapping with other procedures, such as fracture care, ... Read more
READER QUESTIONS:
Discontinue Unlisted-Procedure Code for IDET
Question: Recently, I filed a claim for intradiskal electrothermal therapy (IDET) using un... Read more
READER QUESTIONS:
Orthopedic Surgeons Can Report ED Codes
Question: An emergency department physician asked our surgeon to see a Medicare patient wi... Read more
You Be the Coder:
How Should We Report Liner Exchange?
Question: Our surgeon plans to perform an arthroscopy and a liner exchange of a previous t... Read more
Op Note Checkpoint:
Consider This Case Study Before You Code Another Lisfranc Claim
If the op report is unclear to you, make sure you get help from the surgeon When you code... Read more
Spine Coding FAQs:
Avoid Unnecessary Discounts On Spinal Surgeries
Find out which procedures are modifier 51 exempt--and which aren-t Do you know when to ap... Read more
Protect Your Consult Income By Following New CMS Rules
Check out Medicare's consult request regs before you bill a consult Orthopedic coders hav... Read more
Clip and Save:
This Tool Can Make Your Consult Documentation Complete
Fax this form to requesting physicians to keep those written requests comingNew Medicare r... Read more
Guest Column:
Susan Vogelberger, CPC, CPC-H, CMBS: Take 5 Vital Steps Before You Perform A Self-Audit
What you do before your audit will lay the framework for your compliance plan With al... Read more
Don't Miss a Chance to Improve Your Practice's Coding Skills
Self-audits are well worth the time, experts say You-ve decided which type of audit you s... Read more
Clip and Save:
Let This Self-Audit Checklist Be Your Guide
Consider 9 essential criteria when you sit down with your audit materials Orthopedic c... Read more
Reader Questions:
Therapy Cap Exceptions May Not Be Automatic
Question: I recently learned that Medicare will let some patients exceed the $1,740 therap... Read more
Reader Questions:
Include Joint Visualization in Arthroscopy
Question: Our surgeon performed a meniscectomy (29880) and encountered a hypertrophic impi... Read more
Reader Questions:
Follow the Patient's Fracture Care, Bill 26600
Question: We recently saw a patient for a metacarpal fracture. We examined the patient, to... Read more
You Be the Coder:
Which Modifier Applies to Weekly Castings?
Question: Which modifier should we report when we recast an infant each week to treat his ... Read more
Op Report Examination:
Modifiers Can Ease the Pain of Custom TKRs
Don't panic when your surgeon encounters unforeseen complications during surgeryOrthopedic... Read more
Is Modifier 25 Your Friend:
Decide Before the OIG Does
Carriers are scrutinizing modifier 25 claims this year, so append with cautionThe Office o... Read more
Reap 3 Benefits of New and Revised Special Service Codes
CPT 2006 opens the door to capturing posted evening-hour surchargesBecause old rules for s... Read more
Know the Differences Between Vertebroplasty And Kyphoplasty, and Correct Codes Will Follow:
Guest Column--Henry H. Barnard, MD
Hint:  Look for key terms in the surgeon's notes to identify kyphoplastyAn estimated ... Read more
Are You Using the 22520 Series For Kyphoplasty? Read This
Here's how to report the 3 new kyphoplasty CPT Codes With the addition of three ... Read more
Test Your Kyphoplasty, Vertebroplasty Savvy With Our Q & A
You've read the coding basics--but can you select the right code?If you don't know which c... Read more
READER QUESTIONS:
Look to Q6 for Locum Tenens
Question: My orthopedic surgery group is using a locum tenens to fill in at the hospital w... Read more
READER QUESTIONS:
Include Volar Plate Repair in 26370
Question: Our orthopedic surgeon repaired a patient's flexor pollicus longus (FPL) tendon ... Read more
READER QUESTIONS:
VMO Should Lead You to 27422
Question: Our surgeon performed a procedure and documented medial retinacular reefing with... Read more
READER QUESTIONS:
Classify AC Joint as Intermediate
Question: If our surgeon injects a patient's AC joint, should we report 20610? We consider... Read more
READER QUESTIONS:
Avoid J7318 for Synvisc Injections
Question: Another coder told me that as of Jan. 1, Medicare will only accept code J7318 fo... Read more
READER QUESTIONS:
Look for Clues to Select Ex-Fix Type
Question: If a surgeon does not indicate whether an ex-fix is uniplanar or multiplanar, is... Read more
READER QUESTIONS:
Seek 845.09 for Achilies Tendon Tear
Question: What is the correct ICD-9 code for a tear of the Achilles tendon?Connecticut Sub... Read more
You Be the Coder:
Does 27488 Include Spacer Insertion?
Question: Our surgeon removed an infected total knee replacement (TKR) prosthesis and put ... Read more
NCCI Update:
New Kyphoplasty Edits Are Headed Your Way
Version 12.0 institutes scores of edits involving new codes 22523, 22524 CPT introduced s... Read more
Back to Basics:
4 FAQs Help You Pick Accurate ICD-9 Codes
Know your anatomic terms and you-ll find the right diagnosis codes every time If you don'... Read more
Does Your Surgeon Write a Full Radiologic Report? Find Out
The answer depends on whose rules your payer follows When you-re reporting a procedure th... Read more
Correction:
Posterior Tibial Nerve Blocks Count as Regional Anesthesia
In our December article -CPT Brings ESWT Coding From Temp to Perm,- we stated that surgeon... Read more
Guest Column:
Tammy Tipton -- Know Your QIC From Your ALJ If You Plan to File Appeals This Year
Medicare payers turn appeal rules upside down in 2006 Orthopedic reimbursement profession... Read more
Take 4 Steps to Appeals Success in 2006
We boil the appeals changes down for you Now that you-ve gotten the basics about Medic... Read more
Reader Questions:
Screw Insertion May Fall Under Unlisted
Question: Our surgeon performed an intramedullary implant with screws (27759) in July last... Read more
Reader Questions:
Several Views, but Only 2 Codes
Question: Our surgeon ordered three x-ray views of one knee, with the patient lying down. ... Read more
Reader Questions:
Power Your PMD Prescriptions With G0372
Question: Is there any way we can bill for our orthopedist's time, including transmitting ... Read more
Reader Questions:
Report Hemilaminectomy Separate From Fusion
Question: Our orthopedic surgeon performed a bilateral hemilaminectomy with diskectomy and... Read more
Reader Questions:
Avoid Modifier 21 With E/Ms
Question: Our surgeon performed a level-four E/M service on a new patient last week. The v... Read more
You Be the Coder:
Check Insurer's Drug Discard Policy
Question: One of our patients had an allergic reaction to a drug, causing us to waste near... Read more
Op Report Examination:
Code Complex Wrist Repair in 4 Simple Steps
" Know your anatomy to differentiate tendon codes from nerve codes Hand and wr... Read more
Adult E/M Criteria May Not Apply to Pediatric Patients
You may be able to substitute notes to justify a higher-level E/M Orthopedic surgery ... Read more
E/M Quiz:
Test Your Review-of-Systems Knowledge
3 scenarios from our experts help you improve your E/M skillsBefore you report any E/M pro... Read more
READER QUESTIONS:
Comparison X-Rays May Not Be Payable
Question: We recently saw a patient who injured his leg in a car accident. The surgeon o... Read more
Guest Column:
Walter J. Pedowitz, MD Use Anatomic Clues to Differentiate Toe Surgeries From One Another
Don't know your DuVries from your Girdlestone?  A surgeon shows you the wayCoders hav... Read more
Enliven Your Unna Boot Reimbursement
You might be able to report same-day debridements separately from Unna boot applicationYou... Read more
Unna Boot Basics:
What It Is And Is Not
An Unna boot is a medicated, semirigid dressing that consists of layers of bandage impregn... Read more
READER QUESTIONS:
Don't Be So Quick to Bill Admission
Question: Our surgeon performed a total knee replacement on a Medicare patient on Sept. 19... Read more
READER QUESTIONS:
Therapy Cap Looms for Medicare Claims
Question: Are our therapy claims going to be subject to the PT cap again soon? We thought ... Read more
READER QUESTIONS:
CPT Includes Quad Repair Code
Question: Our orthopedic surgeon recently performed a quadriceps tendon repair but told me... Read more
READER QUESTIONS:
Look to 26230 for Carpal Bossing
Question: Which CPT and ICD-9 codes should I report when the surgeon documents carpal boss... Read more
READER QUESTIONS:
Sinus Tarsi Space Differs From Tissue
Question: I recently received a denial for a cortisone injection to the sinus tarsi with t... Read more
READER QUESTIONS:
Avoid Suspected Diagnoses
Question: Our surgeon suspected that a patient had a torn meniscus and circled 836.0 on hi... Read more
You Be the Coder:
Code Amputation Complication as Primary Dx
Question: Our surgeon admitted a patient for revision of an amputation stump following hem... Read more
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