Orthopedic Coding Alert

2021 E/M Codes:
Use This E/M Changes Overview to Land Safely in 2021
Remember, there will be 1 fewer office/outpatient E/M code next year. The new year is nea... Read more
E/M Coding:
Stay in the Know on Inpatient Care Coding
Remember, changes will only affect office/outpatient services. While there is much attent... Read more
ICD-10 Coding:
Back to Basics: This Guide Resolves Back Pain Dx Problems
… plus, here's 3 scenarios to help you navigate the M54.- codes. Do you feel like your ... Read more
You Be the Coder:
Coding Arthroscopy/Meniscectomy/Chondroplasty Combo Encounters
Question: After a level-three new patient office/outpatient evaluation and management (E/M... Read more
Reader Question:
Follow the Notes to Shoulder I&D Code Choice
Question: I have an operative note that reads: “drained deep infection pocket, R shoulde... Read more
Reader Questions:
Make Targeted Search of Notes on Meniscus Tear
Question: Encounter notes indicate that the patient suffered from a meniscus tear in her l... Read more
Reader Questions:
Be Ready if FBR Gets Complicated
Question: A patient reported to the orthopedist for treatment of a closed forearm fracture... Read more
Injection Introduction:
Select Codes Carefully for Protection on Injection Claims
Here's why ICD-10 smarts are key for these 3 injection services. Do you sometimes feel li... Read more
Medicare Policy Updates:
Proposal Pushes Uncommon Conversion Factor Cut
… but there's good news about the covered telehealth list. If you haven't had enough up... Read more
Case Study Corner:
Time or MDM? Make the Right Choice in 2021
Encounter specifics will determine better E/M factor next year. As you must know by now,... Read more
Reader Questions:
Yes, There Is a Code for COVID-Related Expenses
Question: What do you know about the new CPT® code for reporting additional practice expe... Read more
Reader Questions:
Check Out These Quick Hits on Anatomical Modifiers
Question: I've been coding for about a year, and I'm getting better. One aspect that still... Read more
Reader Questions:
Mind Descriptors When Choosing Inpatient E/M Levels
Question: Encounter notes indicated that our orthopedist performed a first-day hospital ev... Read more
Reader Questions:
Medication Management Makes for Difficult Dx Coding
Question: Which ICD-10 code should I use for medication management? West Virginia Subscr... Read more
You Be the Coder:
Use This Peroneal Muscle Group Primer to Choose Dx
Question: Encounter notes indicate that the provider treated a patient for “laceration, ... Read more
CPT® 2021:
Take Time to Note New E/M Descriptors
Here's why people are already asking about prolonged services codes. A change is going t... Read more
Case Study Corner:
Check Bundles When Coding Cam/Pincer Lesion Encounters
Remember what you can — and can't — code with these treatments. When your orthopedic ... Read more
Expert Q&A:
Use Modifier 24, Tighten Up Unrelated Postop E/M Claims
If the service is related to the surgery, it's not separately codeable. A patient is in... Read more
You Be the Coder:
Keep Achilles Dx Codes Separate
Question: A patient received treatment for a right Achilles injury; there is no other info... Read more
Reader Question:
Wait and See on Permanent Telehealth Expansion
Question: Will the recent telehealth expansion rules expire when the public health emergen... Read more
Reader Questions:
Know New ABN Deadline Extension Details
Question: I was told by a colleague that there's a new advance beneficiary notice (ABN) fo... Read more
Reader Questions:
Knock Down SLAP Lesion Concerns With Coding Smarts
Question: Notes indicate that the surgeon performed a level-four evaluation and management... Read more
2021 E/M Guidelines:
Keep Modifier 25 Rules Straight With New E/M Rules
Remember to maintain stringent documentation standards in 2021. There's going to be a lot... Read more
Case Study Corner:
Check Pair of Procedure Encounters for Extra E/M
Remember, separate E/M must be above and beyond op package. As if remembering all the ne... Read more
You Be the Coder:
Try to Knock Out This Boxer’s Fracture Encounter
Question: An established patient who had Boxer's fracture treatment two months ago report... Read more
Reader Questions:
ID Salter-Harris Fracture Type Before Dx Selection
Question: What ICD-10 code should I report for a Salter-Harris physeal fracture in a patie... Read more
Reader Questions:
Know How to Solve the Decompression/Discography Dilemma
Question: What is the difference between disc decompression and an injection for discograp... Read more
Reimbursement:
Keep Locum Tenens Rules in Mind for Sub Physicians
Remember to include the proper modifier for each of these physician's services. If your p... Read more
Reader Questions:
CPT® 2021 Holds Important Shoulder Arthroscopy Revisions
Question: I know that the CPT® 2021 codes will be published soon, and I was wondering if ... Read more
ICD-10 2021:
COVID-19, Arthritis Codes Coming This Fall
Here's the conditions that'll have expanded coding options in October. The ICD-10 Coordin... Read more
ICD-10 2021:
Don't Kid Yourself; You Need to Know these Juvenile Osteochondrosis Codes
Code sets get major upgrade in new Dx book. ICD-10 2021 will feature three major revisio... Read more
Surgery:
Keep Wheels Turning on Rotator Cuff Fixes
Provider will use MRI/E/M combo to diagnose. Coding a series of encounters in which the p... Read more
You Be the Coder:
Vacation Injuries
Question: The orthopedist in the operating room (OR) treats a patient sent from the emerge... Read more
Reader Questions:
Look for Incision Before FBR Code Decision
Question: If the surgeon performs a foreign body removal (FBR) with forceps alone during a... Read more
Reader Questions:
Know Your E/M History, or You May Be Doomed to Repeat Filing
Question: If I have a chief complaint, an extended history of present illness (HPI), a pro... Read more
Reader Questions:
Duck Pay Cuts With Split/Shared Visit Smarts
Question: Can qualified nonphysician practitioners (NPPs) “split” a service with a phy... Read more
Reader Questions:
Don't Be Out to Lunch Coding This E/M Service
Question: We reported 99211 for a nurse visit with a Medicare patient when the provider wa... Read more
Spinal Procedures:
Tap Surgery Type, Avoid Pressure on Spinal Decompressions
Laminectomy, laminotomy, and laminoplasty: What's the difference? Spinal decompressions c... Read more
Modifier Madness:
Go Deep to Ace Anatomical/Lab Modifier Questions
Know the finger/toe assignments of F1-TA. Most of the time you'll use modifiers based on ... Read more
Case Study Corner:
Go Digital With These Anatomical Modifier Cases
Can you code these scenarios with the correct finger/toe modifiers? Sometimes, a concept ... Read more
You Be the Coder:
2020 Injection Codes
Question: After a level-four evaluation and management (E/M) service for a new patien... Read more
Reader Questions:
Prevent Confusion From Bundling You Up on NCCI
Question: Coders are supposed to learn the National Correct Coding Initiative (NCCI) ... Read more
Reader Questions:
Protect Yourself As COVID-19 Scammers Continue Cons
Question: Even months into the COVID-19 pandemic, I still feel like it's kind of hard... Read more
Reader Questions:
Relax, There's a Dx for Stress Fracture
Question: Encounter notes indicate the patient suffered an ankle stress fracture; sho... Read more
2021 E/M Coding:
Use Time, MDM Smarts to Put Ortho Coding on Right Track
Remember the new rules deemphasizing history, exam, when making E/M choice. Orthopedic of... Read more
Clinical Coding Corner:
Apply 2021 E/M Rules to This Scenario
Can you choose the appropriate level using MDM? During her AAPC webinar “2021 E/M Guide... Read more
Anatomy:
Straighten Out Your Spinal Coding With These Pointers
Remember the difference between vertebral segment, interspace. During her HEALTHCON 202... Read more
You Be the Coder:
Use Single ICD-10 Code for RA With Heart Disease
Question: An established patient with rheumatoid heart disease and rheumatoid arthritis (R... Read more
Reader Question:
Don't Get Torticollis Coding Twisted
Question: After a level-four evaluation and management (E/M) service during which the orth... Read more
Reader Question:
Leave Guidance Off This Arthrography Claim
Question: The provider performed a radiologic ankle arthrography with supervision and inte... Read more
Reader Question:
Be Careful With 'No Sick Contacts' Note
Question: Would you consider a physician documenting “No sick contacts” acceptable for... Read more
Reader Question:
Use 26 to Indicate Professional Component
Question: My colleague and I are having a discussion. She says that we need a modifier on ... Read more
Telehealth:
Use This Guide to Keep Up With Changing Telehealth Guidelines
Here's how telehealth and other virtual services differ. Changes to coding and policy are... Read more
Virtual Services:
Get Real Virtual Check-In Results With These Codes
Remember to use the proper modifiers, when necessary. As evidenced by the cover story in... Read more
ICD-10 Coding:
Prevent Coding Disconnect With Targeted Hip Dislocation Dx
Here's why dislocation status is vital. When you are coding claims for patients who need... Read more
You Be the Coder:
Calcareous Deposit Removals
Question: Encounter notes indicate that the provider treated a patient with calcareous dep... Read more
Reader Question:
Use These Codes for COVID-19 Dx
Question: What's the latest on ICD-10 coding for patients who have COVID-19? Michigan Sub... Read more
Reader Question:
Spot Separate Services, Avoid Cutting Laceration Fix Pay
Question: I am coding for a complex laceration repair with possible additional servic... Read more
Reader Question:
Use Modifier to Separate E/M, Aspiration
Question: An established patient reports with right knee and thigh pain. During an ev... Read more
Surgery:
Keep Hip Dislocation Repair Coding Connected With Op Notes
If you can't I.D. type of dislocation, you can't I.D. repair. Patients who suffer hip dis... Read more
Clip and Save:
Follow This Advice to Proper Hip Dislocation Dx
Look to these code sets for patients suffering hip dislocations. A hip dislocation repair... Read more
Modifiers:
Gain Universal Knowledge of Bilateral Modifier With This Quick Q&A
If code indicates bilaterality, leave modifier 50 off the claim. If the provider perform... Read more
Reader Question:
Keep Calm, Carry on in COVID-19 Age
Question: We're a little on edge about the 2019 novel coronavirus in the office. We're was... Read more
Reader Question:
Get Knowledge for Successful Walldius Arthroscopy
Question: After an evaluation and management (E/M) service for an established patient, the... Read more
Reader Question:
Chart Charcot Joint's Via Anatomy
Question: I have an operative report in front of me with a puzzling diagnosis. The encount... Read more
You Be the Coder:
'Buddy Taping' and Fracture Repair
Question: The provider performed in-office closed treatment on a patient's carpometacarpal... Read more
2021 E/M Coding:
Put Time on Your Side With These 2021 Coding Tips
Count the minutes to decide on E/M level. In the sphere of in-office evaluation and manag... Read more
Clinical Coding Corner:
Check Out This Time-Based E/M Example
The 2021 rule changes could mean different coding for certain scenarios. There's bound t... Read more
Fracture Care:
Check for Presurgical E/M on Fractures
There are 2 E/M modifiers to choose from depending on global. When your orthopedic surge... Read more
Reader Question:
Get Providers on Proper Page for ICD-10 Codes
Question: We have one physician who reports every sign and symptom that the patient presen... Read more
Reader Question:
Get NOPP Right, or Payers Might Say N.O.P.E.
Question: When we are coding for evaluation and management (E/M) services, what role does ... Read more
Reader Question:
Use These Pointers for Sharp ePHI Security
Question: Our office wants to use electronic faxing for medical records, and we want to kn... Read more
You Be the Coder:
'Buddy Taping' and Code Selection
Question:  A new patient reports to the orthopedist with a closed fracture to the sec... Read more
Featured Condition:
Plantar Fasciitis: Get Off on Right Foot When Coding for Plantar Fasciitis
Remember, surgery is a last option. Patients reporting to the orthopedist with symptoms o... Read more
Case Study Corner:
Check Out These Emergency Debridement Scenarios
Remember to pay attention to NCCI on multiple debridements. Patients that need emergency ... Read more
Q&A:
Max Out Incident-To Pay The Right Way — While You Still Can
Remember, the end of 2020 might also be the end of incident-to. Uncertainty swirls about ... Read more
Reader Question:
Documentation Strengthens Unlisted Procedure Claims
Question: It seems whenever our practice reports a service using an unlisted procedure CPT... Read more
Reader Question:
Tighten Up Loose Body in Joint Dx
Question: Our provider recently submitted a claim with a final diagnosis of loose body in ... Read more
Reader Question:
Rack Up Coding Success on Rib Repairs
Question: How should we report rib fracture repairs? New York Subscriber Answer: For so ... Read more
You Be the Coder:
Reporting Ankle Injury Services
Question: A new patient reports to the orthopedist with a badly bruised left ankle. After ... Read more
Injection Coding:
Use This Primer to Back Up Epidural Coding Smarts
Shots for back issues are broken into different groups. At times, patients with spinal co... Read more
Case Study Corner:
Study Scenarios to Sharpen Disc Decompression, Discography Coding
Tip: Decompressions can include 2 codes. In past issues of Orthopedic Coding Alert, we've... Read more
News You Can Use:
Incident-to Be or not to Be?
MedPAC looking into new NP/PA policy. Many orthopedic practices have used "incident-to" b... Read more
Reader Question:
Check for Dx Secondary to Acute Osteomyelitis
Question: An established patient suffering from acute osteomyelitis in his right shoulder ... Read more
Reader Question:
Remember Modifiers for Multiple Phalangeal Base Resections
Question: After a level-three evaluation and management (E/M) service for an established p... Read more
Reader Question:
Remember Add-ons Aren't Primary Codes
Question: What does the plus symbol in front of some evaluation and management (E/M) ... Read more
You Be the Coder:
Go Deep for Knee Arthrotomy Details
Question: Encounter notes indicate that the orthopedist performed a knee arthrotomy. How s... Read more
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