Revenue Cycle Insider

Orthopedic Coding:

Pick the Right Code for Your Pre-Auth Request

Question: I’m seeking a pre-authorization for a surgical procedure, and I need help finding the correct code. The orthopedist is planning a surgical arthroscopy with lower trapezial transfer for a failed rotator cuff repair. Pennsylvania Subscriber Answer: Use 23395 (Muscle transfer, any type, shoulder or upper arm; single) in your pre-authorization request. This code is appropriate since you’re seeking pre-authorization [...]
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