Orthopedic Coding Alert
Reader Question:
PA Seeing New Patients
Published on Mon Jul 01, 2002
Question: We have a physician assistant on staff. Can he use the E/M codes to treat new patients? Connecticut Subscriber Answer: Not if the PA is billing services as "incident-to" the physician's services. Under Medicare's incident-to billing guidelines, if the claims are being submitted using the supervising physician's PIN, the orthopedist must have seen the patient at a previous encounter and developed a plan of care. If, however, the PA bills directly under his own PIN, he may examine and treat new patients as long as he is operating within the scope of his state licensure. When billing private payers, the PA must abide by any contractual limitations placed by the insurer.
Other Articles in this issue of
Orthopedic Coding Alert
- Dont Get out of Joint When Coding Lisfranc Fracture-Dislocations
" Fracture-dislocations of the tarsometatarsal joint nicknamed Lisfranc"" after a field surgeon in the Napoleonic [...] - Harvest Reimbursement for Allograft Procedures
Orthopedic practices that use allograft should be sure to avoid the CPT Codes with descriptors [...] - You Be the Coder:
Supraspinatus Repair
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Modifier of the Month:
Modifier -55 Allows Separate Billing During Global Period
Orthopedists who perform postoperative care for patients whose surgeries have been performed by other physicians [...] - Take the Guesswork Out of Diagnosis Coding
When searching for a diagnosis code to list on a claim when no definitive ICD-9 [...] - When to Use Signs and Symptoms Codes
Symptoms, Signs, and Ill-Defined Conditions codes (780-799.9), listed in section 16 of the ICD-9 manual, [...] - Reader Question:
ER Evaluation
Question: Can we use the 99211-99215 series of codes for ER visits? My insurer denies [...] - Reader Question:
Bivalving a Cast
Question: Is there a CPT code for "bivalving" an arm cast? New Jersey Subscriber Answer: [...] - Reader Question:
Antibiotic Bead Insertion
Question: How should we code for windowing the navicular and cuboid bones, with implanting of [...] - Reader Question:
Disability Forms
Question: Is there a CPT code we can use when the orthopedist fills out disability [...] - Reader Question:
Iliotibial Band Release
Question: Our orthopedist repaired an iliotibial band release for iliotibial friction syndrome. Is there a [...] - Reader Question:
Compartment Syndrome
Question: Is there a CPT code we can bill for measuring the pressure in the [...] - Reader Question:
X-Ray Interpretation
Question: We send our patients to an outside lab for x-rays, but we interpret the [...] - Reader Question:
PA Seeing New Patients
Question: We have a physician assistant on staff. Can he use the E/M codes to [...] - Reader Question:
Tendon Repair
" Question: The orthopedist's operative report for a patient with a peroneus brevis tendon tear [...] - Reader Question:
Plantar Fascia Release
Question: Which code should we bill when the orthopedist performs a plantar fascia release? Maryland [...]
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