Recent content by flipflop40@verizon.net

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    Question Assist at Surgery Modifer Order

    the AS modifier would always go first. However, the 29826 is an add-on code and should not have any modifiers
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    Repeat ID with Replacement of Antibiotic Spacer

    23107/11983 if you are removing/replacing the antibiotic spacer for another round of antibiotics. This note doesn't say a new hemiarthroplasty was done
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    Intraopertive X-ray

    The American Academy of Orthopedic Surgeons (AAOS) has stated that imaging should be separately billable if the surgeon documents a detailed radiographic interpretation in the note and the X-rays are saved in the patient’s medical record and are available to be printed on request. However, if...
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    Surgery Code

    Diagnosis codes for a post op visit should be the same codes you used for the surgery (use 7th character D for injuries). You could also use Aftercare Codes. X-rays are not included in the global period and are billed separately. I always use pain dx for the x-ray and then any applicable...
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    Surgery in Global Period

    if this was a "complication" from the arthroscope, then it is all included in the global period. Management of pain is included in the post op period. Modifier 78 is used for a return to the OR for a complication from the surgery; your scenario is not a return to the OR.
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    Modifier 58 vs 78

    Definitely use modifier 58 as this is an anticipated issue with the joint replacement, and the physician documented that he "planned" on doing it post op if it was necessary 78 is a return to the OR during a post op period, usually for an infection or wound dehiscence
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    Question 25 Modifier

    the G8431 is a PQRS reporting code only. You would not append the 25 modifier to 99214
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    Question 25 & 57

    99213-57, 25 57 Decision for "surgery"-the fracture care code; 25 to distinguish separate from the smoking counseling 28510-you would need RT or LT
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    Steroid and visc injections

    I wouldn't think you would have an issue getting the cortisone injections paid by any insurance. For the Visco injections the osteo diagnosis codes are the ones that pay. We had some issues with getting an auth but it was because we needed to show failed cortisone and PT instead of going...
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    Can you bill e/m with fracture care for first visit to Ortho?

    In most cases the ER does not bill the fracture care code as they are referring the patient to an orthopedic for follow up. I worked in an Ortho office and we ALWAYS billed a new patient visit with a 57 modifier and the fracture care code. We never ran into a denial off of the ER charges...
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    Closed Treatment of a Distal Ulna Fx

    Closed treatment of distal ulna fx 25600 w/out manipulation, 25606 with manipulation-Closed treatment of a distal radial fracture or epiphyseal separation, includes closed treatment of fracture of ulnar styloid; when performed; the term physeal refers to growth plate injuries Sometimes I will...
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    Is this even billable..thoughts? Otho is to new...Please & Thank you!

    I believe this would just be inclusive to the E&M or the fracture care global package. This does not equate to strapping code. You may be able to bill for the supply (ace bandage) with a HCPCS code or 99070 misc supply code. If they had removed the original cast and applied a 2nd cast for...
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