Recent content by NEOSM507

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    Drug delivery devices

    Hello,, With the introduction of new CPT codes for the insertion and removal of drug delivery devices (20700-20705), has CPT code 11981 (insertion of non-biodegradable drug delivery implant) been deleted? Thank you
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    Question implant removal 20670, 20680

    I am in disagreement with a provider over the reporting of IN-OFFICE removal of implants (20670 OR 20680) during the global period. I am under the impression that when you are performing this service in the office, it is included in the global package. When you perform it in a hospital...
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    Question initial inpatient vs subsequent inpatient

    I need help understanding the proper use of inpatient evaluation and management codes. Are initial inpatient codes (99221-99223) for the initial evaluation of a problem and subsequent codes (99231-99233) for follow up visits for the same problem? For example: patient is inpatient, and seen by...
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    inpatient E&Ms initial vs subsequent

    I need help understanding the proper use of inpatient evaluation and management codes. Are initial inpatient codes (99221-99223) for the initial evaluation of a problem and subsequent codes (99231-99233) for follow up visits for the same problem? For example: patient is inpatient, and seen by...
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    ESI injecction

    Good afternoon, PMR provider performed an ESI injection on the following levels Left L4-5 Right L5-S1 I am not certain how to report this. 64483 bilateral or 64483 and 64484 because its not the same level on both sides. Thank you
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    The role of a PA in the OR

    Hello, I am curious as to what is expected of a PA in the OR when assisting in a surgery. Are they just there for prepping, draping, positioning, and closure? Or do the participate in the procedure itself? I'm asking because our surgeons document the medical necessity of the PA assist, and I...
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    3 part distal radius ORIF WITH tenotomy of brachioradialis

    Our provider is performing a tenotomy of the brachioradialis tendon (CPT 25290) during an ORIF of a distal radius fracture (CPT 25609) He is using the same fracture diagnosis on both the ORIF and the tenotomy. Documentation: "due to the pull of the brachioradialis , it was not possible to...
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    replacement of hip cement spacer with debridement

    Hi, I would appreciate any coding advice you can provide.. Patient seen previously by another provider outside of our practice for a displaced femoral neck fracture. A cemented hemiarthroplasty was performed. He fell and presented with an infection and dislocated spacer. He was taken to the...
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    Missing Gel One and Durolane fee schedule

    Does anyone know why there is no 2019 Medicare fee schedule for Gel One (J7326) and Durolane (J7318)?
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    HELP! femoral fracture coding advice needed

    Patient was treated for an upper femoral fracture 5 weeks ago. Reported with 27245. She fell during the global period, injuring her lower femur. To fix the lower femur, we had to remove the femoral rod and replace it with a smaller one - so I think for that we code S72.142A - 27245 (78) and...
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    HELP! femoral fracture coding advice needed

    Patient was treated for an upper femoral fracture 5 weeks ago. Reported with 27245. She fell during the global period, injuring her lower femur. To fix the lower femur, we had to remove the femoral rod and replace it with a smaller one - so I think for that we code S72.142A - 27245 (78) and...
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    2 E&Ms on the same day

    Can 2 different providers with different specialties (hand & ortho) bill for an E&M on the same day? They are the SAME tax ID. Thank you
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    New patient E&M when insurance carrier changes

    Hello, I recently had a conversation with a provider who stated that a patient is considered NEW (for coding purposes) when they have been treating under workers comp and then come in to treat for a separate, unrelated visit under their private insurance in under 3 years. (or vice versa)...
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    Nurse practitioner billing

    Good morning, Scenario: multi specialty practice, ONE tax ID.. Ortho and PM&R. When a patient sees an ortho, and then sees the PM&R within 3 years, the PM&R can bill a new patient visit because the PM&R is a different specialty, and vice versa. Is a nurse practitioner considered a...
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    Nurse practitioner billing

    Good morning, Scenario: multi specialty practice, ONE tax ID.. Ortho and PM&R. When a patient sees an ortho, and then sees the PM&R within 3 years, the PM&R can bill a new patient visit because the PM&R is a different specialty, and vice versa. Is a nurse practitioner considered a...
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