Recent content by smcbroom

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    64483 and 64484 modifier?

    I bill for Nevada Medicaid and they want modifier 51 used for any procedure after the primary even though 51 is not an approved modifier for ASC's but that's what they want and our claims get paid so maybe try calling them and seeing if they would accept it. Good luck! Susan, CPC-H
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    Wound Closure

    If you are asking if it's on the Medicare ASC list, then "yes", it doesn't pay much but it's there. A good resource to use for this list is http://ascassociation.org/ which lists the 2010 Medicare rate calculator for your region. Hope this helps! Susan, CPC-H
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    12035

    Maybe look at your diagnosis code? Does it support medical necessity? You may want to post the op report so we can take a look.... Susan, CPC-H
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    Takedown of adhesions

    If it's through the scope then I would say 29825 would apply, if it's open then revert to your open shoulder codes. Have a good day! Susan, CPC-H
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    Help with 29888

    That would work but you might consider using L8699 if your contract with the payer doesn't state you must use something else. Just my thoughts! Susan, CPC-H
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    66180 vs 0192T

    thank you for the responses. It is appreciated!
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    66180 vs 0192T

    that makes sense. He did the Express mini tube shunt so I will use 0192T correct?
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    66180 vs 0192T

    I don't see where he specifically says he used a reservoir. Are the "key" words to look for in determining if a reservoir was used? Thanks!
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    66180 vs 0192T

    what is the difference between the two codes 66180 & 0192T? is it payer specific or? I can see that Medicare reimburses higher for 0192T and this is a payer that reimburses a percentage of Medicare rates. Any insight would be greatly appreciated. Thank you! Susan, CPC-H
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    64420 vs 64490 battle of the codes

    per CPT book, it states Image guidance (fluoroscopy or CT) and any injection of contrast are inclusive components of 64490-64495. Imaging guidance and localization are required for the performance of paravertebral facet joint injections described by codes 64490-64495. If imaging guidance is not...
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    Irrigation and debridement of post wound

    looks like a 11044 to me.
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    Replantation of Great Toe

    When you look at the crosscodes for 20822- Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation it does show ICD-9 code 895.0 or 895.1 so you can consider a toe a digit also. Any other suggestions? Susan, CPC-H
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    55700

    Well, according to our Medicare ASC rate calculator for the City I am in , CPT code 55700 pays $462.71. Not totally sure about the rev code as we don't do these procedures at our ASC but I googled what rev code would be used with 55700 and 360 seems to be the one? Anyone else have suggestions...
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    Exchange of expander devices for implants

    I need my fellow coders help on this one. The consulting company wants to code this as 19380 RT,LT but I am thinking 19342 RT,LT??? Also, I know in the description for 19380 it states an existing prosthesis is replaced with a prosthesis of a different configuration so I think that's what is...
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    Achilles tendon debridement - Patirent had a achilles

    have you looked at 27654? Description of procedure states debridement is done. This may help you? Susan
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