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    Question Hip capsular repair

    Does anyone know how I would code an arthroscopic hip capsule repair? My provider performed an arthroscopic femoroplasty, and then documented "capsule repair also was undertaken at the end of surgery. An 0 PDS suture was passed using a suture passer through the capsulotomy that had been...
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    Question Periacetabular osteotomy CPT code

    Hi everyone! I'm new to billing for periacetabular osteotomies (PAOs) and I'm trying to find the correct CPT code... According to the op report, the surgeon osteotomized the iliac spine, ischium, suprapubic ramus, and pelvis. The Dx is hip arthritis resulting from dysplasia. Apparently my...
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    Excision of multiple soft tissue masses on same finger

    If it was all through one incision then you can only bill one unit of service. Otherwise, you could use modifier 59 or XS for "separate structure." https://www.aapc.com/blog/29197-specific-modifiers-for-distinct-procedural-services-from-cms/...
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    26040 in office setting

    Hi everyone! I have a claim for 26040 that Medicare denied, saying that "the procedure is inconsistent with the place of service." The POS was 11, office setting. Is this correct? Can this procedure really not be performed in an office? Thanks for the help in advance :)
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    Discontinued Procedure and repeat?

    Okay, that makes sense. These modifiers can get confusing! Thank you so much for the help!! :D
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    Fracture and dislocation treatment

    Thank you so much for your feedback! That's what I was thinking but I wanted to make sure :)
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    Discontinued Procedure and repeat?

    I have a patient whose procedure was discontinued today after the administration of anesthesia, so we are billing with the discontinued procedure modifier. However, the patient is coming back in a few days again for the procedure. Do we need to bill a repeat procedure modifier or will the...
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    Fracture and dislocation treatment

    Does anyone know if we can code a closed reduction of both a fracture AND dislocation at the same site? It looks like the codes I am considering are not bundled, but I'm still not sure if it is technically correct to report both... The doctor dictated a closed reduction and percutaneous...
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    What are you using for online coding resources?

    I use Supercoder, but I don't remember off the top of my head how much it costs. Highly recommend it though!
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    HELP! using modifier 62 and 80 on the same claim and getting denials

    20930 cannot be billed with modifier 62 or 80. The rest look correct though... maybe it's that one line item that's making it deny?
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    Closed Reduction Thumb Fracture

    Hi everyone! Can anyone help me code for a closed reduction and percutaneous pinning of intra-articular proximal phalanx fracture of the thumb? The two codes I am looking at are 26727 and 26742. I can't decide which one is right because 26727 specifies proximal phalanx, while 26742 specifies...
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    Cpc

    Have you looked at W17.2XXA?
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    COding 82550 and 82553 together

    Did you use any modifiers, like -91?
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    Hand infection debridement

    Does anyone know what the appropriate CPT code would be for an irrigation and debridement of deep palmar infection of the hand? OP report says: "First, I slowly cleaned the hand of chronic purulence that was stuck into the palm. Despite a preoperative scrub and sterilization, there was still...
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    Chirotouch

    Hi there! I'm well-versed in ChiroTouch. Do you still need help?
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    Chiropactic Billing-Isurance

    It depends on the insurance policy, not necessarily the insurance company itself. When I was working in a chiro office I went off of what insurance companies we were in network with, and I'd call to verify the benefits for each new patients to make sure chiro was a covered benefit
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    nerve transfer

    CCI edits can be bypassed with the -59 modifier, however you will need to meet the criteria for either separate encounter, separate structure, separate practitioner, or unusual non-overlapping services. The most commonly used is separate structure, however it must be a separate organ/ side of...
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    A1 trigger release and flexor tenolysis same digit

    According to NCCI edits those codes are bundled. You can only bypass the CCI edit rule with a -59 modifier, however since both procedures are done on the same finger it does not qualify. You should stick with just the 26442 in this case
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    Primary or Secondary Achilles Repair??

    Can someone clarify the difference between a primary and secondary achilles repair (27652 vs 27654)? Supercoder says that a secondary repair, 27654 is when "The provider performs repair of Achilles tendon for the second time with or without use of graft because the previous one was unsuccessful...
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    Bilateral Procedures for ASC

    Can someone please clarify how to bill bilateral procedures for ASC (Ambulatory Surgery Center)? I've heard that it varies between payers, but I just someone just told me that Medicare will not accept modifier -50 for ASC and that we have to bill -LT/-RT on separate line items. Is this correct...
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    Fluoroscopy coding in physician office

    Yeah, I know what you mean. It's confusing too because fluoroscopies are continuous X-ray pictures so I'd assume it could be categorized as x-ray in that context but it's always best to find out for sure.
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    Multiple Units of One Code??

    Ahh okay thank you! Do I need to append a 59 or XS modifier to the line items following the first?
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    Fluoroscopy coding in physician office

    I also code 77002 for fluoroscopy during injections so I'd agree with that. I'm not sure about the rest of your question since I've never really dealt with fluoroscopies outside of just for injections. But 76496 in parentheses does include diagnostic flouroscopies so I think that would make...
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    Multiple Units of One Code??

    I'm trying to code for gouty tophi excisions done on multiple fingers and can't figure out how to do this... The code I found to use is 26160 (if you have a better one for gouty tophi then by all means correct me). The doctor performed the excisions on the left index, middle, and ring fingers...
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    Same patient two different dr.

    That would probably fit the -59 modifier description (distinct procedural service). The more specific modifier under that -59 umbrella would be XP (separate practitioner). You can use that modifier when a different practitioner in the same group NPI performs a second procedure in the same day...
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    X-ray billing help!

    Do you mean the way my new job is teaching or the way I learned in school?
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    X-ray billing help!

    I'm new to an ASC facility and when it comes to x-rays (almost always performed along with a surgery), I am told that we code professionally with -26 modifier but don't bill at all for the facility side. It was explained to me that x-rays are included in the global surgery package for...
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    Question on Orthopedic Surgical Coding

    I agree, 27658 includes 27680 so you will want to bill this one only. You can only bill both if it's a separate encounter, provider, structure, or they are non-overlapping services. If each of the two procedures were performed on different sides of the body then you would append modifier XS and...
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    Help! Code for return to OR

    I have a patient who came in a couple months ago for a repair to the Achilles tendon. She just came back in for another procedure because the doctor suspected the wound wasn't healing properly. It sounds from the dictation that when the surgeon opened up the incision and cleaned up the wound...
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    7th character for re-repair

    Oh sorry, that was the secondary code that we were considering. The correct one was S86.011(A or S). But okay thank you! Is the 7th character always an A for a re-injury?
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    Advice for someone who has failed the CPC exam twice.

    Keep your chin up I failed my exam the first time around, and what helped me to pass it the second time was taking advantage of the Study Guide and practice exams that I had purchased. Before I didn't have time to really dig into it so I relied on the training I got in community college. But I...
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    CPC-A unhappy

    I actually just got a coding job a couple weeks ago, shortly after getting my CPC-A. I would recommend you apply to those jobs that require experience because you never know what will come about. They might want to interview you anyways, and if you seem competent and eager to learn then they'll...
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    Dreaded a vs d suffix

    I have no idea if this is going to help, but how I remember it is A= Active and D=Done. So like the other people said, A is when the patient is seeking Active care for their condition. I remember D as the hard work is Done, the condition is mostly resolved, and the patient is now in the...
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    7th character for re-repair

    I work at an orthopedic specialist facility and came across a patient who re-ruptured her Achilles and came in for a re-repair. It looks like we are using the CPT code 27650 and the ICD 10 is T81.32x. However, I'm not sure which 7th character to use? Do we treat this as a initial care (since it...
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