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  1. S

    Decompression lumbar laminectomy for S1-S2 level

    Does anyone know what CPT code to use for S1-S2 level ? 63047 is for lumbar, would I use that or is there an unlisted and use an unlisted ?? Any thoughts would be appreciated. Sheila, CPC
  2. S

    Injection for Hardware

    A pain doctor wants to do “Injection for hardware blocks” to see if pain is coming from hardware ? Any suggestions on a CPT code ? thank you. Sheila
  3. S

    64415 interscalene block for post op pain management

    Hi we are an ASC billing for the facility and was wondering if anyone is billing the 64415 (giving by the anesthesia dr) preoperatively to a shoulder arthroscopy (ex. 29827) and getting reimbursed. Are you billing with the -59 modifier since it is bundled ? I hear we should not bill to...
  4. S

    Colonoscopy with history of polyps

    If you have a Medicare pt & all the dr. notes is "history of polyps" (Z86.010), would you code the G0105 (high risk) or G0121 (not high risk) ? And does anyone have the current criteria for high vs. not high ? thank you so much. Sheila, CPC
  5. S

    UB04 claim form

    Does anybody know if the UB04 claim form is changing for the ICD10 code or will the current one take all the digits?? Sheila, CPC
  6. S

    Colonoscopy - had a colon resection

    if a pt had a colon resection & came in for a colonoscopy with a 40cm ileocolonic anastomosis would i code a 45378 or 45330?? any imput would be appreciated. Sheila,CPC
  7. S

    Replacement of cross link between L4 and L5

    Can I get some imput.. Dr is removing and replacing the cross link at L4 and L5 I am thinking 22840, in addt to revision lumbar laminectomy Thank you Sheila, CPC
  8. S

    ASC facility billing 2 separate dr. 2 separate procedures

    Can I get some imput? We have drs. doing 2 separate surgerys, 2 separate sites. The commercial insurance such as Anthem pays then they take back there money usually on 1 of the cases. Then we would usually have to appeal the case. Is anybody doing these surgeries and not getting their money...
  9. S

    -59 or a new modifier

    I have a dr. removing hardware from a patella fx & a hip fx so i was going to bill out the 20680, 20680 -59 but would i use one of the new modifiers ? It is for Medicare.... thank you for any imput Sheila, CPC
  10. S

    ER visit with following surgery code??

    If a patient is seen in ER, taken to surgery immediately, and then admitted how would you bill? The patient was never shown as Outpatient. My thought is you bill the E& M code under ER, and the surgery under inpatient, even though not admitted until after surgery. Is this correct or should we...
  11. S

    New 2015 modifiers

    Hi, we are wondering if anybody has found any details on the new modifiers besides the explanation of them? Ex. for separate excision of lesions - would you use the -XS ? For different colon techniques for polyp removals - would you use the -XS ? And what does the -XU - Unusual...
  12. S

    Open shoulder deltoid repair

    I am not sure of a code for a deltoid repair of the shoulder?? Any help would be appreciated. Sheila, CPC
  13. S

    Open reduction & internal fixation subtalar joint

    A pt has a dislocation subtalar joint, and the dr. does an open reduction & internal fixation... I was looking at 28445 maybe. Any help would be apprectiated. Sheila, CPC
  14. S

    Release trigger finger and injection of trigger fingers

    A doctor did the release of trigger fingers A1 pulleys (long, ring & small)- 26055 x3 but then he injections to the same finger with Kenalog of the A1 pulleys - according to Medicare bundling they can be unbundled with a -59 but would you consider them bundled?? thanks for any imput Sheila, CPC
  15. S

    Total knee revision with removal of prosthesis

    Dr. does a revision 27486, but can you charge for the removal of the prosthesis 27488 too? Thank you Sheila, CPC
  16. S

    D&C with a foley catheter into cervix

    A D&C was done 58120, the the dr places a foley catheter to maintain the cervical opening due to stenosis. Is there a code for a catheter of the cervix? I can't seem to find one. Thanks Sheila,CPC
  17. S

    Retained methylmethacrylate spacer of calcaneus

    I am looking for a dx. code for removal of "retained methylmethacrylate spacer of calcaneus" thanks. Sheila, CPC
  18. S

    29881 with 29884

    I have read alot of information on these 2 codes being bundled but can be unbundled with a -59 if in a separate compartment. We were told there was an AMA article Aug 2001 that states that 29884 should not be reported with another major procedure. Would the AMA override the CCI edit of...
  19. S

    Abductor digiti minimi muscle to carpal tunnel

    I am having a hard time find a code for abductor digiti minimi muscle to the carpal tunnel for part of the carpal tunnel release surgery. I am looking at 64721 & 25494 Any imput would be great. Sheila, CPC
  20. S

    Circumsion revision

    Would you bill a regular 54161 or a 54163 for a child who previously had a circumsion & they are excising the excess foreskin? thank you for any imput Sheila, CPC
  21. S

    Can you bill 14060 bilaterally?

    Can you bill 14060 x2 with the -50 modifier for bilateral earlobe repair?
  22. S

    Revenue code for pharmacy

    Does anyone know the revenue code for pharmacy/medicine? I am an ASC facility. I think maybe 025x but cant find the last digit anywhere. thanks !!! Sheila, CPC
  23. S

    Microfracture of osteochondral defect of the anteromedial talar dome

    I am looking for a code but really not seeing one to fit the following procedure: Microfracture of osteochondral defect of the anteromedial talar dome (debridement & drilling), it was done open not arthroscopically. Also was done was an ORIF of a bimalleolar ankle fracture (27814) Any help...
  24. S

    Retrograde pyelograms - Billing for the ASC

    Billing for the ASC who owes the equipment & the tech comesover from the xray dept to assist with the machine, could you bill the 74420 -TC ? Also are you required to have some kind of film in the chart or is documentation in the op note enough for the ASC to bill the 74420 ? thank you for any...
  25. S

    PEG tube removal - would you code

    If a physician removes a PEG tube would you code 49460? any imput would be appreciated?? thanks. Sheila
  26. S

    64650

    Does anybody know if this is a bilateral procedure & should be billed with RT /LT or the -50 modifier? thanks for any imput. Sheila, CPC
  27. S

    Wrist arthroscopy with microfracture of lunate & triquetrum

    Dr. does a wrist arthroscopy with microfracture of lunate & triquetrum. I am thinking I need to use the unlisted code. the main part reads: "A small shaver was used to debride the loose articular cartilage. Then a microfracture awl was used to perform a microfracture in both the lunate and...
  28. S

    Arthroscopy wrist with mini-open triangular fibrocartilage

    I had a question: if a physician does a wrist arthroscopy with synovectomy 29844 then he opens & repairs the triangular fibrocartilage tear but uses an anchor & sutures would you use the 25107 or the 29847 (because of the anchor). Any imput would be great. Sheila, CPC
  29. S

    Middle phalangectomy contracted toe

    Can I have some imput on the following procedure: dx: contracted toe operation: Middle phalanx phalangectomy Op note reads: .. incision was made at the level of the middle phalanx of the fourth toe. ... next the extensor tendon was identified & retracted. Next using a bone saw, the base...
  30. S

    Lumbar decompression with partial discectomy

    Can I have some help on this one? Operation is Lumbar decompression L4-5 and L5-S1 with partial discectomy The operation states... " Decompressive laminectomy was performed, decompressing the supperior aspect of S1, entire lamina of L5 and inferior aspect of L4, decompressing the central...
  31. S

    Tear intermetacarpal ligament hand

    I need help with any imput: the operation states "Repair intermetacarpal ligament hand between third & fourth metacarpal heads" the op reads: .... an incision was made between the metacarpal heads through skin & dermis. The extensor hood on the 4th & 3rd metacarpal heads was examined. There...
  32. S

    Open reduction of constrained total hip replacement

    I need help on an "Open reduction of constrained total hip replacement" the op notes reads: .... the anterior capsule was excised. The femoral head was seen to be buttonholed through the posterior scar tissue and the intervening scar was excised. The femoral head was then brought up into the...
  33. S

    Cystoscopy, lithotripy with failed jj stent

    Do you know if you can bill the 52353 with a 52332 (could not place stent) with a modifier? but not sure what modifier? Or would I not bill the 52332? Any thoughts. Sheila, CPC
  34. S

    Arthroscopic hemi-trapeziectomy of thumb

    I am looking for a code... not sure of one, but the dr. "resects 4mm distal trapezium" plus a debridement of the joint was done. Surgery was done arthroscopically. I am thinking a 29846. Any ideas? thanks Sheila
  35. S

    Hemiarthroplasty shoulder

    Can you do a hemiarthroplasty shoulder 23470 for a fracture /dislocation proximal humerus diagnosis? Or I was thinking the 23630. Any thoughts? Sheila, CPC
  36. S

    Biopies SCC nose lesion

    Can I charge 11100 plus 11101 x5 for the following: ... six biopsies were done, consisted of the medial deep margin biopsy involved tissue about the distal portion of the nasal bones inclusive of nasal mucosa. The lateral deep margin involved the tissue about the piriform aperture on the...
  37. S

    Biopsies of SCC nose lesion

    Can I charge 11100 plus 11101 x5 for the following: ... six biopsies were done, consisted of the medial deep margin biopsy involved tissue about the distal portion of the nasal bones inclusive of nasal mucosa. The lateral deep margin involved the tissue about the piriform aperture on the...
  38. S

    Biopsies SCC nose lesion

    Can I charge 11100 plus 11101 x5 for the following: ... six biopsies were done, consisted of the medial deep margin biopsy involved tissue about the distal portion of the nasal bones inclusive of nasal mucosa. The lateral deep margin involved the tissue about the piriform aperture on the...
  39. S

    Long head of biceps repair

    A doctor repairs the long head of biceps places a suture anchor on the lateral side. Any ideas? The only code close is 23430 but not sure for a repair. thanks a bunch for any help. Sheila
  40. S

    Excision Tracheocutaneous fistula with granulation tissue

    A dr. "makes an incision around the trach & granulation tissue... excises the "granulation tissue evident & what appeared to be a fistula type tract" The wound was closed in sutures. I cant really find a code for this. I was looking in the 31750 group of codes. Any imput would be great...
  41. S

    Osteoset beads with vancomycin beads

    I have a doctor who is packing a bone defect site with osteoset beads with vancomycin beads. Any ideas for a code or hcpcs code?? I was looking at 11981 but one article stated these are NOT non-biodegradable. thank you for any help. Sheila
  42. S

    Excision plantar lesion foot

    I have a dr. who "excised a lesion down to level of the basement membrane. Then debrided utilizing a curette. Electrocautery was then used to cauterize the area of excision. A curette was then used to debride again the area after which electrocautery was then utilized to cauterize any bleeding...
  43. S

    Excision plantar lesion foot - I have a dr. who "excised a lesion

    I have a dr. who "excised a lesion down to level of the basement membrane. Then debrided utilizing a curette. Electrocautery was then used to cauterize the area of excision. A curette was then used to debride again the area after which electrocautery was then utilized to cauterize any bleeding...
  44. S

    Circumsion, repair buried penis, penoscrotal web, penile detorsion, etc.

    Can I get some imput on the following op note: Post op dx. buried penis, penoscrotal web, penile torsion, & phimosis Operation: Repair buried penis, Repair penoscrotal web, penile detorsion, circumsion, byar's flaps, urethral catheterization Here is the scrub: .. glanular adhesions were...
  45. S

    Medicare pt Emergency Rm consult

    A medicare pt comes to the ER for a hip fx. & an orthopedic was consulted for an evaluation & difinitive care. Medicine was consulted for eval. & clearance. How would you code for the ortho consult? ER codes (99281-99285) or Office/other outpt. consults. (99241-99245) ? thank you for any...
  46. S

    Dupuytrens

    Operation states: Resection Dupuytrens cords of long, ring, & small fingers & palm. I am not sure if I should code 26121 or 26123, 26125 for the following: ... incisions were marked over the ring finger which would satisfactorily expose the small and long finger cords. The palmar fibrosis...
  47. S

    Tenodesis of proprius tendon

    I am trying to find a code for tendoesis of the proprius tendon. The op states" We performed a side-to-side tenodesis of the proprius to the communis tendon of the index finger and again included this with the epitendious repair. We pulled the proprius tendon distally & excised the stump...
  48. S

    Penile torsion

    Doctor did a revised circumsion & also corrected the penile torsion but I'm not sure if there is an addt code to the 54163 ? any imput would be helpful. Sheila, CPC
  49. S

    Knee arthroscopy help

    I was wondering if a dr. "Harvests articular cartilage for Genzyme ACI procedure arthroscopically", would I code the 29870? But if he does another knee arthroscopy procedure then I cannot use the 29870, am I correct or should I be using a different code for the harvest? thank you for any...
  50. S

    cataract surgery ?

    I have a cataract surgery that was performed & in addition to the dr. then with a "separate stab incision does an anterior capsulorrhexis capsulotomy. I was wondering if these should be coded 66982 or is it just part of the 66984 procedure? Any imput would be appreciated. Sheila, CPC
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