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  1. J

    Trapeziectomy of wrist

    I would also code 25210,LT
  2. J

    29881 or 29877 conundrum

    Code 29877 is a component of Column 1 code 29881 and cannot be billed using any modifier.
  3. J

    Help with Procedure code PLEASE!!!!!!

    Look at 37617 - Ligation, major artery; abdomen Abdominal arteries listed below: abdominal arteries; aorta; appendicular artery; celiac trunk; colic artery; cystic artery; epigastric artery; epiploics artery; femoral artery; femoral circumflex artery; gastric artery; gastroduodenal artery...
  4. J

    Tracheostomy planned procedure with Laryngoscopy

    You have coded one or more CPT codes designated as `separate procedure'. If the procedure was carried out as an integral part of another procedure already coded then the separate procedure CPT code should be deleted. These codes MAY be listed with modifier -59 if the separate procedure is...
  5. J

    Hernia - 49507 or 49525

    49525 The physician repairs a sliding inguinal hernia. The physician makes a groin incision. The hernia sac is identified and dissected from surrounding structures. The hernia sac is opened and the abdominal viscera attached to the sac are dissected away from the sac if possible. The hernia...
  6. J

    Vein to vein transposition

    36819 AV anastomosis by upper arm basilic vein transposition (CPT code 36819) is similar to 36818 but with transposition of the basilic vein.
  7. J

    Need help tackling complicated distal humerus fracture!!

    Definitely complicated...this is my take on the procedure: 24545-LT - Dx: S42422B In 24545, the physician performs open treatment of a supracondylar or transcondylar humeral fracture that does not have an extending fracture line present between the condyles. In 24546, the humeral condylar...
  8. J

    Need help with CPT codes... PLEASE!!!!!

    I am so sorry...slipped past me...all I am coming up with is the unlisted 28899.
  9. J

    bone grafting delayed union humerus fx

    Question bone grafting delayed union humerus fx If I were to code this in our clinic...with regard to the removal of fixation device (screw), which was presumably attached to the plate in which surgeon debrided fibrous union with a curette. This type of debridement would be included in the...
  10. J

    Fracture Care to Surgert

    Fracture Care to Surgery Was surgical intervention planned at the time of applying the cast? If so, you would append Modifier 58 to the surgery. If this was not a "planned" decision for surgery, append modifier 78 to the surgery. Either way, you can still bill for the office visit!
  11. J

    Need help with CPT codes... PLEASE!!!!!

    Default Need help with CPT codes... PLEASE!!!!! 28636-T5 26540-RT 26530-RT Dx: S93121A S93521A
  12. J

    19101 or 19110

    19101 or 19110? Take a look at: 19120 - Excision of cyst, fibroademoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion, open, male or female, 1 or more lesions
  13. J

    Wide Excision of Malignant Neoplasm of skin, soft tissue, and muscle on chest wall

    21552 - Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3cm or greater
  14. J

    Help with bundling issue

    Was surgeon aware of the small bowel perforation, prior to performing surgery? (perforation may have been caused intraoperatively?) If not, this is an incidental finding, and cannot be billed. You still definitely need to code the Dx "perforation of small bowel"...but do not code the...
  15. J

    Am I giving this OP Note too much thought?!?! Help please! :)

    Am I giving this OP Note too much thought?!?! Help please! 29823,59,RT - Debridement +29826,RT - Decompression, acromioplasty 29824,RT - Distal claviculectomy M13811 M75101 S46111A M25811 Note: Report makes no mention of tenodesis of biceps, only debridement
  16. J

    Open McLaughlin procedure

    Op report Open McLaughlin Answer: Surgeons perform McLaughlin procedures to treat posterior dislocating shoulders. During the operation, the surgeon performs a tendon transfer by moving the subscapularis tendon from its location on the lesser tuberosity into the reverse Hill-Sachs defect...
  17. J

    Open McLaughlin procedure

    Open McLaughlin/ shoulder procedure Can you attach an OP note?
  18. J

    Coding of Rotator Cuff Tear

    If rotator cuff tear is not specified as "traumatic"...it would be coded with an "M" code
  19. J

    fractures

    Tufts Fracture of toe? Often a distal phalanx fracture is a "tuft" fracture, which means that a small fragment or fragments of bone are chipped off the edge of the distal phalanx. These bone injuries do not require wiring or pinning, as they will heal by themselves
  20. J

    26720 fracture coding help

    26720 - Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each Append appropriate modifiers: Right: F5 - F9 Left : FA - F4 Modifiers denote: laterality and location
  21. J

    Re-repair of Inguinal Hernia

    We have had this before in our clinics...we coded as: 49505-52 (Reduced services & included OP notes) Dx - G5781 for Right inguinal nerve entrapment syndrome
  22. J

    Coding Op Advice?

    Description of procedure includes, middle ear. 69433-69436 (69433, 69436) In a patient who has received a local or topical anesthetic (e.g., for 69433) or a general anesthetic (e.g., for 69436), the physician inserts a ventilating tube. Under direct visualization with a microscope, the...
  23. J

    please help-am I missing

    any help We do a lot of shoulders in our clinic...this is not an unusual case. Documentation states tear(s) of supra, infra, and subscapularis tendons...these are all part of the rotator cuff. I would code this as: 29827,RT - includes graft, decompression and limited bursectomy if performed...
  24. J

    Modifier 59 for repair code

    No modifier necessary, per Guidelines: 11400-11466 Skin Lesion Removal: Benign Code also intermediate closure (12031-12057) There are no bundling issues or NCCI edits.
  25. J

    Coding help - Can cpt code

    Coding help No bundling issues or NCCI edits for coding these two together.
  26. J

    screening colon no polyp

    45380,PT - Still designates procedure was for screening
  27. J

    Living Back bench liver transplant HELP

    47146 The physician performs venous anastomosis during a backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation. Previously procured iliac vein grafts from the liver donor are anastomosed to the veins of the donor liver as required. Multiple grafts may be...
  28. J

    Please help

    Renal Transplant This is typically not my area of coding, but here is my take...based on dictation: 50360- Renal allotransplantation, implantation of graft; without recipient nephrectomy 50323 - Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including...
  29. J

    Pilonidal Cystectomy help!!

    I would code this as a 11771 - description below: 11770-11772 (11770, 11771, 11772) A pilonidal cyst or sinus is entrapped epithelial tissue located in the sacrococcygeal region above the buttocks. These lesions are usually associated with ingrown hair. A sinus cavity is present and may have a...
  30. J

    Surgery codes

    Message from 3M: You have coded 27447 with an additional code(s) considered a component of this procedure. The Medicare NCCI edits consider this separate reporting of codes that are components of the comprehensive procedure if billed for services provided by the same beneficiary by the same...
  31. J

    With Port or Without Port

    The following is in part, a query sent to 3m: . This similar procedure was addressed in AMA?CPT Assistant, December 2009 Page: 11 where they stated how; "it is not procedurally possible to insert a catheter with a port attached in a manner that is NOT tunneled." Code 36560/36561 would be...
  32. J

    Need a little help!

    From the CPT Assistant, this describes radius & ulna...but would apply to medial & lateral malleolous: Removal of Separate Plate/Screw Systems-Both Bone Forearm Fracture Code 20680 is reported once for each bone when removing internal fixation of healing fractures of "both bones" (radius...
  33. J

    Step

    CPT code for STEP procedure? Unlisted procedure(s) for both: Colon - 45399 Small Intestine - 44799
  34. J

    Medicare and Modifier 78

    Modifier 58? Most of the time we use: Modifier 58 Many of our returns to the OR are anticipated for debridement of wounds. Definition: Modifier 58-Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period : It may...
  35. J

    Rheumatoid nodules

    Soft tissue or bone?
  36. J

    microfracturing

    All inclusive in 29879 29879 - Arthroscopy, knee, surgical; abrasion arthroplasty or multiple drilling or microfracture 29879 - Description: The physician makes 1 cm long portal incisions on either side of the patellar tendon for arthroscopic access into the knee joint. Lesions of the...
  37. J

    CPT needed pretty quick

    planing/resection of hypertrophic sesamoid 28315 - Sesamoidectomy, first toe (separate procdure) would be bundled with 28288 - Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head Code only 28288
  38. J

    Billing CPT 29888 with CPT 29882

    Putting 29888 and 29822 - edits do not occur, but 29876 added...yes an edit does appear: Code 29876 is a component of Column 1 code 29888 We code 29888 and 29822 together quite often, with no edits or issues.
  39. J

    revision hip arthroplasty

    27134 - for the acetabulum and the femoral head 27299 - liner and femoral head
  40. J

    Removal of Scar Tissue?

    Per the 3M encoder...description: The physician revises a total hip arthroplasty. With the patient in a lateral decubitus position, the physician may access the hip through the previous hip surgery incision. Muscles are reflected. A trochanteric osteotomy may be performed with an oscillating...
  41. J

    CPT for reduction of extensor tendon?

    Report states: reduction with a manual manipulation in which the subluxed tendon was returned to its anatomical position I would code this as: 26705 - closed treatment of MCP dislocation, single w/manipulation; requiring anesthesia
  42. J

    External Fixator in the OR

    Put this thru the Encoder just for grins: 25515 - Open treatment of radial shaft fracture, includes internal fixation, when performed 20690 - Application of a uniplane, unilateral, external fixation system Did not get any edits for this test!
  43. J

    re-excision

    Cannot charge for post-op visit, or low evaluation unless unrelated to original procedure or diagnosis. (Modifier 24) You can add modifier 58 (staged or related procedure, during post-op period) to the CPT for the procedure.
  44. J

    need help for cpt code

    27245 - Treatment of intertrochanteric, peritrochanteric or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage 27506 - Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary...
  45. J

    Poplitues release

    Running this through the 3M encoder... 27599 - Unlisted procedure, femur or knee Poplitues is a muscle behind the knee. Release: Release of: spell other specified release Enter site or type of release: Muscle Muscle site - other/unspecified Musculoskeletal system site (unlisted CPT codes) - knee
  46. J

    Closed reduction & perc pinning

    25565 - Closed treatment of radial and ulnar shaft fracture; with manipulation 79.12 -Closed reduction of fracture with internal fixation of radius/ulna
  47. J

    Which codes - 28615, 28485 or another?

    Can fractures be dislocated? Definitely!
  48. J

    Excision of breast lesion

    Per the CPT Assistant: If an excision of a single cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19140), open, male or female, is performed through one incision, code 19120 should be reported for each of the separate...
  49. J

    dupuytrens and trigger finger

    Coding this thru the encoder: 26123-F6 26125-F7 26125-F9 The physician removes the palmar fascia. The physician incises the overlying skin and subcutaneous tissue. The palmar fascia is exposed and resected. Tendon sheaths are freed. The incision is sutured in layers if possible. Z-plasties are...
  50. J

    Which codes - 28615, 28485 or another?

    Lisfranc fracture dislocation Fourth line of the operative note states: C arm fluoroscopy will be utilized throughout the case for visualization of the fracture reduction.
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