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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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    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?

    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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    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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    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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    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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    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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    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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    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

    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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