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  1. L

    996.73 vs 629.32

    Which ICD-9 code would you use? 996.73 vs 629.32. Do I have enough documentation for exposure of mesh into vagina or through vaginal wall? PREOPERATIVE DIAGNOSIS: Chronic severe pelvic pain, status post Prolift mesh insertion with secondary scarring and mesh retraction. POSTOPERATIVE...
  2. L

    Transanal hemorrhoidal dearterialization

    Thanks for the recent input. We are an anesthesia group, so I don't think I would bill a Cat III code, but it's always good to have the information.
  3. L

    lap assisted sigmoid colectomy

    When you have time, will someone please review this op report and tell me how you would code? I looking at 44204 and 44207. It seems I have documentation for low pelvic anastomosis, but I would like someone to take a look at it. Thanks so much in advance. PREPROCEDURE DIAGNOSIS: Recurrent...
  4. L

    Modifying Units

    The total amount of units is 7 plus any modifiers. The base units total 5 plus time units equal to 2. Remember one time unit for every 15 minutes. I'm not sure what your system is giving you.
  5. L

    Butt implants/gluteal augmentation

    Quick!!! Help!!! I am trying to find the code for a butt implant (gluteal augmentation) procedure? Please advise and thanks in advance for your help.
  6. L

    Please help with bypass graft coding

    Hey, thanks in advance for all the help and advice. I am looking at CPT codes 35585, 35566, or 35666. Any clues/tips to help distinguish between in-situ vein, vein, or other than vein will also be appreciated. I know the op report is long, but thank you for your time and advice. PREOPERATIVE...
  7. L

    Help with Lysis of vaginal adhesions?

    Look at 58660 or post the op report.
  8. L

    occurence codes

    Hey fellow coders, I am studying for the CPC-H exam, and I do not know if the list of occurence codes are located in any of our coding manuals. I found a list online, but I cannot take this into the exam with me. Does anyone know if they are found in our books? Thanks in advance!!!
  9. L

    frustration with office staff

    I agree-knowledge is power. If you can support your codes, there is nothing to argue.
  10. L

    abdominal abscess and revision of hartmanns procedure

    Thanks I really appreciate your coding advice!
  11. L

    abdominal abscess and revision of hartmanns procedure

    Please advise with proper codes. Thanks in advance!!! PREOPERATIVE DIAGNOSIS: 1. Abdominal wall abscess. 2. Peritoneal abscess with suspected Hartmann pouch disruption. POSTOPERATIVE DIAGNOSIS: 1. Abdominal wall abscess. 2. Peritoneal abscess with Hartmann pouch disruption. OPERATION...
  12. L

    Newsletter has gone out

    add me to the list too please at jamie@atlanticanesthesia.com
  13. L

    occurence codes

    Where can I find occurence codes? Are they in any of the coding manuals? Thanks in advance!
  14. L

    Battery Change for spine nuerostimulator

    This is exactly how I would code the battery replacement. Now, if the pulse generator or receiver is revised or removed all together, then report code 63688. However, you should not report these two codes together.
  15. L

    01967 with 01968

    Yes, you should bill 01967 for first day and 01968 for the second.
  16. L

    debridment

    With anesthesia, you bill the total time of both procedures, but only code for the procedure with the highest base value. If bone debridement is more than wound repair, charge for the bone debridement (look at 11044) for entire time of case. You will need the appropriate anes code as well.
  17. L

    large abdominal wall abscess

    Please help with codes. Thanks in advance!! PREOPERATIVE DIAGNOSIS: Large abdominal wall abscess. POSTOPERATIVE DIAGNOSIS: Large abdominal wall abscess. PROCEDURE: Debridement of abdominal wall abscess with placement of abdominal wound VAC FINDINGS: Large amount of fat necrosis and fluid...
  18. L

    47563/574.20

    Please advice with all codes applicable with modifiers. I am stumped. I have 47563 for the CPT with 574.20. Do we have documentation to support any additional codes? Thanks in advance for your help!!!
  19. L

    excision

    21555. Check path report to accurately code diagnosis. Lipoma 214.1
  20. L

    Open Wound Debridement

    For anesthesia, we use 00790 for debridement of an open abdominal wound. I would think CPT code 11005 would be the correct code, however, I was advised not to use and it does not cross over to the anesthesia code we were instructed to use.
  21. L

    Canpc

    1 time unit is equal to 15 minutes, so if the case took 1 hour, you have 4 time units. The study guide for CANPC states if the time is 1 hour and 6 minutes, you still have 4 time units, however if the case is 1 hour and 7 minutes, your time units will be 5. CANPC states do not round time units...
  22. L

    Foot and Ankle Coder Needed - Temp Assignment for few months

    I am interested in the position. I will send resume tonight. Thanks so much in advance.
  23. L

    coding dx of basal carcinoma w/o a path

    without a path report, i would code the dx with an unspecified nature of neoplasm depending on where the lesion is located.
  24. L

    Coding Anesthesia

    No, the anesthesia provider will charge for his services.
  25. L

    upper vs lower abdomen

    Always confusion on this subject matter. I code for anesthesia and it is not always clear if surgeon is in upper or lower abdomen, so I wanted as much info as possible. Thanks again.
  26. L

    femoral thromboendarterectomy

    thanks so much!!!
  27. L

    upper vs lower abdomen

    CALLING ALL CODERS Please allow me to hear your thoughts on the topic of the abdomen. I want to know all you know about the upper versus the lower abdomen. Where does the upper abdomen begin and end? When coding and trying to decide between upper and lower, do you choose based on incision or...
  28. L

    angiograms

    Yes, anes code 01926 is correct. Look at CPT code 61624 as well.
  29. L

    femoral thromboendarterectomy

    Please advise with coding. Thanks in advance (I know its a long op report)!!! I know I can code 35371 for the femoral thrombroendarterectomy, but I am unsure of angioplasties. PREOPERATIVE DIAGNOSIS: Bilateral lower extremity claudication and rest pain in left lower extremity. POSTOPERATIVE...
  30. L

    Lap Hernia Repair Question

    Yes, I would use 43281.
  31. L

    Excision of Abdominal Wall Abscess

    Not completely sure without note, but look at 11042 with 682.2. Depending on the cause of the abscess, you may be able to code 998.83 as secondary diagnosis.
  32. L

    Cardioversion with TEE

    I just did further research and now have come to the conclusion that only the TEE can be billed (because it has the higher base value). If the anesthesiologist actually did the TEE and not just administered anesthesia for it, then we could bill separately for it with a modifier 59. In our...
  33. L

    Anesthesiologist and CRNA Billed at the same time???

    Yes, your codes and modifiers are correct and can be placed on one claim. We submit all our claims this way. Most insurances accept one claim for both charges, however, special commerical insurances may break down into 2 claims themselves and pay separately.
  34. L

    Anesthesiologist and CRNA Billed at the same time???

    Yes, you can bill for 01992 for both dr and CRNA with appropriate modifiers. 01992 carries a base of 5 plus the 1 unit for time, so total time units would be 6 and the type of service is 7. Also, anes code 01991 states anesthesia for diagnostic or therapeutic nerve blocks and injections when...
  35. L

    19301 vs 19125

    In reading the description for code 19301, it states the physician excises a breast tumor and a margin of normal tissue by performing a partial mastectomy by making an incision through the skin and fascia over a breast malignancy and clamping any lymphatic and blood vessels. The physician...
  36. L

    Cardioversion with TEE

    Yes, external cardioversion 92960. So, I should just charge for the TEE? I was confused because when studying for the CANPC exam, it stated that TEEs are typically bundled with anesthesia services but can also be reported separately if performed for diagnostic or therapeutic purposes. When...
  37. L

    Cardioversion with TEE

    If patient has a cardioversion with a TEE, can you code both procedures if coding for the anesthesiologist? If so, should I code a modifier 59 on the TEE? Thanks in advance!
  38. L

    19301 vs 19125

    I only read documentation to support 19125. In 19301, a malignant lesion/tumor is removed with surrounding tissue. Is there a malignancy present?
  39. L

    Incision and drainage abdomen and wound vac

    Please assist with proper codes. Thanks again in advance! PREOPERATIVE DIAGNOSIS: Worsening cellulitis, erythema, and tunneling of chronically infected right abdominal/flank wound. POSTOPERATIVE DIAGNOSIS: Worsening cellulitis, erythema, and tunneling of chronically infected right...
  40. L

    wound revision

    Please assist with coding. Patient had a lower abdominal hernia months ago and has since had debridement and placement of wound vac. Patient now presents for continued follow up from her recent abdominal wall reconstruction and surgeon performs a wound revision and then closes the resulting...
  41. L

    lipoma coding

    Yes, you are correct. Thank you so much for your advice!!
  42. L

    lipoma coding

    Patient had a subcutaneous mass of the scalp. Surgeon removed mass and sent to pathology to discover it was a lipoma. This is the entirety of the operative report: Preop dx: Subcutaneous mass of scalp Postop dx: Subcutaneous mass of scalp Procedure: Excision of subcutaneous mass of scalp...
  43. L

    Physical status and extreme age modifiers

    Yes, we code for the physical status modifiers P3-P5 and get paid from Medicare. We do not bill for the 99100 age modifier (Medicare will not pay for it or emergencies (99140).)
  44. L

    Exploratory laparotomy, lysis of adhesions

    Yes, I agree with the anesthesia codes given above. 00790 for upper abdomen and 00840 for lower. The problem I have coding these is proper documentation. It is not always noted what part of the abdomen, so for these cases I try to contact surgeon's office. Also, if you have access to...
  45. L

    wound vac application with debridement

    Need advice on proper coding. Here is the procedure: Debridement of abdominal wall abscess with placement of abdominal wound VAC Postoperative diagnosis: abdominal wall abscess I used cpt code 11042 with a diagnosis of 682.2. Would there be any additional codes? Thanks in advance for any...
  46. L

    Central Line under ultrasound guidance

    I code for anesthesia and if our doctors/nurses place the line, then we bill for it with 76937 with a modifier 26. I would assume if your doctor places it, then he can charge for it, but I am not an expert.
  47. L

    Ileocecectomy

    Could you post the op report? I could help with more info. 44160 may be the code you are looking for, but it is hard to say without the report.
  48. L

    Vascular erectile dysfunction following pelvic fracture

    If a patient is having penile revascularization performed due to ED following a pelvic fracture, would the primary diagnosis be 607.84 (ED) and would you need a secondary code indicating the pelvic fracture? Would it be considered a late effect?
  49. L

    Cpt Code

    Yes, I agree 300.29 is the appropriate diagnosis code. When ICD-10 is implemented, we will have specific codes for each diagnosis.
  50. L

    Transanal hemorrhoidal dearterialization

    Since the procedure was done with a transanal approach, if you were going to use an unlisted code, why not 46999? Also, what about 37799 for unlisted vascular procedures?
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