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    Bundled Service

    Thank you, I will look into this as a possible scenario. Have you heard of ins billing ONLY pts with HSA for services denied as "Bundled"?
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    Bundled Service

    Thank you "mitchellde" That is what I have always thought, however I am somewhat surprised that only 1 response has been posted...has this become a grey area? I thought it was clear cut - a patient cannot be billed for a service that the insurance company has already denied as "Bundled". It has...
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    Bundled Service

    If the insurance company has denied a procedure code as a "Bundled Service" can the patient still be billed for the cost of that service?
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    Hand/finger coding

    Try 26160, 26210 and 15240 for starters...
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    injection into second extensor compartment

    What was the purpose of the injection?
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    Tuft fx

    I think 26765 because there is no mention of removing the nail matrix or amputating the tuft - only tuft fragments were removed to give the remaining bone stability.
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    How do you code Aponeurotomy hand

    A needle aponeurotomy is done by repeatedly inserting a needle into the hand to break up Dupuytren's contracture. It is considered a "percutaneous Dupuytren's contracture release". If this is the procedure that was performed, the code is 26040
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    ORIF for distal radius and ulna fx.

    The surgical findings say "severely comminuted distal radius fracture as anticipated" This report reads like a 25608 or 25609, in my opinion, however it still needs to be clarified by the surgeon.
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    Median Nerve Block for CTR - The physician is doing a CTR

    If the physician is doing an injection for CTR, then use 20526. If the anesthesiologist is performing a nerve block, then it is up to the anesthesiologist to code and bill for that procedure. If the same provider that performs the CTR also performs the nerve block, then you would use 20526 plus...
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    Wound Vacs

    I don't know if 97605 is billable during global (try it & see?), however I think it applies to every time the patient comes in and the wound is checked, assessed & the bandage replaced. Since a wound vac is a sort of "non-selective" debridement, 97605 is not billable with 97602, however 97605...
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    Pes Anserine Bursa

    I don't code knees, however if you can't find a code that matches exactly, see if there is one that closely represents the procedure performed and the RVUs involved. Even though Pes Anserine is not truly 'prepatellar' maybe 27340 is the most accurate code to use. Doesn't it drive you crazy when...
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    Radial Artery Biopsy

    The surgeon biopsied the radial artery by harvesting a 1cm length of the radial artery from the forearm and 2cm from the wrist. Is there a code for this?? Thanks in advance :confused:
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    Nerve Testing & Wound Vac Eval

    Never Mind Never mind - answered my own questions. Just having a "coding" moment :o
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    Nerve Testing & Wound Vac Eval

    I have 2 questions for which I could really use some help: 1) Can a surgeon (Hand Surgeon in this case) bill for intraoperative "neurological stem testing" and if yes, what would be the correct CPT? 2) The same surgeon "assessed, evaluated and confirmed" placement of a wound VAC...
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    Conscious Sedation by Surgeon

    The patient is an adult - I am questioning this because of the words "monitored by the surgeon". I would have used 99144 but the CPTdescription says "requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological...
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    2nd Request!! Please Help!!

    What code was used for implanting the bone stimulator? Depending on the type of bone stimulator, I would try something in the 20670-20694 range...
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    Conscious Sedation by Surgeon

    Does anyone have feedback on how this should be coded? "Versed with local, conscious sedation administered and monitored by the surgeon" Thanks!
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    Hands-ITC Arthroplasty & Traction Release

    After reflecting on your input Mary, I decided to code it as a 26055. Sometimes it helps so much just to have someone else look at the problem and give their feedback - especially after you've been staring at it your self for a few hours :) Thanks again, Ann
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    Hands-ITC Arthroplasty & Traction Release

    It does - sort of - but he usually calls a trigger finger release an "A1 Pulley release" or "Trigger finger release"... and states "trigger finger" in the dx. In this case in the dx he says "contracture PIP joint" which would be a 28272, I believe, but the narrative does not describe either...
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    Have you tried 26145?
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    Hands-ITC Arthroplasty & Traction Release

    Can't Upload Op Report I am not able to upload the actual report, but the last paragraph reads: "Thereupon, we proceeded to apply traction and tenolysis, releasing the joint contractures of the proximal phalangeal joint with improved excursion of the PIP joint of the middle finger and performed...
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    Hands-ITC Arthroplasty & Traction Release

    OP Note I am at my other job now, however I will post it as soon as I get home this evening. Also, do you know of any good reference books or any other media to assist with coding for Hand Surgery? I have only been doing this for about 6 months and sometimes it drives me crazy...
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    Good Home-Based Medical Billing Software

    Billing Software Try Pertexa Healthcare Technologies - (I use it) Security is built in, it is very quick and easy to install, and reasonably priced. The sw price includes electronic connectivity with "Availity" clearinghouse so there is no extra charge for commercial claims that go...
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    Hands-ITC Arthroplasty & Traction Release

    Does anyone know what "ITC Arthroplasty (hand) is? I suspect this is actually some kind of graft??? And how to code for "Traction contracture release, PIP joint"? Many thanks in advance...
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    Just Coding

    As a Coder, I often abstract E/M levels, Procedures and Diagnoses from reports. If I never see, or have knowledge of the Payer's responses to the claims I have coded, how do I know if I am coding these encounters correctly and within the AAPC Code of Ethics? In short, what external response is...
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    Coding Blind

    Payers I also know from billing experience that most payers include coding advice and/or advisories with their RA.
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    Coding Blind

    As a Coder, I often abstract E/M levels, Procedures and Diagnoses from reports. If I never see, or have knowledge of the Payer's responses to the claims I have coded, how do I know if I am coding these encounters correctly and within the AAPC Code of Ethics? In short, what external response is...
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    Who gets to bill the 38792?

    38792 Based on the article posted previously, both the Radiologist and the Surgeon can bill this code because the actual interpretation of the procedure is different for each provider.
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    Peterson Defect/More Hernia Stuff

    I don't know much about hernia repair, but from the op report given, it sounds like the surgeon repaired 2 internal hernias; one in the biliary limb and one in the jejunojejunostomy???
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    Who gets to bill the 38792?

    Maybe you just need to decide who adds the 59 modifier as a routine...
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    Help with coding

    Vicky, You could bill for 44160 and 22900 (or something similar) if that is appropriate based on the op report. You mentioned that the tumor did extend into the abdominal wall. Ann
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    Leech Therapy

    Is there a 'correct' CPT code for the initiation of leech therapy, i.e. when the provider makes simple incisions down to bleeding tissue in the affected area, and then leeches are applied at the incision site. I think the code for the leeches themselves is C1765, what about the initial procedure?
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    carpometacarpal boss dorsum

    CMC Boss Dorsum The carpometacarpal boss is "a bone prominence involving the carpometacarpal joints of the index and long fingers". Apparently trauma to the dorsum can cause lesions which can also result in some deformity. Perhaps you should be looking at excising a lesion from the CMC joint? I...
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    Hand Surgery HELP! - RASL procedure

    Thank You! Thanks, based on the op report, I think your answer is right on! Do you know where I might be able to get reference material specific to coding for Hand Surgery?
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    Hand Surgery HELP! - RASL procedure

    Does anyone know what the CPT code is for RASL (reduction-association scapholunate)???? Dx: "capitolunate disassociation of left wrist". Is there any such thing as a "modified" RASL? If not, should I add mod 52 to the procedure code, whatever it may be? Apparently this is an arthroscopic...
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    Is it appropriate to use 76000?

    Can you use 77002 -26? 77002 "Includes all radiographic arthroscopy with the exception of supervision and interpretation for CT and MR arthrography."