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    66180 vs 0192T

    what is the difference between the two codes 66180 & 0192T? is it payer specific or? I can see that Medicare reimburses higher for 0192T and this is a payer that reimburses a percentage of Medicare rates. Any insight would be greatly appreciated. Thank you! Susan, CPC-H
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    Exchange of expander devices for implants

    I need my fellow coders help on this one. The consulting company wants to code this as 19380 RT,LT but I am thinking 19342 RT,LT??? Also, I know in the description for 19380 it states an existing prosthesis is replaced with a prosthesis of a different configuration so I think that's what is...
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    Arthroscopic microfracture?

    Ok, so I need my fellow coders to help me with this one. Please read the op report and let me know what you think. Not sure if it should just be 29879 20926 (is this supposed to be for the plasmax?) PREOPERATIVE DIAGNOSES: 1. Anterior cruciate ligament tear, complete versus partial...
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    Tarsys spacer implant

    Can someone please help me with what HCPCS code to use for the actual Tarsys Lid Spacer Implant? I work for an ASC and it is for a commercial payer not Medicare. Wasn't sure if I should just use L8699 or ???? Any help is appreciated! Susan, CPC-H
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    Manipulation under anesthesia shoulder

    Is anyone doing these procedures (23700) in their ASC's? My boss gave me an article saying something about this code being billable for three dates of service and usually multiple billable regions can be performed stating each region is separately reimbursable???? I need some help with this...
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    HELP Knee Coders!

    Can I please get anyone's opinion regarding this operative report... It's a worker's comp and the consulting company wants to use 29877-RT 27422-RT 27425-59-RT I know it's a long report but any assistance would be appreciated! PREOPERATIVE DIAGNOSIS: 1. Recurrent right patellar dislocation...
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    67311 with 67335? - I have what may be

    I have what may be a dumb question....when the physician dictates a strabismus surgery 67311 (bilateral) and just states bilateral medial rectus recession, is 67335 (placement of adjustable suture(s) always reported with that code? I am wondering as it does say in the CPT book to use 67335 in...
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    ENT Coding Help Please ASAP

    :)Can someone else please take a look at this op report and tell me what your thoughts would be about the code(s)? A consulting company is telling us to use 30430 but not sure if I agree. I was thinking something like 30020 & 20912? HELP!!!! PREOPERATIVE DIAGNOSIS: 1. Nasal tip infection...
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    Help with 62290 & 72295

    There is some debate here about whether you can code 62290 & 72295 together. Can they be billed together? Also, the way descriptor for 72295 looks, you can only bill it once not matter how many levels are done??? If anyone can please point me in the right direction I would greatly appreciate...
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    HELP! Modifier 50 and facet injections

    I need some help clarifying codes 64490-64495 (new facet joint block code as of 1/1/10)...we are under the impression that you can only be reimbursed up to a maximum of three per day per patient, unless performed bilaterally. If billed with modifier 50 then they will be reimbursed at the number...
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    So frustrated with 41899!!!

    I need some input from all of you....our local Medicaid (I'm in the state of Nevada, Reno) just dropped our reimbursement for our oral rehabilitation dental cases 41899 from a group 7 to a group 1. My executive director and I are floored!!!! Not only that, they just made a web announcement...
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    Shoulder scope help please!

    I am thinking there should only be one code for this with a modifier for repeat repair but I wanted to get some thoughts just in case. I was thinking a 29827-76 or 29827-52? I was going to use a debridement but it looks like it was only for visualization purposes right? and in order to get to...
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    Help with shoulder scopes

    I need some help with this one today. I'm just not feeling well so I think that's what is blocking my brain. If anyone can take a look at this op report for me and tell me what you think. I was thinking: 29823 29827 29806 29826 wasn't sure about 23430 or 23440 for the biceps tendon...
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    Wide excision malignant melanoma

    I need some help in regards to the code(s) for this procedure. The MD office scheduled as 14040 w/172.2 as the ICD-9 but I'm not convinced that these are the correct codes. Or would you use 172.8? Also, because of the undermining done, would you code it as a an intermediate or complex repair...
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    Ortho coders I need your input!

    I wanted to get others opinions in regards to what codes you feel should go with this op report. I work at an ASC. The surgeon's office coded as 29806 & 29823 I used 29806 & 29822 (I didn't feel it justified an extensive debridement but maybe I am wrong???) Of course, now they are denying...
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    Podiatry help!!

    OK, so here's my dilemma. I think I was able to come up with the codes for this but I wanted to have others review it to verify it they are correct. These feet procedures get tricky sometimes. 28250 - plantar fasciotomy 28290 - Silver bunionectomy 28110 - fifth metatarsal ostectomy...
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    Lipoma removal(s) help!!

    I would like to get some opinions regarding this op report. We are trying to come to an agreement in our office in regards to this procedure. The surgeon's office coded as 24075x1 and that's not right since there were some on each forearm. Our consulting company is telling me to only bill up...
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    Another breast procedure

    I wanted to get some opinions regarding these CPT codes, also the doctor states in the operation portion of the report that he did a left breast bx times two and a right breast bx (I do have a path report) but I don't clearly read it in the report, am I not seeing something or should he add an...
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    Opthalmology coding help please!

    I'm still new at these opthalmology procedures and I'm confused. I work obviously at an ASC so I wanted to be sure that these codes were ok to use here and if I am missing something? Here is the op report: POSTOPERATIVE DIAGNOSIS: Aphakia, both eyes. OPERATION: 1. Bilateral examination...
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    Expert shoulder scope coder please!

    So, I wanted to get someone's opinion regarding the 29806 & 29807 codes and whether you feel they warrant being used together in this scenario? It looks to me like it does but before I went any further I wanted to see what anyone else thought. So far, I have it coded this way. 29823 29819...
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    Help with foot procedure

    OK, so I know I'm probably reading this and making it seem harder than it is but can anyone assist me with the codes for this. I'm thinking 28124 & ??? but not totally sure. I work for an ASC and it's a commercial payer. PREOPERATIVE DIAGNOSES: 1. Exostosis of bone left great toe involving...
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    Itemized billing

    I would like to get some feedback in regards to itemized billing for ASC's. My supervisor has been speaking with some people and they have talked with her about itemized billing for our surgery center. We do not itemize currently and just use appropriate CPT code(s) for the procedure. I am a...
  23. S

    Breast Procedures

    I am needing someone's opinion in regards to the correct codes for this procedure. I work at an ASC & it's for a commercial payer. I am thinking I have too many codes but maybe not. I believe all of the CCI edits were ok. 19330 RT&LT 19340 RT&LT 19380 RT&LT 19371 RT&LT Here is the op...
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    Sling Procedure

    I have a question for someone...we performed a sling procedure on a Medicare patient and billed with 57288 but also was trying to get paid for the implant itself by using L8699. I know the L8699 has a status indicator of N1 but was wondering if anyone else had experience billing Medicare with...
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    Help on another knee arthroscopy

    Here is the op report that I need some help with....I think doctors come up with their own verbage sometimes. PREOPERATIVE DIAGNOSIS: Left anterior knee ganglion cyst. POSTOPERATIVE DIAGNOSES: 1. Left knee anterior ganglion cyst. 2. Lateral gutter fibrous band. 3. Grade II chondrosis of...
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    Help with knee arthroscopy

    I wanted to get your opinion on this case. Should it be only 29880 or should a 29877 be coded also due to chondroplasty of patella? There has been some debate in our office as to correct coding. It is a commercial payer and I work at an ASC. Any suggestions would be appreciated...
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    AAPC Kansas City Regional Conference

    Is anyone out there attending the conference in Kansas City September 25-27, 2008? I have never attended an AAPC conference, it has always been with FASA for me so I'm interested what everyone thinks of them? I work at an ASC so would it be worth my time to attend or is it physician/office...
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    Removal of nasal packing

    PREOPERATIVE DIAGNOSIS: Nasal fracture. I need some assistance with this, the physician office when it was scheduled used CPT code 30905 but isn't this code for nasal hemorrhage specifically? If anyone has another idea, please let me know. I appreciate your time! I work at an ASC and this is...
  29. S

    IOL lens exchange

    Since I'm still new to coding opthalmology, I need some assistance with this one. I'm not sure if it's just the 66986 code and what code do I use for the lens replacement since I can't find a HCPCS code for it. Here is the op report.... PREOPERATIVE DIAGNOSES: Dislocated intraocular lens...
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    Fall Coding Seminar w/ Ambulatory Association

    I just wanted to let everyone know that it looks like the coding seminar that is normally held in the Fall/Winter with the Ambulatory Surgery Center Association (formerly FASA) will not be held this year. I just went onto the website & it shows coming early 2009 and I just got off the phone &...
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    Help on knee arthroscopy - Right anterior cruciate ligament

    PREOPERATIVE DIAGNOSES: 1. Right anterior cruciate ligament graft failure with retained hardware. 2. Medial meniscal tear. POSTOPERATIVE DIAGNOSES: 1. Right anterior cruciate ligament graft failure. 2. Medial meniscal tear. 3. Retained tibial and femoral hardware. PROCEDURES...
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    Help on knee arthroscopy - I am so confusing myself

    I am so confusing myself on this one and need some assistance.... PREOPERATIVE DIAGNOSES: 1. Left knee patellar chondromalacia. 2. Left anterior cruciate ligament instability. 3. Status post left anterior cruciate ligament reconstruction in 9/2001. POSTOPERATIVE DIAGNOSES: 1. Left knee...
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    Coding Alert Subscriptions

    I just wanted to get some opinions in regards to the coding alerts that I have seen posted on some of the responses to help answer questions on coding issues. How much is the subscription to the Coding Institutes Coding Alerts and are they worth it for ASC's or do they apply mainly to Physician...
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    New to opthalmology

    I need to get some input as to correct coding for this one. It's a Medicare patient and I work at an ASC. I'm quite stumped!! PREOPERATIVE DIAGNOSES: 1. Thyroid ophthalmopathy. 2. Exotropia. 3. Left hypertrophia. 4. Status post glaucoma shunt device x2, left eye. 5. Pseudophakia, left...
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    Correction Of Astigmatism

    Just a question...I have recently started coding opthalmology for our ASC and the physician performed a correction of astigmatism with limbal relaxing incision along with a Phacoemulsification of cataract with IOL, is there an additional code for the limbal relaxing incision or is it inclusive...
  36. S

    Help! Multiple nasal procedures

    I have a commercial claim and I think I have the first codes correct: 1. 21320 2. 30520? 3. 30140 50 52 4. 30999??????? If someone can assist me with these, I would be truly grateful. OPERATIVE PROCEDURE: 1. Closed reduction of the nasal fracture. 2. Open reduction of the septal...
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    Help with Medial epicondylectomy

    I do not have my current Coders Desk Reference to check on this but I know since the 2007 codes 24350-24356 have changed codes to 24357-24359, I'm not sure how to code this....Right medial epicondylectomy with neurolysis of the ulnar nerve right elbow and local injection of ropivacaine right...
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    Tricompartmental chondroplasty

    OK, here is my dilemma....I have a Medicare patient and the doctor dictated he did a right knee arthroscopy with tricompartmental chondroplasties and a limited synovectomy was performed throughout the anterior aspect of the joint. I know about the G0289 code but a while ago I called Medicare...
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