1. E

    Wiki CABG with open vein harvest bilateral (not used for surgery) ??35682-52

    Hello, Can someone please help me in determining if 35682-52 is the correct code for the open vein harvest on this procedure? I have the CABG coded as 33533, but the procedure also lists a saphenous vein harvest endo converted to open. the closest cpt i can find is 35682. Append -52 for...
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  3. A

    Wiki Billing a bilateral knee xray with a unilateral knee xray

    Ex: When a provider orders a bilateral xray of the knees AND 3 additional views of the right knee, per CCI guidelines we are not allowed to bill the bilateral xray with a unilateral xray code. What we have been doing is removing the charge for the bilateral xray (CPT 73565) and instead using...
  4. KStaten

    Wiki Humana Denials: Why Does Humana Request Bilateral Modifier 50 for Non-Bilateral Body Parts?

    Hello Everyone. :) Does anyone else have issues with Humana denying injections for non-bilateral body parts (such as a left shoulder and right knee injected on the same visit) because they are requesting the bilateral modifier 50, rather than the correct LT/RT; XS modifiers ? Is there a way to...
  5. C

    Wiki Bilateral Renal Stent Coding

    Bilateral renal stents and superior mesenteric artery stent placed. Do you bill 37236-50 with 37237 or 37236 and 37237(x2)?
  6. S

    Wiki 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...
  7. A

    Wiki Coding recurrent bilateral lung cancer?

    I've gotten myself so confused, so I'm hoping you can help me. My case: In 2006, patient has left upper lobe squamous cell carcinoma. Treated with lobectomy and chemo. In 2015, patient returns with bilateral lesions that physician decides is a recurrence. This time right upper lobe and...
  8. S

    Wiki q7, q8, q9 modifiers......

    i am second guessing myself and just need some reasurrance as to what mod you would add to this: i am saying Q9. thoughts anyone?! this is a podiatry exam with a systemic disease. Vascular: dorsalis pedis pulses were ¼ equal and symmetrical bilateral. Posterior tibial pulse was nonpalpable...
  9. kathymoon

    Wiki Balloon dilation 31295-31297 and FESS

    I'm very new at ENT coding and I would like some input from those a little more knowledgeable in this area. Out-patient surgery at the hospital. I am coding the professional components. Dr. states that bilateral frontal balloon sinuplasties were performed and irrigated with saline. Next...
  10. J

    Wiki What can Radiologist bill for Epidural done by another doctor in radiology office?

    Can anyone tell me what to bill for the radiologist when an outside physician uses the radiologists office to do an epidural injection? The radiologist is dictating a report documenting the fluoro used & needle placement. This is the documentation from 2 different reports: EPIDURAL CLINICAL...
  11. C

    Wiki Bilateral renal artery angioplasty and stent placement HELP

    Hello, I am fairly new to vascular coding and I want to make sure I code this correct. I am thinking 36252 (bilat)and 37236, 37237. From what I have read angio is included in stent placement so I would not use 35471. I attached the op note below. Thanks for any help with this. Procedure...
  12. M

    Wiki Need help with cpt for VAIN2

    Here is the op note. Provider is billing 57061. PROCEDURES: 1. Wide local excision of vaginal intraepithelial neoplasia 2 (VAIN 2), bilateral fornices. 2. Laser brushing of vaginal mucosa. FINDINGS AT THE TIME OF SURGERY: Atrophic vaginal mucosa. Bilateral fornices areas of acetyl white...
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    Wiki ICD9 code

    I cant find the the ICD9 code for Bilateral reduction mammoplasty
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    Wiki Bilateral Knee xrays

    Did something change with coding bilateral knee xrays? We use to bill 73560-50, but it looks like the 50 modifier is not longer allowed.
  15. R

    Wiki Problems with deciding whether a modifer 50 should be used or right and left

    I have noticed that different insurance companies are requiring right and left when performing bilateral procedures vs the 50 modifier (bilateral procedure). Does anyone have documentation on what Tricare demands? I cannot get an answer from them. Would appreciate any help you can give me...
  16. T

    Wiki 63047 denying for modifier ....

    Recently Tricare began denying 63047 stating "...INHERENT BILATERAL PROCEDURE WITH UNITS GREATER THAN ONE...." The procedure done was "DECOMPRESSION OF L3 & L4 LAMINECTOMY WITH BILATERAL FORAMINOTOMIES" The original claim was sent with 63047 x1 & 63048 x1 & 69990 x1. According to the CPT...
  17. S

    Wiki Bilateral inguinal hernia/one side repaired - I have an op report that has Pre and Po

    I have an op report that has Pre and Postoperative diagnosis of bilateral inguinal hernia, but they only repaired the Lt side because the right was not causing patient issues and the patient did not want it done (had to be done open). For the dx would I code it as bilateral or unilateral? Thanks!!!
  18. M

    Wiki Bilateral laminectomies L4 to S3 63047?? OR 63030? 63035?? help please!!

    PREOPERATIVE DIAGNOSIS(ES): Epidural lipomatosis with significant dural compression from L4- S3. POSTOPERATIVE DIAGNOSIS(ES): Epidural lipomatosis with significant dural compression from L4- S3. PROCEDURE(S)/OPERATION(S) PERFORMED: Bilateral laminectomy from L4-S3. SUMMARY: Under general...
  19. C

    Wiki Cathplacemt Code when LHC and Carotid Angio performed same session

    I am seeking some opinions and advice. I code procedures for the Cath Lab and IR in a the hospital setting. I am looking for advice for Abdominal Aortagram Bilateral Extremity and Carotid angiograms from the same access site, in the same setting by the same physician. I have been getting...
  20. M

    Wiki Ear wash

    I billed 69210. Pt had bilateral procedure. The guidelines state to use modifier 50 for bilateral. It rejected stating "procedure is inconsistent with modifier." Do I bill each one separately with modifier 50 on one of line items? I first filed w/modifier 59, then saw that 50 was needed. TIA Judy
  21. K

    Wiki Bilateral Codes

    Can someone please post the link to CMS that has the page for Bilateral codes? I've looked all over their website and I would prefer taking on an actual Labyrinth instead. The actual link, so that when I click on it it will take me right to the page, not the CMS homepage. Thank you for your help...
  22. M

    Wiki 31645 bilateral

    ok my office does bronchs and i have always billed this code with 2 units with the correct modifers if it was done bilateral however mcd is telling me that I cannot bill more than one unit per day. I am so confused this is the way I have always billed it and do not understand if he does twice...
  23. krburke

    Wiki How best to report bilateral 20610 to Medicare

    One of my providers has given 20610 injections in both knees. How does Medicare want to receive these codes? These are the options I came up with: 20610-RT x 1 unit 20610-LT x 1 unit OR 20610-50 x _ units? Would this be billed as 1 or 2 units? Any other modifier besides -50? I have not had...