orthopedics

  1. L

    Orthopedic Surgical Coder (Certified)

    Coding since 2018. Looking for part time or contract work coding trauma, other orthopedic surgeries, or office visits. Please email certworkbiz@gmail.com for inquiries
  2. R

    Hand-and-Wrist Procedures performed in an Office-Based Surgical Suite (OBSS)

    Hand-and-wrist procedures lend themselves to WALANT (Wide Awake Local Anesthesia with No Tourniquet) where the surgeon can communicate with an awake patient and ask them to move their fingers during the operation to obtain immediate feedback. Even though there are dozens of peer-reviewed...
  3. R

    Question Negotiating for office overhead when Site of Service Differential (SOSD) = zero?

    Does anyone have any experience with contract negotiations for surgical procedures, which are typically performed in a facility (SOSD=0), and are now performed in an OBSS (Office-Based Surgical Suite)? The POS is now 11. This is growing in popularity in orthopedics (hand and wrist), podiatry...
  4. A

    20694 Denied during GSP

    My provider performed a 20694 (removal of external fixation device, requiring general anesthesia) during the GSP of the previous arthroscopic procedure, and Medicare denied for being performed within the GSP. I'm trying to decide which modifier to use in this case. Any help would be appreciated...
  5. H

    Question Orthopedic After Hours Clinic

    Our office is in the process of opening an after hours orthopedic only clinic. I was wondering if anyone else has any experience with this? I have several questions regarding billing and coding, as our office will be staffed by APP's and not surgeons. If anyone has any knowledge please let me...
  6. F

    Question How many coders do you have in your clinic?

    I've been begging for help in my clinic and wonder if I'm off base. We have 8 surgeons (3 of them spine), 4 midlevels, 1 physical therapist and 2 PTAs. I code and post all of the encounters for all patients (1000 per week), plus code and post all surgeries. Also have to enter/verify insurance...
  7. T

    Question Outpatient knee

    I need any help I can get on this one. Dr performed 3 procedures that I cannot find codes for. The ORIF he is dictating comes back as CPT 27540 but that is an Inpatient only code and we are an ASC. POSTOPERATIVE DIAGNOSES: 1. Left knee tibial tubercle avulsion fracture. 2. Periosteal...
  8. H

    Orthopedic Walk-in Clinic (Not urgent care)

    Our practice is opening a after hours clinic 2 days a week to service non urgent care orthopedic issues. I have a question concerning billing new vs established. In our other family med walk in clinics they bill all patients that have been seen with in our health system as established when...
  9. J

    URGENT: Orthopedic Coder Needed

    In urgent need of IP/OP remote multi-specialty pro-fee coder that is an expert in ORTHOPEDIC SURGERY and E/M coding. DOMESTIC coders only. Please see details of project and how to log your experience HERE: https://goo.gl/K8MLoH
  10. N

    fx repair of osteocutaneous graft donor site

    Osteocutaneous graft taken from radius (roughly 4 cm of bone). the provider wants to bill for fx care of radius (we did place a plate to strengthen the area). wound covered with skin grafting from another site. Can we bill for fx care and supporting documentation please. thank you
  11. H

    Wiki subsequent orthopedic inpatient visits, i. 99231, 99232

    I am an orthopedic coder needing some clarification. A patient is initially seen in the ED with a femoral neck fracture and the ED provider is requesting Ortho consultation; a hospitalist accepts them as an admit. The Ortho provider consults and determines that the patient needs to be taken to...
  12. S

    excision of palmaris profundus tendon...help!

    Hi, I am hoping someone can help me with my coding dilemma...during a typical Carpal Tunnel release the surgeon noted that there was an accessory tendon draped over the median nerve and defined it as a the palmaris profundus tendon. He excised this tendon. I am hoping someone can help me...
  13. J

    COSC exam practice?

    Hello I failed the orthopedic exam once and I'm retaking it in a few weeks. Other than the AAPC practice exam , are there any other good resources for practicing / studying ? Thanks!
  14. C

    Billing Ortho Sports medicine

    My question is when the ortho doctor has a sub-specialty of sports medicine and the provider is billing under the sports medicine does the injury have to be sports related in order to bill under the sub-specialty?
  15. S

    modifier 25 help

    Can anyone tell me where to find the OIG or CMS guidelines for use of modifier 25? I work in Orthopedics and there is some confusion on appending modifier 25 to E/M services when also billing an injection. I need something clear cut to give to our providers as a guide. Thanks!
  16. C

    Experienced CPC looking for remote opportunity

    I am a certified coder (CPC) with almost six years- experience in a wide range of expertise including remote coding. I have experience in outpatient hospital (including a teaching facility), profees, risk adjustment, and physician E/M. I have experience in the following specialties: family...
  17. C

    Experienced CPC looking for Remote-UTAH

    I am an experienced coder looking for a part-time remote position. I have experience in ophthalmology, physical therapy/orthopedics, risk adjustment, and EKG/ECHO. I am a very quick learner and will catch on to any specialty. I have experience in both hospital outpatient coding and physician...
  18. S

    fracture care question

    A patient is seen by another provider at a different practice and a cast was applied and a fracture care code billed. the patient called our practice and wants to make an appointment to be seen. How would be bill this? Can we bill an office visit even though she is currently in a global...
  19. K

    How to determine levels in spine

    I have a physician who documented radio-frequency ablation for "levels L4, L5 and S1." I understood this to be 3 levels and the doctor says this is only 2 levels. I understand her reasoning behind this, but I am wondering about the documentation. I understood the documentation L4/5 and L5/S1 as...
  20. H

    Billing OVs with Medicare injections for Orthopedics

    For Orthopedics, For Visco supplementation injections which occur once a week for 5 weeks with the same diagnosis code, can an OV be billed on each visit? The physician does document a physical exam, but the diagnosis code is osteoarthritis. Thanks
  21. A

    Excsion of 5 cm spurtrophus and excision of bursa from olecranon

    The surgeon removed a 5 cm spurtrophus and an excision of bursa from the olecranon. I am thinking that it should be coded with 24105 and 24073. What do others think? We are having a difference of option in our office on this one. Please help! Can't find anything relating to this anywhere!
  22. S

    Orthopedic Fracture table 7th character

    If our orthopedic surgeon sees a patient in the office for consultation for a fracture (for example...S82.61XA). I would use the 7th character 'A' for the initial encounter. What would I use for a follow up visit after a CT scan? And what would I use for the surgery? I understand 'A' is only...
  23. M

    Orthopedics and Modifiers

    I am billing these three codes and am wanting to know opinions on the -59 and -51 mods on the 27437 and any feedback on this surgery in general. Thanks 27446 27437 59-51 20985 all of these on the same claim for the same patient, this is one surgery. Thanks
  24. S

    aborted procedure-spine arthrodesis

    I would like anyone's comments regarding billing a staged spine surgery involving an aborted surgery. My surgeon performed a scoliosis thoracic-lumbar multi-level 360 arthrodesis involving three separate surgical days. Day 1: anterior fusion with instrumentation and caging-successful Day 2...
  25. R

    Orthopedic Surgical Coding Consultant

    I'd like to form a connection with a seasoned, experienced Orthopedic Coder that I can send cases for coding assistance(shoulders and a few knee cases). I am happy to pay for these services and would love to have this back-up connection. I have just a few cases at this time, but would very...
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