surgery

  1. J

    Fracture Manipulation and Surgery

    we had a patient with a displaced distal phalanx fracture which was manipulated in the office and then scheduled for surgery for the next week. can we bill for the manipulation or just the ov/xr/splinting?
  2. S

    X-ray billing help!

    I'm new to an ASC facility and when it comes to x-rays (almost always performed along with a surgery), I am told that we code professionally with -26 modifier but don't bill at all for the facility side. It was explained to me that x-rays are included in the global surgery package for...
  3. K

    Mohs

    Hi - I work for a Dermatology Practice. Our Mohs surgeon performed Mohs on a patient's ear. The surgery had a total of 8 stages. I billed 17311 at 1 unit Then 17312 at 7 units I'm pretty sure only 6 units are allowed for 17312, but how do I account for the 8th stage on the claim? Please...
  4. G

    Decision for surgery was made... and then the surgery was cancelled. Can we bill?

    I'm not sure what's correct for this visit: The patient was seen on 8/1 and the decision was made to proceed with a partial mastectomy. Consent forms were signed and surgery was scheduled for the end of the month. The patient was seen again on 8/10 because she had questions about the procedure...
  5. C

    Office Based Procedure Billing

    I work with a surgeon who has started doing minor surgical procedures in his office, some of which require an anesthesiologist. I am trying to verify if the anesthesiologist can bill insurance separately for these, or if the fee that the surgeon receives is all inclusive, in which case he would...
  6. 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...
  7. L

    Lap vs Open partial colectomy

    The surgeon feels this partial colectomy with anastomosis should be coded as a laparoscopic procedure, but I think it should be coded as an open one. Just curious what any one else would think & why. Thanks! "After the induction of general anesthesia, the abdomen was sterilely prepped and...
  8. A

    Resident Surgery

    Hello All! Looking for help clarifying surgical assist involving residents. I'm not 100% comfortable and therefore I keep doubting and confusing myself. First off, if a resident is the first assistant, I understand we can not bill for there service but would it be necessary to add a GC...
  9. J

    Surgery Coding Help

    Can someone help me code for this procedure please thank you! PROCEDURE PERFORMED: 1. Re-exploration of lumbar wound. 2. Utilization of intraoperative fluoroscopic imaging. 3. Removal of L4-5 transforaminal lumbar interbody fusion spacer. 4. L4-S1 posterolateral autologous lumbar fusion...
  10. B

    AS/UD Modifier

    New to PA billing for assisting in surgeries. Have done some research, but found contradicting answers. I bill physician billing, not facility billing. 1st Question: Difference in AS and 80 modifiers? I see the definitions in the CPT book, but a few examples may make these make a little more...
  11. C

    Decision for SX & Pre-Op Clearance Same Day?

    Hi all, I need some help directing an ortho practice I work with. They have been billing 2 E/M codes per day; 1. the PT sees the physician who makes a decision for surgery and bills an E/M code with modifier 57 2. the PT sees an NP within the practice, who bills for a "medical clearance"...
  12. D

    Pain management during global period for shoulder arthroscopy

    Can I code for an injection to a shoulder site non specific to a shoulder arthroscopy during the global period? Is there any way to unbundle this? Please advise. Peace ?_?
  13. P

    Exploratory laparotomy with silo placement

    Good morning, My surgeon performed an exploratory laparotomy (49000) on a pediatric patient and decided to place a silo rather than close the patient's abdomen. How would you code this procedure? Thank you!
  14. P

    Exploratory laparotomy with silo placement

    Good morning, My surgeon performed an exploratory laparotomy (49000) on a pediatric patient and decided to place a silo rather than close the patient's abdomen. How would you code this procedure? Thank you!
  15. M

    General Ortho Surgery Charge Posting

    Hello all, I have recently made the move from a pediatrics office to a Pediatrics Orthopedics specialist and while I am familiar with office visits, post-op visits, xrays, & casting. I have NO experience with surgery charges and DME billing. Currently someone else is billing all of our...
  16. L

    Spinal Hardware Removal

    If the surgeon removes fusion hardware at the L4(locking cap, portion of rod, tulip head, and pedicle screw) in a patient with a history of fusion L4 - S1 can we code 22830 for Exploration of Fusion? During the procedure, the surgeon states "The fusion bed at this level appeared to be robust...
  17. L

    Lateral Canthotomy Question

    This was a trauma patient. The procedure states it was done for elevated pressure, proptosis, and decreased vision. "Lateral canthus of left eye was cleansed and anesthetized with ...Iris scissors were utilized to cut the skin laterally. I then turned my attention to the inferior crus of the...
  18. L

    Partially inverted uterus with delivery

    This is a new one for me. I'm not sure if I can code anything extra for the Dr. that delivered, but seems I should be able to bill something for the Dr. that came in and assisted with replacening the uterus. I would appreciate any suggestions for coding this. It was not a package, so I will be...
  19. R

    Urgently looking for 10 Medical coders for Onsite and Remote coding positions

    Looking For Remote coders for Auditing Physicians Charts. Willing to travel when necessary. • Surgical oncology coder/Auditor for physician services with E&M coding. • Radiation oncology coder for physician services with E&M coding. Responsibilities: • Surgical coder with oncology experience...
  20. M

    Global Period Question

    Hello, If a resident or a fellow (non-billable) from Urology performs a major surgery (90 day global period), can the following days (subsequent visits) be billed by the Urology Attending physician since the Attending did not perform the surgery? Please advise. Thanks, Mary V., RHIA, CPMA
  21. J

    Certified Coders Needed at Wichita Surgical Specialists

    Coder needed, CPC or RHIT. Full-time, Monday-Friday, 8am to 5pm, busy surgical practice. Coding experience preferred. Communication, computer & organizational skills necessary. Excellent benefit package. Apply online at: www.wsspa.com/careers EOE/Vets/disabled/M/F/Federal Contractor.
  22. S

    level of risk

    Could I get some opinions please? Note says: Surgical procedure for resection of plantar calcaneal spur is explained to her in detail.* Surgery is not recommended as of yet. Does anyone else think that the "surgery is NOT recommended" part cancels out the Moderate level of risk that would be...
  23. A

    Trigger Point at Bedside

    Patient was supposed to go to surgery for a lipoma removal and a shoulder trigger point injection. The patient never made it to surgery and while in holding they did the trigger point injection. I know we cannot charge OR charges but can we still charge for the injection?
  24. S

    ASC Billings/ Coding

    Our surgery center bills for the ASC Facility fee and we have an Orthopedic surgeon who wants to do a 29827 (arthroscopic rotator cuff repair) and then have a Pain Management physician come into the OR and do a 64483 (lumbar transforaminal epidural) on the same patient, for a completely separate...
  25. S

    ASC Billing/ Coding

    Our surgery center bills for the ASC Facility fee and we have an Orthopedic surgeon who wants to do a 29827 (arthroscopic rotator cuff repair) and then have a Pain Management physician come into the OR and do a 64483 (lumbar transforaminal epidural) on the same patient, for a completely separate...
  26. S

    Surgery Assist non payable procedures

    Where can I get a list of all procedures that aren't AS payable? TIA Sharon, CPC General Surgery and Hospitalist
  27. D

    HELP is there a Code for large group Refractive surgery seminar

    We have a physician who performs Lasik PRK surgeries. Once a month the have a seminar for all the West Point Cadets interested in the surgery, anywhere from 30-200 cadets attend the 60 minute seminar for refractive surgery options. Counceling covered multiple areas, to include purpose of...
  28. M

    Global Denial - out of sequence dates of service

    We have a claim that denied as being included in the global period of another procedure, however this was the first surgery we had performed on this patient. When I called Cahaba I was told the claim was billed out of sequence with a subsequent procedure performed 2 weeks after the first...
  29. P

    Bariatric surgery - lap band deflation

    Is there a CPT for this or would this be included in the office/clinic visit? AP standard band deflated Numbing spray used Port cleaned with alcohol Huber needle used to access port 7 ml of saline removed from band
  30. D

    How to code Medicare Preop evaluation

    What code should I use for a Preop evaluation for a patient that is going for cataract surgery and has Medicare for insurance? I use as first diagnosis Z01.818 and was denied. Do I have to use the Z code as a second diagnosis and code the reason of the surgery first?
  31. V

    Piggyback IOL done same date of service

    Patient had two IOL's inserted same surgery session traditional lens with a toric. Also had limbal relaxing incisions. Does this surgery qualify for complicated cataract surgery? Do we need to report two lens implanted for reimbursement? Thank you.
  32. C

    Charge for intracopertive TEE during AVR (for facility)

    Charge for intraoperative TEE during AVR (for facility) Question regarding Intraoperative TEE for facility during open AVR surgery. I am not familiar with the non invasive cardiology side for facility coding. However the cardiology dept is asking if they are able to charge/code for their...
  33. K

    Office Based Surgery Billing/Reimbursement

    Hello All! Does anyone have any information on office based surgery billing/actually have a surgical suite in your office? We are researching the possibility of opening a suite in office for our pain management/spine doctors to perform level II surgeries. I have a few questions: Do you still...
  34. K

    EXPERIENCED Outpatient surgery coders for ASC’s/Both part and full time REMOTE CODING

    Chapter Officers, Do your members need a job? WE ARE HIRING!! Pinpoint Healthcare Consulting, LLC is quickly becoming one of the nation’s leading healthcare vendor consulting companies. We are a member of AAPC and we need help from the members. WE ARE HIRING, PLEASE LET YOUR MEMBERS KNOW. We...
  35. R

    Modifiers 25 and 57

    How do I do this? New inpt initial hospital care (99221) with the decision for both procedures (19303, 90 day global) & (36561, 10 day global). Medicare patient. I used the 57 modifier on the 99221. Medicare denied 99221 so we appealed. This is the response from Medicare: We received an...
  36. S

    post op care only

    could someone refresh my memory on how we follow the format for post op care only. My provider is caring for a patient after she had a fx hip surgery done at other facility and is now in our office for fu care.
  37. F

    thoracic surgery

    My MD did an open flap drainage and a decortication at the same visit. I used cpt codes 32036 and 32225-59, however we are being denied for bundling. What can I do to get pass this? Any suggestions?
  38. C

    Drain tube removal by another physician.

    How would I code for this when the patient did not want to drive 5 hours to the physician that performed the surgery and inserted the tube and, instead, decided to do it locally. What CPT should I use and ICD-10-Code? Please advice. Thanks in advance!
  39. 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...
  40. H

    Office surgery vs otpt surgery

    Can a physician schedule a surgery in the office (place of service code 11) and take the patient into the ambulatory surgical center (place of service code 24) and bill only the physician portion with place of service code 11? Example: A physician schedules a YAG in the office. Physician takes...
  41. L

    Multiple fractures - Can anyone help me on this one

    Hello, I have one where on 10/12/15 patient comes into the office for a 1. displaced metaphyseal fracture of right distal radius and ulna 2. mildly angulated closed left midshaft clavicle fracture Treatment Plan: Taken to Operation Room and had a closed reduction and percutaneous pinning...
  42. J

    E/M & Surgery Coder Needed (Remote, Contract)

    Hi Coders, Aviacode is looking for coders that can code both E/M and SURGERIES for the following specialties: Cardiology Gastroenterology General Surgery Nephorology Neurology Neurosurgery Orthopedic Pulmonology If you have experience in one or more of those specialties with BOTH E/M and Surgery...
  43. J

    E/M & Surgery Coder Needed (Remote, Contract) - Gastroenterology

    Hi Coders, Aviacode is looking for coders that can code both E/M and SURGERIES for the following specialties: Cardiology Gastroenterology General Surgery Nephorology Neurology Neurosurgery Orthopedic Pulmonology If you have experience in one or more of those specialties with BOTH E/M and Surgery...
  44. J

    E/M & Surgery Coder Needed (Remote, Contract)

    Hi Coders, Aviacode is looking for coders that can code both E/M and SURGERIES for the following specialties: Cardiology Gastroenterology General Surgery Nephorology Neurology Neurosurgery Orthopedic Pulmonology If you have experience in one or more of those specialties with BOTH E/M and Surgery...
  45. J

    E/M & Surgery Coder Needed (Remote, Contract)

    Hi Coders, Aviacode is looking for coders that can code both E/M and SURGERIES for the following specialties: Cardiology Gastroenterology General Surgery Nephorology Neurology Neurosurgery Orthopedic Pulmonology If you have experience in one or more of those specialties with BOTH E/M and Surgery...
  46. J

    E/M & Surgery Coder Needed (Remote, Contract)

    Hi Coders, Aviacode is looking for coders that can code both E/M and SURGERIES for the following specialties: Cardiology Gastroenterology General Surgery Nephorology Neurology Neurosurgery Orthopedic Pulmonology If you have experience in one or more of those specialties with BOTH E/M and Surgery...
  47. J

    E/M & Surgery Coder Needed (Remote, Contract)

    Hi Coders, Aviacode is looking for coders that can code both E/M and SURGERIES for the following specialties: Cardiology Gastroenterology General Surgery Nephorology Neurology Neurosurgery Orthopedic Pulmonology If you have experience in one or more of those specialties with BOTH E/M and Surgery...
  48. 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
  49. Lynda Wetter

    Subsequent hospital care

    Does the below statement fulfill the requirement for a subsequent care code 99231? Seen and examined. Left leg lesion is raised around hair follicle. There is some fluctuation. I believe he would benefit from I & D. I called Dr. X, acute care surgery service who would evaluate him for possible...
  50. D

    Injections-someone can help

    I hope someone can help. I have a patient who will be having a hip injection in a surgery center. Dr. told this patient that since he will be doing the hip, he will also just give him his first set of Euflexxa injections in the knee. If the surgery center will allow us to bring the...
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