Wiki Am I coding this correctly? - bunionectomy


Grantville, GA
Best answers
Am I coding this correctly:

Second degree burns of the abdomen and third degree burns of the hands
and fingers secondary to steam.
E924.0, 942.33, 944.38

Dx: Replacement of silicon breast implants, bilateral - V52.4
Procedure: Removal of intact breast prostheses; Insertion of saline
implants - 19328-50 and 19350-50

Dx: Hammertoes, bunion - 735.4 and 727.1
Procedure - Hammertoe repair x 3 toes; Keller-McBride bunionectomy,
left foot - 28285 x 3 and 28292-LT

For #1 I get:
943.38 third degree multiple sites wrist/hand
942.23 second degree abdominal wall

for #2 I get:
V52.4 fitting/adjustment breast prosthesis/implant
19328-50 removal intact mammary implant
19340-50 immediate insertion breast prosthesis

for # 3 I get:
735.4 acquired hammer toe
727.1 bunion

28292 bunion correction; keller/mcbride/mayo type
28285 correction hammertoe x 3 (you should use the correct toe modifiers to differentiate)

Anyone else?
Ok thank you.......Any suggestions on the following, I feel as if I am unbundling the CPT codes or I am completely wrong:

Procedure: Left knee arthroscopy; repair of medial meniscus, removal of loose bodies, limited synovectomy and chondroplasty

29874-LT, 29875-LT and 29882-LT

Procedure: Cystourethroscopy with multiple unsuccessful attempts to remove ureteral calculus and insertion of in-dwelling ureteral stent to facilitate passage of stones

52332 - I am thinking I need to add a modifier to this

Procedure: Bilateral nasal endoscopic maxillary sinusectomy with ablation of the turbinates

I can't seem to find a code for bilateral nasal endoscopic maxillary sinusectomy I only found the code for ablation of the turbinates
30801, if it is in fact the correct one.
Knee- Per the NCCI, both 29874 and 29875 are components of the 29882. So the 29882 is the only billable service.

29882 - Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
29874 - Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)
29875 Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)

Cysto - It appears this was over and above the work usually involved in a cysto. Therefore, in my opinion, the modifier 22 could be appended to identify that additional work was involved.

Sinus - I'm not an ENT expert, but I'll put my 2 cents in here. I'm interested in what others think.

What about 31020 for Sinusotomy, maxillary (antrotomy); intranasal? Sinusotomy vs. sinusectomy?

The destruction of the turbinate(s) would be billable, as well. However, regardless of how many turbinates are destroyed, code the turbinate destruction code once. The turbinates could be coded as follows, depending on what was documented.

30801 Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; superficial

30802 Cautery and/or ablation, mucosa of inferior turbinates, unilateral or bilateral, any method; intramural

30999 for Cautery and ablation of superior or middle turbinates.

As an aside, I have a sinus question out there, but haven't received any responses. If anyone has experience in ENT, would you please contact me? Thanks