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Wiki Code 29999 Ortho Surgeon

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Janel1972

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Has anyone had issues or kickback from an ortho surgeon consistently billing CPT 29999 at a very high rate? I am trying to get my provider to use more specific codes for his procedures but he keeps using this and I am afraid it will cause an audit. Help...
 
I'm confused. Who's deciding to use the unlisted code, the provider or the coder? If the procedure done has a specific CPT, then that code would be used. That's not a "choice". If there is no CPT that describes the procedure performed then unlisted is used. If the procedure has an assigned CPT but was more extensive then modifier -22 would be added.
 
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