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In need of clear-cut rule

  1. Default In need of clear-cut rule
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    We have a couple of debates going on within our office that we need some clear rules and guidelines and we aren't getting them. A couple of years ago we started billing for OnQ pain pumps placed during surgery (we are general surgeons by the way). I researched how to bill this. Got info from AAPC to use 11981. Have been using it and getting paid. Another person in our office called the American College of Surgeons coding hotline and was told not to use that. That code is only for antibiotics. It doesn't say that in the description anywhere. ACS told us to use an unlisted code.
    We have almost the same going on with Wound Vac placement. Can we bill it or can we not? We are getting conflicting advice.
    I searched the AMA website since they are in charge of the codes. I couldn't find a help line or anything. The only thing I found was a feature that charges $320 for you to ask them 2 questions!!
    Please, someone, HELP!!!

  2. #2
    Default Clear cut answers, you are in the wrong business I think!
    Ok what I have on the On Q pain pumps is from the STS and they state that 11981 is correct but Medicare considers it bundled with the procedure and not separately billable. It is up to the individual carriers as to whether or not the commercials cover it.

    We don't bill it but most of ours are medicare, CVT practice.

    On the wound vac, I am going to assume you are talking about 97605/97606.

    I completely disagree with using this code for the placement at the end of the surgery. If you read the definition it is more that just putting the dressing on, which is what they are doing when closing in surgery. This is just part of the procedure unless someone can provide something that states otherwise.

    Hope that helps,

    Laura, CPC, CPMA, CEMC

  3. Default thank you
    Thank you so much for your reply and it does help.
    I am assuming the STS is the Society of Thoracic Surgeons??


    Quote Originally Posted by katmryn78 View Post
    Ok what I have on the On Q pain pumps is from the STS and they state that 11981 is correct but Medicare considers it bundled with the procedure and not separately billable. It is up to the individual carriers as to whether or not the commercials cover it.

    We don't bill it but most of ours are medicare, CVT practice.

    On the wound vac, I am going to assume you are talking about 97605/97606.

    I completely disagree with using this code for the placement at the end of the surgery. If you read the definition it is more that just putting the dressing on, which is what they are doing when closing in surgery. This is just part of the procedure unless someone can provide something that states otherwise.

    Hope that helps,

    Laura, CPC, CPMA, CEMC

  4. #4
    Default
    Yes, the Society of Thoracic Surgeons.

    Sorry, I get so used to the abbreviations I don't even realized I am using them any more!

    Laura, CPC, CPMA, CEMC

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