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Thread: Arthroscopic Ankle Procedures

  1. #1
    Join Date
    Apr 2007
    Chicopee, Mass

    Default Arthroscopic Ankle Procedures

    AAPC: Back to School
    Hello everyone,

    I am writing to see if anyone else is having trouble getting paid for arthroscopic ankle debridement, peroneal tendon repair, OS Trig excision, and the Brostrom procedure. Our MD does a totally separate arthroscopic procedure to debride impinged tissue (it is not an arthro. converted to open situation). We are getting paid very low, and they are denying most of those procedures when billed together (they are not bundled either) Anyone have any suggestions or have gone through this scenario?

    Much appreciated,

  2. #2
    Join Date
    Apr 2007


    Just throwing it out there, but mod (-59) might help along with sending the op note each time noting (i usually underline) the proof of the seperate 'incision.' Even though not bundled, sometimes if it's the same body area, yet seperate incision, (-59) along with documentation will work.

    Hope this helps....

  3. #3
    Join Date
    Apr 2007
    Greater Pittsburgh


    Ankles/feet are very sticky, I put 59 modifiers on all separate procedures even if they are not bundled and add a mini decsciption on the HCFA field, anything to help them understand and if all else fails send the note as mentioned previously with each separate procedure marked in some way ( I use and asterik and underline instead of highlighting for copying purposes). I think they really do not understand how intricate the ankles/feet can be.
    jdemar, CPC, CMA

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