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Orthopedic Coding Alert

CPT® 2020:
Look for Injection, E/M Changes Next Year
CPT® announced its official list of codes for 2020, and the results aren't exactly earth-... Read more
Fracture Care:
Check for Possible Additional Services With This FAQ
Secondary injury, fracture, wound care all possible in fracture encounters. It's safe to ... Read more
Modifier Madness:
Keep 78/79 in Separate Buckets With This Advice
Unplanned postop procedures separated by OR question. When the surgeon needs to perform a... Read more
You Be the Coder:
Diagnosing Knee Injuries
Question: A new patient reports with right knee pain, which the orthopedist suspects to be... Read more
Reader Question:
Query Provider on Ganglion Cyst Procedure
Question: An established patient with a history of wrist issues reports to the orthopedist... Read more
Reader Question:
Follow This Advice on Refill/MDM Decision
Question: Can you count a routine prescription refill as a moderate level of risk whe... Read more
Testing:
EMG Testing: A Tale of 2 Scenarios
Coding changes completely when this test accompanies EMG. Coding needle electromyographie... Read more
Procedure Coding:
Stick Suture Removal Coding With This Advice
Remember; these modifiers could make a mess of your claim. When it comes to suture remova... Read more
ICD-10 Quiz:
End Contusion Confusion With These Answers
Remember; code Dx, not symptoms. Many a coder's ego has been bruised by choosing an incor... Read more
You Be the Coder:
Coding Arthroscopies That Change Scope
Question: Our orthopedist began performing a diagnostic arthroscopy of the patient's right... Read more
Reader Question:
Deep I&Ds; Require You to Dig for Codes
Question: Notes indicate that the provider performed a level-four evaluation and mana... Read more
Reader Question:
Drill Down for Pathological Fracture Dx
Question: If a patient suffers from age-related osteoporosis with a current pathologi... Read more
Reader Question:
Take Up the Challenge of Differentiating Bone Cysts
Question: The provider performs a level-three evaluation and management (E/M) service... Read more
CPT® 2021:
3-Pronged E/M Guidelines Are Coming
Summary details plan to bring more order to E/Ms. CPT® plans to split evaluation and man... Read more
Case Study Corner:
Stay Open to Options When Coding These Forearm Fractures
Check out this rundown of open/closed repairs on ulnar/radial breaks. When your orthopedi... Read more
Compliance:
Use ABNs When Necessary, or Trouble Could Be Coming
Failure to secure ABN could lead to your practice footing patient bill. When you're treat... Read more
Reader Question:
Separate Dx, Surgical Arthroscopies
Question: Notes indicate that the orthopedist performed an arthroscopy on a patient's righ... Read more
Reader Question:
2-Sided Rib Fracture Patients
Question: Encounter notes indicate that the orthopedist performed open treatment on three ... Read more
Reader Question:
Parse Anatomy for Vertebral Disc Dx
Question: Notes indicate that the orthopedist saw an established patient recovering from a... Read more
Reader Question:
Separate Shoulder X-Ray Codes
Question: How should I report an X-ray of the shoulder? Also, if the orthopedist performs ... Read more
You Be the Coder:
Coding Arthroscopy/Arthrotomy Combos
Question: Can I submit codes for an elbow arthroscopy and an elbow arthrotomy during the s... Read more
ICD-10 2020:
Laterality Is the Reason for New ICD-10 2020 Codes
New diagnoses expand several sets of ICD-10 codes. When ICD-10 2020 goes into effect, the... Read more
ICD-10 2020:
Revision Is the Word for These 2020 Ortho Codes
Codes go into effect in October 2019, so know them well. There's a new list of ICD-10 cod... Read more
Treatment:
Spinal Stenosis Tx Often Involves Injections, PT
Surgery isn't the first option for these patients. An orthopedist will often confirm spin... Read more
Surgery:
Look to These Codes on Spinal Stenosis Surgeries
There's a slew of surgeries orthos can perform. If conservative treatments for a patient ... Read more
Reader Question:
Check Out This Double-Consult Conundrum
Question: Our surgeon saw a non-Medicare patient in the office for a consultation, and the... Read more
Reader Question:
Keep Solid on Casting Reporting
Question: Can we report a cast application code when the orthopedist casts a patient's ent... Read more
You Be the Coder:
Use This Dx Advice If Bone Bruise Confuses
Question: After a level three evaluation and management (E/M) service for a new patie... Read more
Surgery Coding:
Use These Tips, Avoid Miscodes on Radial/Ulnar Fx Fixes
Patient could suffer from an open or closed fracture. When a patient reports to the surge... Read more
E/M Coding:
Changes Brewing for 2021 E/Ms
Say goodbye to 99201. Big changes are coming to outpatient evaluation and management (E/M... Read more
Telemedicine:
Use This Advice to Navigate New ‘Tele’ Codes
Uncertainty still shrouds how to use these codes. If you've hesitated to use the new inte... Read more
You Be the Coder:
Get Your Modifiers Right on ‘Vacation’ Injury
Question: I just started coding for an orthopedic practice in a mountainous area, and we g... Read more
Reader Question:
Get to the Most Proper FBR Code
Question: Notes indicate that a new patient with an injured foot had a foreign body (FB) r... Read more
Reader Question:
Documentation Key to Patient I&D
Question: Our provider recently drained an abscess on one of our patients. What documentat... Read more
Reader Question:
Reason for Infusion Helps Separate Codes
Question: Notes indicate that the physician provided 55 minutes of intravenous (IV) infusi... Read more
Q&A:
Keep Your TPI Skills Sharp for Bullseye Coding
Trio of experts runs down some of the finer points of TPI. Coding for trigger point injec... Read more
Integumentary Coding:
Wound Care Is Codeable … but Only Sometimes
Service could be part of package, or be separately codeable. Most orthopedic coding invol... Read more
E/M Coding:
Use Care When Employing ‘Counseling Exception’
You might be able to code E/M based on time … in certain situations. Patients that repo... Read more
You Be the Coder:
Getting Shin Splint Coding Right
Question: A new patient reported to the orthopedist complaining of shin pain. After a leve... Read more
Reader Question:
Keep These Codes Handy to Avoid ICD-10 Pain in the Neck
Question: When a patient reports to the orthopedist complaining of neck pain, what is the ... Read more
Reader Question:
‘Meta’ Makes a Difference When Coding Arthroplasties
Question: Is there a difference between coding metacarpopha­langeal joint arthroplasty an... Read more
Reader Question:
Get Hip to Auditors’ Patient Status Rules
Question: Our practice was recently audited, and an established patient visit was marked a... Read more
Reader Question:
Write Off Risk Level Concerns With This Advice
Question: I'm trying to determine the level of risk in the following encounter: a patient ... Read more
Surgery:
Get Anatomy, Procedure Type Right for These Foot Fractures
 Calcaneal, talus fractures are similar, but not identical. There are many procedure... Read more
Case Study Corner:
Use These Clinical Examples to Paint Hip Replacement Picture
1 expert coder + 1 surgeon = coding gold. When you get the chance to pick the brain of so... Read more
Compliance:
Employ These Tips to Stay Out of Auditors’ Crosshairs
Hint: Look for the same patterns CMS is seeing. If the word on the street is that the lat... Read more
You Be the Coder:
Don’t Let ICD-10 Terminology Spur Confusion
Question: After a level-three evaluation and management (E/M) service for a new patient, t... Read more
Reader Question:
Follow These Consult Rules in 2019
Question: What is the difference between an office consultation and an inpatient consultat... Read more
Reader Question:
Check Laterality on ESIs
Question: I have some questions about coding for epidural steroid injections (ESIs). Patie... Read more
Reader Question:
Interpreter Won’t Always Mean More MDM Points
Question: We recently took on a new patient who is deaf. The patient came with a family me... Read more
Reader Question:
Keep Up With MBI Requirements for Medicare Px
Question: We have posted everything available from the Centers for Medicare and Medicaid S... Read more
Reader Question:
Dig for Details on Spinal CT
Question: Encounter notes indicate that the provider performed a computed tomography (CT) ... Read more
Surgery:
Write Off Wrist Arthrodesis Coding Worries With This Advice
Check for graft before choosing code. Patients who report to the orthopedist with wrist i... Read more
CPT® Coding:
Get the Whole Story on Subcutaneous FBRs
Incision a must for any FBR claim. Orthopedic practices are most often focused on fixing ... Read more
Modifier Madness:
Use These Tips on ‘The 5’ Modifiers to Code Successfully
Correctly I.D. situations for use of modifiers 51, 54, 57. Have you ever misused a modifi... Read more
You Be the Coder:
Straighten Out Arthrography Knowledge for X-ray Success
Question: Notes indicate that the orthopedist performed an elbow X-ray examination along w... Read more
Reader Question:
Use These Tips for Spontaneous Rupture Dx
Question: Notes indicate that the orthopedist performed a level-three evaluation and manag... Read more
Reader Question:
Knowledge Is King on Critical Care Bundles
Question: I am new to coding. Can you help me understand what constitutes as critical care... Read more
Reader Question:
Dig Into Details on Decompression Fasciotomies
Question: Notes indicate that the provider performed a decompression fasciotomy on a ... Read more
Surgery:
Stay Current With Partial, Total Hip Replacement Coding Rules
Use this code when the procedure includes femoral stem, neck only. High-dollar surgeries ... Read more
Clip & Save:
Use Evidence of Prior Tx, Proper Dx to Cement Hip Replacements
Some payers want to see what you've done before opting for 27125, 27130. Coders that are ... Read more
E/M Coding:
Keep New/Established Patients Straight With This Refresher
Remember, it's not just the 3-year rule you need to apply. There is a myth in the coding ... Read more
You Be the Coder:
Debridements and Fracture Treatment
Question: The orthopedic surgeon is treating a patient with an open transverse radial shaf... Read more
Reader Question:
Discern Diagnostic From Surgical on ACL Procedures
Question: Operative notes indicate that the surgeon performed a level-four inpatient offic... Read more
Reader Question:
Remember Separate Code for Wrist Arthroscopy
Question: Notes indicate that the orthopedist performed an arthroplasty on a patient's spr... Read more
Reader Question:
Get Percentages Right on Acromioclavicular Dislocations
Question: Notes indicate that the orthopedist performed a level-three evaluation and manag... Read more
Reader Question:
Avoid Billing Workers’ Comp for Non-Work E/M
Question:  A 66-year-old Medicare patient came into our office after injuring an arm ... Read more
2019 Fee Schedule:
CMS Sets Sights on Reducing Provider Paperwork
‘Patients over Paperwork' takes it up a notch this year. In 2017, CMS started its “Pa... Read more
E/M Q&A:
Optimize Coding With ED, Office E/M Smarts
Scouring the claim to see if ED E/M patient is new or established? Don't bother. Filing e... Read more
Study Coding:
Remember Latency Length, and You’ll Be OK on EPs
Master evoked potential base codes, then move on to specifics. Patients presenting for an... Read more
Reader Question:
Keep I&Ds;, FBRs Separate
Question: What is the difference between an incision and drainage (I&D) and a foreign ... Read more
Reader Question:
Don’t Get Caught Off-Guard by Spontaneous Dislocations
Question: What is a spontaneous hip dislocation, and how do you code surgeries for th... Read more
Reader Question:
Keep Updated on New Codes Each Year
Question: After a level-three evaluation and management (E/M) service for a new patie... Read more
Reader Question:
Keep Office, Inpatient Consult Rules Straight
Question: What is the difference between an office consultation and an inpatient consultat... Read more
You Be the Coder:
Try Coding This E/M, X-ray, Rib Fix Scenario
Question:  An established patient reports to the orthopedist complaining of severe ri... Read more