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Orthopedic Coding Alert

CPT® Coding:
Follow These Debridement Rules for Maximum Payment
Multiple debridements can mean multiple codes … sometimes. When your orthopedic surgeon... Read more
Modifiers:
Hand In Claims With Finger/Toe Modifiers, When Required
If you sleep on these modifiers, it could end up costing you. In general, orthopedic prac... Read more
E/M Coding:
Keep Payers' HPI Elements Straight for Accurate Coding
Duration is an HPI element … except when it isn’t. Anyone who has to file a code for ... Read more
Reader Question:
Employ 'Other' Classification for Some Spondylopathies
Question: The orthopedist performs a level-two evaluation and management (E/M) service for... Read more
Reader Question:
NGS Launching NPP-Related 'Patients Over Paperwork' Drive
Question: I have heard a lot about the latest push by Medicare to stress “patients over ... Read more
Reader Question:
Count Negatives for Positive ROS Coding
Question: Can we count a “complete” ROS when the surgeon includes a statement such as ... Read more
You Be the Coder:
Reporting Monteggia Type Fracture Fixes
Question: I have a claim in front of me that is completely bewildering. Notes indicate tha... Read more
News You Can Use:
Proposed PFS Rate, E/M Level Assignment Highlight CMS Release
There’s not much of a hike to proposed 2019 fee schedule rate. CMS released its proposa... Read more
Testing:
Unlock the Mysteries of MRI Coding With These Tips
Anatomy, guidance questions play a big part in correct coding. Before deciding on a treat... Read more
E/M Coding:
Use 99211 Correctly for E/M Success
Check out these rules for reporting E/M without a physician present. Even the most skille... Read more
Reader Question:
Get on the Level for Correct Debridement Add-On
Question: During the course of treating a patient who was in an automobile accident, our o... Read more
Reader Question:
Keep Pathological, Recurrent Separate with These Tips
Question: For ICD-10-CM coding purposes, what is the difference between unclassified patho... Read more
You Be the Coder:
Dx Coding for Ankle, Fibula Fractures
Question: Our orthopedist performed a three-view ankle x-ray for a left, displaced lateral... Read more
ICD-10-CM Update:
Code Set for 2019 Includes Expanded Myalgia Options
Remember, ICD-10-CM 2019 begins on October 1, 2018. The final list of ICD-10-CM codes for... Read more
Procedures:
Walk Correct Coding Path With Clavicular Fractures
Remember difference between open and closed treatments. Patients presenting to the orthop... Read more
E/M Coding:
Check Provider Before Choosing Prolonged Services Codes
Remember to choose different codes for clinical staff. When your orthopedic practice sees... Read more
Reader Question:
Make Sure E/M's Unrelated for Modifier 24
Question: A patient has a diagnosis of bilateral carpal tunnel syndrome, right worse than ... Read more
Reader Question:
Ace CCI Edit with Exclusive, Unlikely Knowledge
Question: The Correct Coding Initiatives (CCI) is an enigma to me; I have a lot of trouble... Read more
Reader Question:
Watch Out for Different Lateral Release Codes
Question: Operative notes indicate that after a level-four evaluation and management (E/M)... Read more
Reader Question:
Employ Education to Cut PHI Breaches
Question: What can I do to make sure our practice stays current on best practices to avoid... Read more
You Be the Coder:
Ankle Pain Diagnosis Coding
Question: A patient reported to our practice complaining of pain in the right ankle region... Read more
CPT® Coding:
Dodge Denial Bullet with Arthrocentesis/Aspiration/Injection Advice
Here's why anatomy is so important to correctly coding these claims. When you're coding f... Read more
Scrubbing the Claim:
Don't Miss Multi-Code Chances on Arthrocentesis/Aspiration/Injection
Pre-procedure E/M could increase your code count. When your orthopedist performs arthroce... Read more
CPT® Coding:
Know Your Levels, then Code these Facet Joint Injections
Remember: Cervical/thoracic, lumbar/sacral shots might be multi-code encounters. Patients... Read more
Modifiers:
Using 24 Gets Easier with this FAQ
Recoup money for E/Ms unrelated to postop with this modifier. How to use modifier 24 is o... Read more
Reader Question:
Get More Detail for Discitis Dx
Question: During the course of a level-two evaluation and management (E/M) service for a n... Read more
Reader Question:
History Knowledge Vital for E/M Chart Coding
Question: When coding a chart for an evaluation and management (E/M) service, how do we kn... Read more
You Be the Coder:
Choosing Fracture Fix Code
Question: How should I code for closed treatment of a humeral shaft fracture? My orthopedi... Read more
Surgery:
Stay on Your Toes with this Achilles Repair Coding Advice
Here's why a graft is a major detail in any Achilles op report. When a patient suffers a ... Read more
FAQ:
Keep Compliance Concerns at Bay with Incident-to Smarts
Medicare benefit can maximize your payouts. Orthopedic practices that provide services in... Read more
ICD-10:
Fill in Whole Dx Picture with Chapter 20 Codes
Reporting external causes pinpoints condition, can improve patient outcomes. While it's t... Read more
Reader Question:
Guidance Type Matters on Arthrocentesis Claims
Question: Our orthopedist performed an arthrocentesis injection on a patient's left ring f... Read more
Reader Question:
Save Room for 7th Character on Crush Injuries
Question: The orthopedist performed a level-three evaluation and management (E/M) service ... Read more
Reader Question:
UHC Now Demands this Modifier for Some NPP Claims
Question: We've been having some problems with payment for our nonphysician practitioners ... Read more
Reader Question:
New CMS Program Aims to Simplify EHR Regs
Question: What do I need to know about the MyHealthEData initiative recently announced by ... Read more
You Be the Coder:
Master Subluxation Subtleties for Optimal Dx Coding
Question: Our provider had her first office visit with a patient who has a recurrent patel... Read more
Shoulder Surgery:
Keep Your Options Open on Shoulder Arthroscopies
Note surgical technique to avoid coding confusion. Patients presenting to the orthopedist... Read more
Compliance:
ABNs Are Handy for Medicare ... and Some Private Payers
When there's an issue with payment, ABN can be your friend. Most practices providing serv... Read more
ICD-10 Coding:
Look to these Rib Fracture Dx Codes for Open/Closed Fixes
Remember the S22.--- codes for breaks. Orthopedic practices that treat patients for rib f... Read more
Reader Question:
Check Out this Change to Student E/M Documentation Rules
Question: Our physicians often complain about having to re-document the elements of evalua... Read more
Reader Question:
Scrub Notes to Unlock this Myositis Mystery
Question: Our orthopedist documented that a patient was suffering from pain, swelling, ten... Read more
Reader Question:
Use these 2 E/M Modifiers Together ... Sometimes
Question: Can you ever report modifiers 24 and 25 on the same claim? Ohio Subscriber Ans... Read more
Reader Question:
Choose Flexor Tendon Fix Code Carefully
Question: What code should I use for extensor tenosynovectomy of the hand/fingers? Notes i... Read more
Reader Question:
Narrow Hamstring Tenotomy Choices to this Code Trio
Question: Operative notes indicate that my orthopedist performed a knee-to-hip hamstring t... Read more
You Be the Coder:
Dig for Arthrodesis Details
Question: Operative notes indicate that the provider performed tarsometatarsal arthrodesis... Read more
Knee Surgery:
Ace ACL Claims with these Tips
Look for evidence of arthroscopic aid on 29888 claims. For professional athletes, weekend... Read more
Knee Surgery:
Know Your Anatomy Front and Back for Cruciate Ligament Repairs
ACL, PCL repairs are different sides of the same coin. When most people think of knee inj... Read more
E/M Coding:
Observe Different Rules for Medicare, Private Payer Consults
You can't use CPT® codes for Medicare consults. When your orthopedist is called for a co... Read more
Modifiers:
Experts: G Modifiers Gaining Steam Toward Mainstream
GA is now required by many Medicare payers to indicate ABN. When your provider performs a... Read more
Reader Question:
Determine Site for Definitive Debridement Documentation
Question: One of our patients was recently involved in a skateboard accident, which result... Read more
Reader Question:
1 Code Covers Aspiration, Injection of Same Joint
Question: How do I code a scenario in which the provider performs a knee aspiration and th... Read more
You Be the Coder:
Go to 7th Spot for Fracture Dx
Question: Noted indicate that the orthopedist treated a patient with a closed oblique frac... Read more
CCI:
Heed Hammertoe Edit on Capsulotomies
New edit sports modifier indicator of '1.' To kick off 2018, let's take a look at a late-... Read more
FAQ:
Know Your Open/Closed Rib Fracture Fix Codes
Incision key in coding these scenarios correctly. When patients report to the orthopedist... Read more
E/M Coding:
Use Targeted ROS Advice, Zero in on Correct Code
This FAQ sheds light on common system review problems. A key component to most evaluation... Read more
Reader Question:
Remember 25 for your E/M/Injection Encounters
Question: Encounter notes indicate that the provider performed a level-four evaluation and... Read more
Reader Question:
Prove Previous Tx Attempts on CT Appeal
Question: Three months ago, our provider saw a patient complaining of wrist pain, a burnin... Read more
Reader Question:
NPI Leads the Way to Part A/B Decision
Question: The hospital admitted a Medicare patient three days ago, and she underwent emerg... Read more
Reader Question:
Lean on this List for PFSH Conundrums
Question: Can you give me an example of pertinent past, family, and social history (PFSH) ... Read more
You Be the Coder:
Go Deep into Details for Specific Limb Length Dx
Question: Notes indicate that the provider performed a level-three new patient evaluation ... Read more
Fracture Care:
Freshen Up Your Fracture Terminology Acumen with this FAQ
Remember, open and closed fracture knowledge essential. Orthopedic coders will be dealing... Read more
Injection Coding:
Stay Sharp to Ace Trigger Point Claims
Providers can perform TPIs for various ailments. Patients in pain will often require trig... Read more
Compliance:
Adhere to Locum Tenens Rules for 'Substitutes'
Replacement physicians often sub for providers on leave. Just about every orthopedic prac... Read more
Reader Question:
Don't Fall for this Prolonged Services Myth
Question: Can you report prolonged services with any level of evaluation and management (E... Read more
Reader Question:
Use Long-Arm Splint Code for Elbow Injury
Question: A young athlete came into our office with a sprained elbow he received while pla... Read more
Reader Question:
Check for E/M on this I&D Encounter
Question: One of our established patients with diabetes recently competed in a marathon. S... Read more
You Be the Coder:
X-Ray Coding Rules
Question: For an x-ray that included three shoulder views, our coder reported 73020 (one v... Read more