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Orthopedic Coding Alert

Hips:
Help - Don't Hinder - Your Total Hip Replacement Recording By Following This Expert Advice
Never skip the underlying cause, infections, or dislocations. If you’re overlook... Read more
Unlisted Procedures:
3 Tips Help You Use Unlisted Codes - Without The Hassle
Here’s why using plain English to describe the service matters.  As you alr... Read more
ICD-10-CM:
Adjust How You Report Osteoarthrosis in 2014 Based on 3 Criteria
ICD-10 no longer has group unspecified locations alongside the specific locations for ea... Read more
Reader Question:
Define ''With or Without' In a CPT® Descriptor
Question: What exactly does “with or without internal or external fixation” ... Read more
Reader Question:
Assess PHI Risk With 6 Questions
Question: I’m always concerned about protecting our patients’ health informa... Read more
You Be the Coder:
Modifiers Make All the Difference for Multiple Shoulder Scopes
Question: An orthopedist in my practice arthroscopically repaired a rotator cuff on the ... Read more
Hand:
Think Twice Before Appending Modifier 22 to This Hand Surgery Case
Look for clues in the op note to signal the surgeon’s extra work. Little-known f... Read more
E/M:
Navigate the New-Versus-Established-Patient Maze With Expert Tips
Different locations, same physician? Use established patient codes. When reporting man... Read more
Ulna Boot:
6 Expert Steps Give Unna Boot Denials the Boot
Follow our experts’ 6 simple steps for strapping success. With just one CPT®... Read more
ICD-10:
Check Out How 717.7 Expands in 2014
Pay attention to the laterality of this condition. Chondromalacia patellae (CMP) is pa... Read more
Reader Question:
Latch on to This Liner Exchange Coding Advice
Question: Our surgeon plans to perform an arthroscopy and a liner exchange of a previous... Read more
Reader Question:
Perform a Sacrococcygeal Injection? Use 20605
Question: What’s the proper way to code a sacrococcygeal joint injection? Mich... Read more
Reader Question:
You May Need 2 Codes for Routine Hip Follow-Up
Question: Which diagnosis code should we report for a patient who comes in for a routine... Read more
Reader Question:
Figure Out How to Code Splinting/Strapping Services
Question: What are the keys to deciding when to report splinting and when to report stra... Read more
You Be the Coder:
Depend on 1 Unit for Deep and Superficial I&D
Question: Which codes should we report for an incision and drainage of a lumbar wound th... Read more
CPT® 2014:
Perfect These New Prosthesis Removal and Chemodenervation Codes Before Jan. 1
Overlooking these revised descriptors could land your claim into limbo. The American M... Read more
ICD-10:
Pinpoint Your Rib ICD-10-CM Fracture Code Using This Chart
Don’t overlook your “bilateral” option for a multiple rib fracture sit... Read more
Anatomy Corner:
Go In-Depth With the Structure of the Human Bone
This ICD-10 example shows you why you should know these terms. Bone comprises of a rig... Read more
Reader Question:
Splitting the Reimplantation of THR? Do This
Question: One of our orthopedic surgeons did a planned reimplantation of a total hi... Read more
Reader Question:
Debridement Requires This Documentation
Question: May I bill debridement if the physician documents no gross contamination?... Read more
You Be the Coder:
Billing an E/M Service With FNA of Bone Lesion
Question: Our payer is denying a claim involving an E/M and a fine needle aspiratio... Read more
Knee:
Kick Your Knee Surgery Payment Into Gear With These Expert Tips
Hint: Precertification does not address coverage issues. Knee surgery remains one of t... Read more
Clip 'n' Save:
Apply the Accurate Knee Repair Codes With This Chart
Match the site to the documentation and you’ll choose the right code every time. ... Read more
Surgical Assists:
PA Assisting at Surgery? Follow These Steps to Bill Properly
Differentiate modifiers AS and 80 for billing success. When PAs serve as first assista... Read more
ICD-10:
Some Worker's Comp Insurers May Opt out of ICD-10, CMS Says
But Medicare and Medicaid plans will not give you an extension past Oct. 1, 2014, the ag... Read more
Reader Question:
Submit One Cast Supply Code Unit Per Cast
Question: Should we use supply code Q4010 as one unit, or can we report multiple units? ... Read more
Reader Question:
Beware "Separate Procedure" Codes for Rigid Mallet Toe Treatment
Question: A patient came into the office with a rigid mallet toe. How will my physician ... Read more
Reader Question:
Chondroplasties Are Inclusive to Meniscectomies
Question: What percentage of the meniscus must the surgeon remove before we should bill ... Read more
Reader Question:
Straighten Out Levels Versus Interspaces
Question: If the surgeon fuses vertebrae L1 through L3, should I report 22612, 22614; or... Read more
You Be the Coder:
Pinpoint Triceps Repair Code Options Here
Question:  How should I code a triceps repair? Should I use the biceps code (24342)... Read more
Foot:
Heed This Advice and Cross the Finish Line To Heel Spur Treatment Claims Success
Rule out fracture, check for casts and orthotic devices. If you’re reporting hee... Read more
Brush Up on Heel Spurs
Heel spur, also called calcaneal spur, may be caused by the tears in the origin of the p... Read more
Workers Compensation:
Standardize Your WC Processes With 3 Tips
Successful WC reimbursement starts long before the claim gets filed. Even if most of y... Read more
Modifiers:
Use This E/M Modifier Cheat Sheet to Bill Correctly Every Time
Learn the criteria you have to meet. If you’re often mixing up your E/M modifier... Read more
ICD-10:
Effusion of Joint Receives an Effusion of ICD-10 Codes
Focus on left, right for the new 2014 diagnoses. Joint effusion (not to be confused wi... Read more
Reader Question:
Uncover This Arthroscopy, Meniscectomy Solution
Question: My orthopedist performed an unusual surgery of an arthroscopy and partial medi... Read more
Reader Question:
Apply Modifier 22 for ACL Revision
Question: My orthopedist did an ACL repair on a patient several years ago. The graft fai... Read more
You Be the Coder:
Extra Compensation for Obese Patient Case
Question: Recently, our surgeon performed spinal fusion (22630) on an extremely obese pa... Read more
Spine:
Get Smarter In Reporting Spinal Instrumentation
Tip: Distinguish removal and reinsertion. To ensure reimbursement for spinal instrumen... Read more
Op Note:
If Hand Surgery Dissection Isn't 'Unusual,' Don't Append Modifier 22
Tip: Lump the exploration of the radial or ulnar arteries in with the global service. ... Read more
E/M:
Don't Let 3 EHR Pitfalls Compromise Your E/M Coding
These mistakes may cost your practice money and set you up for payer scrutiny. Many or... Read more
ICD-10:
No Need to Stick Your Neck Out When Choosing Chronic Neck Pain Code in 2014
ICD-9 and ICD-10 codes share a common descriptor. Chronic pain the neck is a common di... Read more
Reader Question:
Don't Automatically Combine ER and Office Visits
Question:If a patient was seen for an office visit (99214) first and then later on the s... Read more
Reader Question:
How Should We Report Open Capsular Shift?
Question: Our surgeon performed an anterior reconstruction of the shoulder with a capsul... Read more
Reader Question:
Avoid Modifier 50 for TPIs
Question: How should I report bilateral trigger point injections in three locations for ... Read more
Reader Question:
Confirm Fracture Care Vs. Excision
Question: Our surgeon recently diagnosed and treated a left thumb accessory ossicle frac... Read more
Reader Question:
Ask, Was This a Decompression or Bony Lesion?
Question: One of our physicians performed a partial corpectomy at T-11 and a partial cor... Read more
Reader Question:
Show Your MD 4 Arthroscopic Tibial Repair Code Options
Question: Our surgeon repaired a proximal tibial fracture using the scope. Is there a pr... Read more
Reader Question:
Consider 27630 for Achilles Lesion Excision
Question: Our surgeon documented an excision for thickening of the Achilles tendon, and ... Read more
You Be the Coder:
Discover Whether to Report Fluoro Per Site
Question: We have a fluoroscopy machine in our office, and we bill 76000 when the surgeo... Read more
Tactics Take The Stress Out Of Your Nerve Repair Reporting
Tip: Don’t get tied up counting sutures. Capturing all your deserved pay for ha... Read more
Apply This Expert Advice For Spinal Instrumentation Claims Success
Location and levels lead you to the correct code. When reporting spinal instrumentatio... Read more
CCI 19.1:
Watch These Edits In Epidural And Chemodenervation Procedures
Tip: Check for procedures like pacing electrode and central venous catheter insertion,&n... Read more
Reader Question:
Confirm Laterality to Specify Distinct Procedures
Question: Our surgeon did an open treatment of femoral shaft fracture with screw inserti... Read more
Reader Question:
Check Excision Diameters on Claim
Question: When reporting excision of benign lesions, how do we measure the excision diam... Read more
Reader Question:
Each Hand Procedure Can Fetch You Payment
Question: In a patient with rheumatoid deformity in the right wrist, our surgeon did th... Read more
Reader Question:
Don't Overlook Elbow Procedures
Question: In a patient who was diagnosed with chronic right lateral epicondylitis and ra... Read more
You Be the Coder:
Count Muscles for Trigger Point Injections
Question: In a patient who sustained whiplash injury in a road traffic accident, our ED ... Read more
Coding Strategies:
Adopt These Winning Strategies to Finesse Your Wrist Arthroscopy Coding
Do not miss the repair when your surgeon does one. You’ll stand a better chance ... Read more
Coding Tips:
Defeat Coding Problems For De Quervain's Syndrome
Hint: Injections and incisions guide your reporting. You can take the tension out of y... Read more
Coding Insights:
3 Steps to Sharpen Your Skills For Strapping Codes
Hint: Checking materials helps your claims. A simple treatment like strapping could re... Read more
Reader Question:
Check for Sinus Tracts with Nodule Excision
Question: Our surgeon excised rheumatoid nodules on the right and left elbows. The nodul... Read more
Reader Question:
Internal Fixation May Be Inclusive In Open Ankle Repair
Question: Our surgeon documented a diagnosis of left ankle Weber C fracture in lateral m... Read more
You Be the Coder:
Earn For Each Repair in Shoulder
Question: Our surgeon wants to report two units of 23410 (Repair of ruptured musculotend... Read more
Coding Strategy:
Master Hand Mass Excisions With These Tips
Confirm location, incision, and synovectomy, if any. Reporting nodular masses in the h... Read more
Coding Tips:
Refine Your Post-Op Infection Coding With These 3 Examples
Hint: Global period and modifiers help you avoid the guesswork. You could be sabotagin... Read more
ICD-10 Update:
Closed or Open Guides Your Patellar Fracture Reporting
Look at type of open fracture, ignore morphology and laterality. Don’t let elabo... Read more
Determine Type Of Open Patellar Fractures
Since the ICD-10 codes for open fracture depend upon the type of fracture, it is good to... Read more
Reader Question:
Best Choice for Rheumatoid Nodule Excision is 28043
Question: How do we claim for excision of rheumatoid nodule in the metatarsal bone. The ... Read more
Reader Question:
26540 Is Specific To Hand Collateral Ligament Repair
Question: In a patient diagnosed with left thumb chronic MCP radial collateral ligament ... Read more
Reader Question:
Confirm Debridement and Decompression in Shoulder Arthroscopy
Question: In a patient diagnosed with posterior labral tear, subacromial bursitis with i... Read more
Reader Question:
You Have Common Code for Dorsal/Volar Wrist Ganglion Excision
Question: In a patient who was diagnosed with right wrist dorsal ganglion and underlying... Read more
Reader Question:
Determine Extent in Bone Debridement
Question: A post ankle arthroplasty patient presented with hindfoot pain and impingement... Read more
Reader Question:
Count On All Procedures for Loose Body Removal in Knee
Question: In a patient diagnosed with multiple loose bodies in the knee, lateral meniscu... Read more
Reader Question:
Report 29916 For Labral Repair
Question: The diagnosis reported by our surgeon includes the following: 1.  ... Read more
You Be the Coder:
Document Pathology for Tendon Ruptures
Question: Our surgeon repaired a bimalleolar fracture and the posterior tibial tendon. T... Read more
Coding Strategy:
Heed This Advice And Cross the Finish Line To Heel Spur Treatment Claims Success
Rule out fracture, check for casts and orthotic devices. If you’re reporting hee... Read more
Coding Tips:
2 Strategies Upgrade Your Post-Op Infections Reporting
Payers and modifiers deserve special attention. You could be forfeiting legitimate rei... Read more
Brush Up on Heel Spurs
Heel spur, also called calcaneal spur, may be caused by the tears in the origin of the p... Read more
ICD-10 Update:
Simple Tips For Success In Infected Surgical Wounds Diagnosis Reporting
Hint: Identify the infection and document an infected device, if any. When selecting t... Read more
Reader Question:
Never Miss Any Component in Hand Repair
Question: Our surgeon did repair of the right median nerve, right ulnar nerve and the ri... Read more
Reader Question:
Earn For Both Tendon and Nerve Repairs in Hand Procedures
Question: Our patient had complete laceration zone 2 of middle and ring flexor digitorum... Read more
Reader Question:
Clarify Extent of Excision in Finger Tendons
Question: Our surgeon removed half of the sublimis in the patient’s finger in Sept... Read more
Reader Question:
Report both Meniscal and Articular Shaving in Knee
Question: Below is the operative note that describes the procedures our surgeon did on t... Read more
Reader Question:
Nonunion May Call For Excision
Question: Please provide the ICD-9 and CPT codes for the following: Diagnosis: 1. Nonu... Read more
You Be the Coder:
Report Both Tendon Repair and Joint Fusion
Question: In a patient who was injured by a power saw, our surgeon diagnosed a laceratio... Read more
Coding Tips:
Step Up Your Heel Bone Fracture Coding Skills
Best bet: Confirm closed, open, or percutaneous treatment. Calcaneal fractures (heel b... Read more
ICD-10 Update:
Report Non-traumatic Rotator Cuff Tears With Confidence
Laterality guides your choice for partial and complete tears. When you report non-trau... Read more
CCI Update:
Latest CCI Edits Allow You To Report Nerve Conduction As Distinct Procedure
You can report nerve conduction with biopsy, injections, and arthrocentesis. The most ... Read more
Reader Question:
Turn to Unlisted for Thermal Shrinkage of Ligament
Question: How do we report a left wrist arthroscopy and thermal shrinkage of scapholunat... Read more
Reader Question:
Be Vigilant About Documentation for 29806, 29807
Question: Our surgeon did a superior labral repair with a separate posterior labral repa... Read more
Reader Question:
Turn To Unlisted For Biceps Tenotomy
Question: For a patient diagnosed with bicipital tendonitis and left shoulder impingemen... Read more
Reader Question:
Check for Other Procedures with Foreign Body Removal
Question: The patient was diagnosed with retained foreign body, right index finger, with... Read more
You Be the Coder:
Confirm Complications in Hardware Removal
Question: In a patient who has previously undergone ‘closed reduction and percutan... Read more
Coding Strategies:
Count Your RVUs When Reporting Multiple Fractures
Apply this sequencing advice to ethically maximize reimbursement. Not paying attention... Read more
ICD-10 Update:
Justify Your Choice of Jones Fracture Code in ICD-10
Confirm side of foot and displacement of fracture. ICD-9 offers only a single code for... Read more
What is Jones Fracture?
Jones fracture is a diaphyseal fracture of the fifth metatarsal bone of the foot. This f... Read more
2013 CPT® Update:
Descriptor Revision Opens Up 20665, 28890 Reporting for 2013
Tong removal and extracorporeal shock wave become less specific for physician services. ... Read more
Reader Question:
Charge Together For Observation and Fracture
Question: Our orthopedist gave orders to do an inpatient admit for a patient previously ... Read more
Reader Question:
Report Trochanteric Bursectomy as Unlisted
Question: What CPT® code do we report for ‘arthroscopic trochanteric bursectom... Read more
Reader Question:
Excision for Osteomyelitis Foot Has a Specific Code
Question: In a patient diagnosed with osteomyelitis of left second metatarsal bone, our ... Read more
Reader Question:
Report Multiple Units of 28485 for Lisfranc Injury
Question: In a patient diagnosed with Lisfranc injury in the left foot, the following pr... Read more
Reader Question:
Synovectomy Encompasses Ganglion Excision In Hand
Question: In a patient diagnosed with synovitis with first dorsal compartment tendinitis... Read more
Reader Question:
Confirm Provider and Global Period for AminoMatrix Injection
Question: A patient who underwent ulnar osteotomy came in for an injection of AmnioMatri... Read more
You Be the Coder:
Hardware Removal is Inclusive of Debridement and Irrigation
Question: In a patient who was diagnosed with a finger infection ten days after ope... Read more