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Orthopedic Coding Alert

Weather This Wrist Fracture Coding Case Study With Expert Advice
Warning: One documentation slip could lead to a $230 mistake. You could be setting you... Read more
Here's How to Avoid Double-Billing Interp Claims
You may not always be able to report CPT® code, but discover this big benefit. Whe... Read more
Have Complication Claims? Study Modifier 78 Guidelines
Don’t shortchange your “return to the OR” fee. When complications fr... Read more
Do You Know How to Report Olecranon Bursitis? Find Out
Don’t miss these ‘Excludes’ notes. Olecranon bursitis is the inflamm... Read more
Reader Question:
Here are the Codes You Need for New, Recurrent HNP
Question: Our physician performed surgery due to recurrent HNP at L5-S1 and a new HNP at... Read more
Reader Question:
Always Check Codes Before Counting Synovectomy Compartments
Question: The orthopedist completed a three-compartment major synovectomy, medial and la... Read more
Reader Question:
Nail Down Supervision Levels
Question: Our carrier asked us to verify that our tech performed a patient’s elbow... Read more
You Be the Coder:
Here's How to Use a Modifier for Separate Plates
Here’s How to Use a Modifier for Separate Plates Question: Our orthopedic surgeo... Read more
Stay in the Game With the Correct Ligament Repair, Reconstruction Codes
Remember ligament repair abbreviations to simplify elbow ligament surgery coding. If c... Read more
Protect Your Epidural/Spinal Injection Pay With ABNs
Heres when to append modifiers GA, GY, and GZ. Services a patients insurer doesn&rsquo... Read more
Here's How to Capture Carpal Tunnel Coding With Your New Diagnosis System
Don’t miss this Excludes1 note under the G56 category. When your orthopedist tre... Read more
Reimbursement News:
Look Beyond Code Changes to Billing and Policy Updates
CMS pulls back on some proposed changes. With ICD-10 and CPT® code changes on the ... Read more
Reader Question:
CMS's Billing Software Won't Eliminate ICD-10 Conversion
Question: I have heard that Medicare has created free billing software that will le... Read more
Reader Question:
Resolve Secondary Payer Issues With Conversations
Question: Our doctor performed surgery on a patient 11 months ago. We just learned ... Read more
Reader Question:
Tackle 25606 and 25607 Bundle
Question: One of our physicians did an “open reduction and percutaneous pinni... Read more
You Be the Coder:
Clear Away Your Debridement Questions
Question: May I bill debridement if the physician documents no gross contamination?... Read more
2016 Update:
Prepare To Embrace These Epidural Code Revisions in 2016
CPT® 2016 will revise fluoroscopic guidance instructions and also introduce new code... Read more
Steer Your Spinal Bone Graft Claims Towards Success With These Tips
Graft source and extra services are your keys to correct codes. Coding for spinal bone... Read more
News You Can Use:
Move Beyond ICD-10 Implementation, But Don't Stop Training
Continue to stress coder/provider cooperation for success. While you can breathe a sig... Read more
Recognize the Positive Impacts ICD-10 Brings to Your Practice
Hard copy resources may make your job easier. Even though Oct. 1 has passed, your prac... Read more
Reader Question:
Check With Your WC Payers Before Using ICD-10
Question: I have heard I won’t use ICD-10 for workers’ compensation rel... Read more
Reader Question:
Confirm Structure Affected In Neck Sprain
Question: Which are the best ICD-10 codes do you report for sprain in cervical regi... Read more
You Be the Coder:
Budin Toe Splint
Question: What supply code should we report for a Budin toe splint (toe straightene... Read more
External Fixation:
Highlight These Key Terms To Choose Between 20690 and 20692
Do this when you see “ring fixation” mentioned. If your surgeons use the t... Read more
Boost Your Bone Biopsy Claim Accuracy With These 3 Strategies
Pay attention to the term “open” in CPT® descriptors. Are you confused... Read more
2 Scenarios Untangle Your Pathologic/Traumatic Fracture Code Diagnoses
Discover this new tool to help you ‘build’ a traumatic fracture code. If y... Read more
Here Are Your Seventh Character Possibilities for Fracture Codes
The first code (M84.551A) mentioned in the article “2 Scenarios Untangle Your Path... Read more
Reader Question:
Was the TP Was Available? You Need to Know
Question: What are the rules on teaching physicians being present during surgical p... Read more
Reader Question:
You Must Count Levels for Arthrodesis
Question: Should I report four units of arthrodesis when the surgeon fuses vertebra... Read more
You Be the Coder:
Check Out These Radiculopathy Codes in ICD-10
Question: What ICD-10 codes can we submit to report the diagnosis of lumbar radicul... Read more
Casts and Splints:
Conquer Cast and Splint Claims By Keeping 3 Key Factors in Mind
Tip: The cast is billable if you are not coding fracture care. When school goes back i... Read more
3 Scenarios Test Your Modifier 25 Know-How
Here’s what to do when the patient has an unexpected pain increase. To know when... Read more
Know What Services Are Included In Global Surgical Package? Find Out.
Count on preoperative, intraoperative, and postoperative services and care. Below are ... Read more
Your Stiffness in Joint NEC Options Expand After October 1
Don’t miss this Excludes1 note underneath M25.6. If you’re used to reporti... Read more
Reader Questions:
You Can Report Multiple E/Ms for Different Specialties
Question: Our practice has multiple specialties, including orthopedics, neurosurger... Read more
Reader Questions:
Modifier 55 May Mean a Coding Headache
Question: Our orthopedic surgeon is seeing a patient for follow-up visits after car... Read more
Reader Questions:
Be Careful with Supply Codes for Cervical Collar
Question: Can we code separately for fitting a cervical collar following closed treatmen... Read more
Reader Questions:
Follow CPT Assistant Advice for Proximal Hamstring Repair
Question: The surgeon performed a proximal hamstring repair and stated that, &ldquo... Read more
You Be the Coder:
Reverse Shoulder Arthroplasty
Question: Which code should we report for a reverse total shoulder arthroplasty? ... Read more
5 Tips Will Have You Acing Your ACL Claims
If your surgeons are using pain pumps, then consider it part of the surgery. As many a... Read more
Denials Management:
Bust 4 MUE Myths to Minimize Your Denials
If you ignore the medically unlikely edits, you’re asking for a claim rejection. ... Read more
Here's How Your Neuritis, Radiculitis Codes Will Change As Of Oct. 1
If the patient condition includes radiculopathy, do this.  Neuritis means a nerve... Read more
Reader Questions:
You Can Report Multiple E/Ms for Different Specialties
Question: Our practice has multiple specialties, including neurosurgery, neurology,... Read more
Reader Questions:
Submit Multiple Dx For Lumbar and Sacral Spine Subluxation
Question: A patient presents with a subluxation of the lumbar and sacral spine with... Read more
Reader Questions:
Bill DME Application to Insurer
Question: Our office has an outside durable medical equipment (DME) supplier that b... Read more
You Be the Coder:
Draw the Line Between Levels Versus Interspaces
Question: If the surgeon fuses vertebrae L1 through L3, should I report 22612, 2261... Read more
Deploy These Techniques to Avoid Traumatic Hip Dislocation's Hidden Traps
At $596 extra a pop, understanding ‘requiring anesthesia’ is worth the Are... Read more
ICD-10 Coding Quiz:
Navigate Your Neck Pain Diagnosis Options With This Quiz
Watch out: Not all conditions have a one-to-one match. Try answering these top questio... Read more
2 More Tips Will Hone Your Hip Dislocation Skills
Search beyond trauma codes for spontaneous and post-THR reductions. CPT® and ICD-9... Read more
ICD-10 Coding Quiz Answers:
Assess How Much Neck Pain ICD-10 Coding You Understand
ICD-10 offers more definitive codes for cervical spondylosis, stenosis, subluxation, and... Read more
Reader Questions:
New Injury Means Separate Encounter
Question:  Our physician saw and treated a patient for a scaphoid fracture. The pat... Read more
You Be the Coder:
New, Recurrent HNP Mean Multiple Codes
Question:  Our physician performed surgery due to recurrent HNP at L5-S1 and a new ... Read more
CCI 21.1:
Heed New Coding Edits Affecting Your Joint Injection Claims
Plus, steer clear of 77003 with common epidural insertions. CCI 21.1 went into effect ... Read more
2 Steps Simplify Your Arthrocentesis Services
Limit to one unit for every single joint. In the list of CCI Manual updates from CM... Read more
8 Steps to Take Right Now to Avoid Medical Identity Theft
Beneficiaries aren’t the only potential victims of this problem. As a medical pr... Read more
You Will Have to Become More Specific With 714.0 Starting October 1
Your physician likely already documents the location. Rheumatoid arthritis is a chroni... Read more
Reader Questions:
Make the Most of Multispecialty Visits
Question: I work in a practice that has multiple specialties such as orthopedic, ca... Read more
Reader Questions:
Define A Sagittal Band This Way
Question: Is a sagittal band in the metacarpal (MCP) area an extensor tendon? If the sur... Read more
Reader Questions:
Primary, Secondary Matters for Quad Tendon Repair
Question: How should we report a quadriceps tendon repair? Should we use the infrap... Read more
Reader Questions:
Report Unlisted for Medial Retinaculum
Question: What is the correct code for an open repair of the medial retinaculum? Th... Read more
Reader Questions:
Does Patient's Status Change E/M Level? Find Out
Question: My orthopedist’s notes indicate an expanded problem focused history... Read more
You Be the Coder:
Arthroscopic Excision of a Shoulder Bursa
Question: How should I code an arthroscopic excision of a bursa in the shoulder when sur... Read more
Orthopedic Billing:
4 Tips Ensure You Don't Forfeit Pay When Treating SNF Payments
Hint: Make sure you have the right POS for consolidated billing. You perform services ... Read more
Hand Surgery:
Try Your Hand at These 5 Surgery Coding Questions
From the finger to the wrist, these microsurgeries can be troubling to bill. You might... Read more
AMA, AAOS Voice ICD-10 Concerns
So far, Congress appears to support Oct. 1 implementation date. You may be furiously p... Read more
You Be the Code:
Look to State Guidelines for 90-Day Supplies
Question:  We have patients who have instructions from their employers to get a 90-... Read more
Reader Question:
Get to Know QSS 
Question: What is Quadrilateral Space Syndrome, and which ICD-9 code should I use t... Read more
Reader Question:
Same Day Hospitalization Only Bundled With Same Doc
Question:  My colleague said that if a patient is admitted to the hospital on the s... Read more
Are Your Intraoperative X-Ray Claims Setting You up for Fraud Accusations?
You can only report modifier 26 for these—if anything at all. If you perform x... Read more
Several Carriers Provide Modifier X{EPSU} Examples
Nail down your modifier 59 alternatives with these scenarios. CMS has been slow to o... Read more
Still Feeling ICD-10 Defiant? CMS Responds
If you’re feeling hesitant to adapt to ICD-10, it’s time to start planning. ... Read more
Reader Question:
Avoid Routine Write-Offs
Question: Our front office manager has been writing off a lot of patient copays and dedu... Read more
Reader Question:
Report Subsequent Hospital Care Per Day
Question: My doctor wants to bill for initial hospital care using 99221, as well as thre... Read more
Reader Question:
Modifier 22 Could Be Your Friend
Question: Our surgeon removed 56 antibiotic beads from a patient’s distal radius t... Read more
Reader Question:
Accurately Report Verruca Removal
Question: Our surgeon diagnosed a patient with a verruca formation on the right middle f... Read more
Reader Question:
Don't Feel Required to Tie Concussion to Unconsciousness
Question: We went to a seminar where they said to only report a concussion diagnosis cod... Read more
Reader Question:
Be Careful With Same-Side Facet Joint Injections
Question: We performed several facet joint injections and appended modifier 50 to repres... Read more
You Be the Coder:
Screw Removal Included in Revision
Question: Our patient underwent an open reduction/internal fixation (ORIF) of a mid-shaf... Read more
CPT 2015:
Make Specifics of U/S-Guided Arthrocentesis Part of Your Permanent Record
These new codes have very specific documentation requirements. You’re aware of t... Read more
CMS: Orthopedic Surgeons Struggle to Maintain Sufficient Documentation
The agency also points to major joint replacements as a sore spot. If your practice&rsquo... Read more
CMS Invites Practices to Join Upcoming ICD-10 Testing Rounds
Each MAC will choose 50 participants per session. If you were overlooked for the curre... Read more
Global Periods Will Be Gone By 2018
CMS will slowly phase out global surgical packages starting in 2017. Following through... Read more
Reader Question:
Second Surgical Group Doesn't Warrant Repeat Modifier
Question: Our patient’s hip prosthesis got infected and he presented to the O... Read more
Reader Question:
Can You Downcode to 99211 for Incomplete Documentation?
Question: A patient presented for a visit but the orthopedist failed to complete th... Read more
You Be the Coder:
Bunionectomy with Osteotomy? Payers Differ
Question: One of our physicians is trying to bill for a bunionectomy with 28292 (Co... Read more
Asking 6 Questions Clear Up Your Ankle Fracture Coding Confusion
Knowing the answers to these frequently asked questions could mean over $70 to your prac... Read more
Revise Codes To Rejuvenate your Coding For Common Intervertebal Disorders
Regions guide your coding for disc displacement, degeneration, disorders with myelopathy... Read more
Complete Your Compliance Plan By Following This Compliance Director's Advice
Here’s how to gain physician interest and cooperation. Last month, in the articl... Read more
Reader Question:
Your Orthopedic Surgeons Can Report ED Codes
Question: An emergency department physician asked our surgeon to see a Medicare pat... Read more
Reader Question:
Tack This Modifier On to Weekly Castings
Question: Which modifier should we report when we recast an infant each week to tre... Read more
Reader Question:
Don't Bill 99051 as Stand-Alone Code
Question: I have three questions about using 99051: 1. Should we use 99051 in add... Read more
You Be the Coder:
Discover If Aircasts Differ From Splints
Question: Does an aircast qualify as a splint? Kentucky Subscriber Answer: ... Read more