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Orthopedic Coding Alert

Ankles:
Amp Up Your Ankle Fracture Claim Success By Answering 6 Questions
Be sure your diagnosis specifies whether the fracture was open or closed. Are you scra... Read more
Modifiers:
Modifier 50 Is the Backbone to Your Bilateral Spinal Surgery Reimbursement
Ask your carriers how they want these surgeries reported to avoid reduced reimbursement.... Read more
E/M:
Benefit from These 4 Handy E/M Coding Tips or Lose Precious Dollars
Watch for chances to upcode the encounter. When reporting E/M encounters, you might en... Read more
Reader Question:
Verify Brace Fitting Purpose Before Billing
Question: Can we bill for a brace fitting prior to surgery? If so, what codes do we... Read more
Reader Question:
Multiple Units of 77002 May Cause Problems
Question:  When we perform multiple injections at the same time, can we report... Read more
You Be the Coder:
Reduction for Dislocation
Question: Our orthopedist completed a reduction in the office for a dislocation, pl... Read more
CPT® 2017:
5 Changes Will Update Your Sedation, Biomechanical Device, and Fracture Treatment Services
Plus: Don’t miss these biopsy, fluoroscopic guidance revisions. As you gear up f... Read more
ACL:
Score Points with Accurate ACL Coding With This Expert Advice
Start with 29888, but check global package and add-ons for your most complete claim. W... Read more
Global package:
Check Global Package and Graft Terminology Before Finalizing Your ACL Claim
Some extra services mean more codes — but many don’t. Don’t be too h... Read more
Reader Question:
Count Regions to Determine Debridement Level
Question: The physician’s notes state, “Bursal side rotator cuff showed... Read more
Reader Question:
No Modifier 26 for Your Own Equipment
Question: The physician used our X-ray equipment in the office to place the needle ... Read more
Reader Question:
Follow These Rules for Critical Care Claims
Question: CPT® states that a patient must be “critically ill or injured&r... Read more
You Be the Coder:
Check Out 28300 for Evans Procedure
Question: Our surgeon is a foot and ankle specialist, and he did an Evans procedure... Read more
CPT® 2017:
Get Ready to Apply New CPT® Codes For Spinal Procedures And Devices In the New Year
Location and image guidance are key to coding for spinal interlaminar injections. With... Read more
Casts:
Q4050 Could Boost Your Claim's Bottom Line — Here's How
But heed payers’ A and Q code preferences — or pay the price. Suppose a pr... Read more
ICD-10:
Medicare's 'Code Family' Clemency Has Ended
Denials could skyrocket if your specificity isn’t up to scratch. So you know CMS... Read more
Hips:
2 Tips Tell You How to Report Hip Dislocations
Search beyond trauma codes for spontaneous and post-THR reductions CPT® and ICD-10... Read more
Reader Question:
Define Trephination Before Coding This Scenario
Question: What is trephination, and how should I code for an arthroscopic knee trep... Read more
Reader Question:
Don't Use 99050 When Running Late — Here's Why
Question: If our office hours are 8 a.m. to 5 p.m., Monday to Friday, but the surge... Read more
Reader Question:
Avoid Fracture Care Code When No Fracture Present
Question: If our physician sees a patient in the office and dictates that the patie... Read more
Reader Question:
Go In-Depth With 'Maintenance Therapy'
Question: Our insurers don’t allow us to pay for “maintenance therapy.&... Read more
Reader Question:
October 2016 Brought New Postprocedure Haemorrhage, Hematoma Dx
Question: What are the changes for ICD-10 postprocedure haemorrhage codes for the s... Read more
You Be the Coder:
2nd Stage of THR Reimplantation
Question: One of our orthopedic surgeons did a planned reimplantation of a total hi... Read more
Scopes:
4 Strategies Will Help You Master the 'Multiple Scope' Rule
Coding 29805, 29806, 29807, 29819? Here’s what you need to know. Your orthopedic... Read more
Tools:
Check Out This Base Code Cheat Sheet
Find the ‘Base’ arthroscopic procedure fast. If you want to find the &ldqu... Read more
Documentation:
Avoid Making Your Nurse's History Note Into Audit Bait
The physician must indicate that he or she reviewed any nurse’s notes. Warning: ... Read more
Coding Quiz:
Test Yourself With Real-Life Modifier 25 Scenarios
See if you arrive at the same coding conclusions our experts recommend. You’ve g... Read more
Reader Question:
Highlight Your Options for Birmingham Resurfacing
Question: One of our surgeons says we should use a total hip code for Birmingham re... Read more
Reader Question:
For Instrumentation, Number the Vertebrae
Question: Our surgeon performed anterior cervical discectomy at C3-C4, C4-C5, and C... Read more
Reader Question:
Use This Modifier For Follow-Up for Another Doc
Question: Our orthopedic surgeon is seeing a patient for follow-up visits after car... Read more
You Be the Coder:
MRI of L5 Spine, Sacrum, and Coccyx
Question: How should I code “MRI of LS spine and sacrum and coccyx”? My... Read more
ICD-10:
Simplify Hundreds of Salter-Harris Fracture Diagnosis Code Changes
Pay particular attention to your sixth, seventh characters. If you look at the raw dat... Read more
Unlisted Procedures:
No Exact CPT® Code? Then, Use an Unlisted Code instead
Tip: Including an explanation in the op note will streamline your claim. Suppose an op... Read more
CMS:
Ask These 5 Questions to Untangle the CMS Rule For Overpayments
CMS has shifted the responsibility of identifying payment errors on providers and suppli... Read more
Reader Question:
Correctly Code Crush Injury of Hand
Question: We have a patient who had a severe crush injury of the left hand, which l... Read more
Reader Question:
Observation Services on a Single Day? Check Payer Policy
Question: In a patient who reported with a head injury after a traumatic fall, our ... Read more
Reader Question:
Follow this Guidance for Lateral Releases
Question: Our orthopedist performed a total knee replacement with a lateral release... Read more
You Be the Coder:
Code Correct for Wound Dehiscence and Delayed Primary Closure
Question: After a total knee replacement done three weeks ago, one of our patients ... Read more
Tools:
Define These Top Ortho Acronyms to Pinpoint The Perfect Code
Follow this advice to ensure you’re speaking the same language as your physician. ... Read more
ICD-10:
New Cervical Disc Disorder Diagnoses Identify Level
Abandon the mysterious “mid-cervical” term for more specific options. Afte... Read more
Modifiers:
For Bilateral CTS Shots, Don't Always Rely on Modifier 50
Here are the exceptions. If both of a patient’s wrists require injections to tre... Read more
Reader Question:
Attack This Achilles Tendon Scenario
Question: How do you code for the following procedure? “Over the point of ten... Read more
Reader Question:
Discover How 27331, 29881 Apply
Question: My physician documented an arthroscopic medial meniscectomy (29881). A la... Read more
Reader Question:
Select Code for Tenolysis of Biceps Done in Scope Surgery
Question: How can we code an open tenolysis of biceps tendon done during a scope su... Read more
Reader Question:
Learn Split/Shared Visit Rules to Avoid Pay Cuts
Question: I’ve heard nurse practitioners (NPs) and other providers talk about... Read more
Reader Question:
Find Out if Casts Are Part of Global Care
Question: When correcting club feet by releasing the Achilles and then applying the... Read more
You Be the Coder:
Highlight These TLIF Coding Options
Question: During the same operative session, the orthopedic surgeon performed the f... Read more
ICD-10:
Adopt These New Atypical Fracture Diagnoses Starting October 1
Check out the evolution of this unique terminology. If you are baffled by the term &ld... Read more
Knee:
Have a TKR Claim? Confront the Layers of Diagnosis, CPT®, and E/M Codes
Make certain you know what a TKR global package includes. To successfully report a tot... Read more
Medicare:
Incorrect Incident-to Billing Could Cut Into $$
Keep your bottom line strong with incident-to coding smarts. Coders who don’t kn... Read more
Reader Question:
Relate Guyon's Decompression to Ulnar Nerve Release
Question: In a patient with left wrist pisiform-triquetral arthritis (pisotriquetra... Read more
Reader Question:
Confirm Prosthesis for Patellar Arthroplasty
Question: Our surgeon did a patellar resurfacing in an outpatient facility. Is it c... Read more
Reader Question:
Report Tendon Repair of Glutei as Unlisted
Question: Our surgeon did a tendon repair of the gluteus minimus and gluteus medius... Read more
Reader Question:
Arrange Follow-Up with Original Surgeon
Question: We have taken over post operative care on a patient who had surgery from ... Read more
Reader Question:
Count Bursae and Not Incisions in Palmar Drainage
Question: In a patient who complained of pain in the hand and inability to move the... Read more
You Be the Coder:
Rongeur and Curette Do Not Imply Osteotomy
Question: Our surgeon did an open repair and internal fixation with Vitoss bone gra... Read more
News You Can Use:
Rejoice for This Shoulder Arthroscopy Edit Reversal
Preview this 29823 edit reversal. You’ve got big news for shoulder arthroscopy c... Read more
ICD-10:
Get Ready for Thousands of Ortho Changes Planned for ICD-10-CM 2017
You’ll find brand new codes, such as these for Salter-Harris fractures. The CDC ... Read more
Modifiers:
Bust 5 Common Myths to Manage Your Modifier 24 Claims
Focus on the surgeon’s documentation, not the appointment book. If you want to e... Read more
Reader Question:
Here are Physician Signature Requirements
Question: What are the necessary requirements for physician signatures? Are E-signa... Read more
Reader Question:
Multiple Injections? Don't Expect More Payment
Question: If the surgeon gives 2 injections into the (same) knee in two separate lo... Read more
Reader Question:
Every Laminotomy Adds Up
Question: How do we report if the surgeon takes a paramedian approach and does oste... Read more
Reader Question:
Hesitate Before Billing E/M with Every Surgery
Question: Can I charge for a 99213 and a 17250 on the same day at the same visit if... Read more
Reader Question:
Dig for Info to Code Acute or Chronic Pain
Question: For diagnosis coding purposes, what is the difference between acute and c... Read more
You Be the Coder:
Highlight These Terms to Determine Graft Differences
Question: What’s the difference between a spinal allograft and an autograft? ... Read more
Fractures, Part 1:
For Multiple Fracture Repairs, Take Into Account E/M and Modifier 51
Don’t miss this 2016 Medicare guidance for global fracture treatments. Miscoding... Read more
Fractures, Part 2:
Reporting Multiple Fractures? Add Up Your RVUs
Your sequencing matters to your bottom line. Not paying attention to work units for al... Read more
ICD-10 Coding Quiz:
Can You Assign the Correct 7th Character? Find Out.
Take note of the expanded option for fractures. You have no real default seventh chara... Read more
OIG Work Plan 2016:
Prepare To Cover Any Compliance Gaps -- Or Face the Consequences
On the OIG’s radar for 2016 are quality reporting and inpatient care. On Nov. 2 ... Read more
Reader Question:
Triplane Tibial Fracture Means Single Code
Question: How do you report the cannulated screw fixation of a triplane fracture? ... Read more
Reader Question:
Highlight Your Contract Language
Question: Can you please help us understand if it is better to bill the patient for... Read more
Reader Question:
Differentiate Meniscectomies, Chondroplasties
Question: What percentage of the meniscus must the surgeon remove before we should ... Read more
You Be the Coder:
Repeat Drainage Of Finger Abscess
Question: For a patient who reported back to the ED for a wound check following dra... Read more
Case Study:
Examine This Lesion Excision Coding Scenario and See What is Missing
Go in-depth with both your CPT® and ICD-10 coding options. The reports you receiv... Read more
Lesions:
Avoid Excision Coding Snafus With These 3 Steps
Example 2 reveals why you need to watch for the narrowest margin. When patients with l... Read more
News You Can Use:
Discover More About The Medicare Drug Spending Dashboard
Learn more about prescribing trends, drug utilization; do not expect to see price conces... Read more
ICD-10:
Access Your 3 Achilles Tendon Rupture Options
Don’t miss this Excludes2 note. A complete rupture of the Achilles’ tendon... Read more
Reader Question:
Learn How Leg Amputations Differ
Question: How do leg amputation codes differ from each other? Minnesota Subscribe... Read more
Reader Question:
Strike Through Fracture Care Code Without Fx
Question: If our physician sees a patient in the office and dictates that the patie... Read more
Reader Question:
Pick Apart 'Primary' vs. 'Secondary'
Question: For codes such as 27695, 27696 and 27698, what do the terms “primar... Read more
Reader Question:
Failed Reduction May Mean Modifier 52
Question: The orthopedic surgeon saw a patient in the emergency department for a me... Read more
Reader Question:
Consider AC Joint as Intermediate
Question: If our surgeon injects a patient’s AC joint, should we report 20610... Read more
Reader Question:
Follow the '72285 Includes 77003' Rule
Question: May I report CPT® 77003 and 72285 together for the same service? A co... Read more
Reader Question:
How to Report the Proper Pectoralis Code
Question: Which CPT® code should I report for a torn pectoralis major muscle re... Read more
You Be the Coder:
Modifier 53 with E/M for Cancelled Surgery
Question: Our surgeon decided not to take the patient for an elective surgical proc... Read more
Hips:
Help Yourself to These 27033, 27125, 27132 Coding Insights
Can you report an osteotomy with a previous hip surgery conversion to total hip arthropl... Read more
Coding Quiz:
3 Questions Challenge Your X-Ray Coding
Find out whether you’re a shoulder-view ace with question 2. Diagnostic imaging ... Read more
Practice Management:
10 Essential Reqs Mean You'll Be Avoiding the Appeals Process
Align with MAC requirements and keep clean and precise documentation. Are you appealin... Read more
Coding Answers:
Examine Your X-Ray Coding With These Expert Answers
Check your answers to the quiz on page 11. How did you do? Find out below. Beef Up Y... Read more
ICD-10:
Reflect Flat Foot With One of Three Specific Diagnoses
Don’t miss these Excludes1 and Excludes2 notes. When a patient suffers from flat... Read more
Reader Question:
Using 20900? Check for Separate Incision
Question: Which codes should I use for a TKA with structural bone grafting of the l... Read more
Reader Question:
Use 35236 for Blood Vessel Repair
Question: What CPT® code should I report if the orthopedic surgeon had to perfo... Read more
Reader Question:
Keep Track of Refills for E/M
Question: May we bill an insurance carrier for a prescription refill outside the gl... Read more
Reader Question:
Narrow Down Your Tenotomy Options
Question: Which CPT® code should I report when the surgeon documents treating m... Read more
You Be the Coder:
Draw the Line Between Reconstruction And Repair
Question: Our surgeon performed a left knee medial collateral ligament reconstructi... Read more
Foot:
Heighten Your Chance to Heel Spur Treatment Claim Success With This Advice
Rule out fracture, and check for casts and orthotic devices. If you’re reporting... Read more
Forearm:
3 Steps Help You Complete Compartment Syndrome CPT® Codes
Hint: Compartment and debridement dictate the right code. When treating compartment sy... Read more
Add-On Codes:
Adopt These Tips To Improve Your Add-On Code Success
Beware of modifier 51 for add-on procedures. Add-on codes can augment your payment for... Read more
ICD-10:
Formalize How You Assign Diagnosis Codes for Falls
You should read the rules about including Z codes—here’s why. ICD-10 may b... Read more
Reader Question:
Safeguard Your Second X-Ray Claims
Question: An X-ray was taken after manipulation; the surgeon was not happy with the... Read more
Reader Question:
Solve This ER, Then Assumed Care Scenario
Question: My orthopedist treated a patient who was first seen in the ER for an open... Read more
Reader Question:
Differentiate 23334, 23335 From 23107
Question: Our patient had a total shoulder replacement, and the glenoid component h... Read more
You Be the Coder:
Post-Op Brace Fitting and Education
Question: Can my physician bill for a fitting and education of a brace during the p... Read more