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Orthopedic Coding Alert

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
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
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
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
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
Medicare's 'Code Family' Clemency Has Ended
Denials could skyrocket if your specificity isn’t up to scratch. So you know CMS... Read more
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
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
Check Out This Base Code Cheat Sheet
Find the ‘Base’ arthroscopic procedure fast. If you want to find the &ldqu... Read more
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
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
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
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
New Cervical Disc Disorder Diagnoses Identify Level
Abandon the mysterious “mid-cervical” term for more specific options. Afte... Read more
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
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
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
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
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
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
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
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
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
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
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
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
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