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Orthopedic Coding Alert

E/M Coding:
Use Updated Descriptor Info on Observation Coding
CPT® 2018 shifts language to end outpatient confusion on 99217, 99218-99220. Reporting y... Read more
E/M Coding:
Make Subsequent Observation Coding a Breeze with these Tips
Second day of observation? Look to 99224-99226. Though it is rare, your provider might el... Read more
Modifier Madness:
Keep these Tips Handy for 25, 59, 51 Encounters
Here's how many, but not all, payers now deal with 51 claims. When an orthopedic office p... Read more
Reader Question:
Seek Federal Guidance on IT Training
Question: I am the head of the coding department at a practice that has been under the sam... Read more
Reader Question:
Choosing the Correct NPI for Incident-to E/M
Question: An established Medicare patient with a plan of care in place to treat a chronic ... Read more
Reader Question:
Check Out How MPFS Final Rule Shook Out
Question: I know that Medicare usually releases its final rule on the Medicare physician f... Read more
You Be the Coder:
Leave Synovectomy Code Off Arthrotomy Claim
Question: My physician performed a right knee arthrotomy revision with a single-component ... Read more
Modifier Madness:
Keep Calm, Carry on Coding with these Tips
Remember, some modifiers are for E/Ms; others are for procedures. Orthopedic offices see ... Read more
Procedure Coding:
We Got Your Back: Use FAQ to Master Disc Decompression, Discography Coding
Remember, injection for discography is diagnostic, and a decompression is therapeutic. If... Read more
Inside the Notes:
Mind Each Payer's Preferences on Discography Claims
Remember to check with your payer for its approved ICD-10 list. When reporting discograph... Read more
Reader Question:
Keep RAC Targets on Your Compliance Radar
Question: I've been doing some reading about recovery audit contractors (RACs), and frankl... Read more
Reader Question:
Ensure Fracture Payment with Initiation Note
Question:One of our orthopedists performed a closed treatment of a clavicular fracture wit... Read more
You Be the Coder:
Making the New/Established Patient Decision
Question: What is the difference between a new and established patient when reporting eval... Read more
CPT® 2018:
Add-On Code Highlights New Manual Additions
CPT® includes new marrow aspiration code, revises observation codes. The CPT® 2018 manu... Read more
Modifiers:
Payer's Policy Should Guide Your 27/57 Decision
Coding E/M-fracture care? You'll need one of these E/M modifiers. When your physician pro... Read more
Clip and Save:
Put New Aspiration Code in Its Place
Check out where 20939 will fit in CPT® 2018. In a perfect world, everyone would get a ne... Read more
Case Study Corner:
Use These Examples to Illustrate Modifier 25 in Action
Here's a look at a pair of common modifier 25 scenarios. Individual cases always vary, bu... Read more
Reader Question:
Postop E/M Might Require Modifier 24
Question: A patient developed a postoperative infection during the global period for ... Read more
Reader Question:
Check for these Elements, then Choose HPI Level
Question: What elements should we look for when selecting the history of present illn... Read more
Reader Question:
Try This Strategy for Iliopsoas Lengthening
Question: Our provider performed an arthroscopy with iliopsoas lengthening. We cannot... Read more
Reader Question:
Use these Tips to Sort Out CCI Indicator 1
Question: I was looking up Correct Coding Initiative (CCI) edits for 99221 and 99212,... Read more
You Be the Coder:
Coding for Ankle Fracture Surgery
Question: The orthopedic surgeon performs a closed reduction and percutaneous pinning... Read more
FAQ:
Get the Total Rundown on Knee Arthroplasties
Total knee replacement takes center stage with these codes. When your orthopedist perform... Read more
ICD-10:
Check for Arthroplasty when You See Certain Dx Codes
Get to know arthritis codes; you'll use them often for arthroplasties. Have you ever wond... Read more
Mythbusters:
Dx Will Help You Draw a Bead on CTS Shot Coding
CTS diagnosis a must for some, but not all, payers on 20526. If you're not familiar with ... Read more
Clip and Save:
Knowing Drug Amount Helps You Maximize CTS Shot Claims
Remember, not all CTS injections involve the same drug. Be sure to pay careful attention ... Read more
Reader Question:
Keep These Achilles Coding Tips in Your Hip Pocket
Question: Operative notes indicate that the provider repaired a patient's Achilles te... Read more
Reader Question:
Choose Osteoporosis Dx Based on Fracture History
Question: The orthopedist performs a level-three evaluation and management (E/M) serv... Read more
You Be the Coder:
Put Effusion Confusion to Rest
Question: During the course of a level-four evaluation and management (E/M) service f... Read more
ICD-10 2018:
New Diagnosis Codes Expand Spinal Stenosis Set
Experts: Make sure providers and coders are on the same page for successful transition. S... Read more
News You Can Use:
Feds Propose (Slight) Conversion Factor Increase
If this proposal sticks, 2018 reimbursement rate won’t rise much. The Centers for M... Read more
Compliance:
Payer Set to Slash Some Modifier 25 Pay
Experts: New policy ‘absurd,’ ‘awful.’ Orthopedists typically use... Read more
Reader Question:
Alert Patient to Payment Issues with ABN
Question: A Medicare patient requested an ankle x-ray quite insistently, but it appea... Read more
Reader Question:
Heed Locum Tenens Guidelines for 'Substitute' Provider
Question: One of our physicians is going on vacation next month, and we are hiring a ... Read more
Reader Question:
Get Specific with Limb Pain Dx
Question: A patient reports for treatment of limb pain. What steps should I take to a... Read more
Reader Question:
Use this Guide for Jones Fracture Dx
Question: In the medical documentation, the provider diagnosed the patient with a Jon... Read more
Reader Question:
Report Cast Application when You Spot Physician Involvement
Question: Our physician recently saw a patient who reported to our practice with comp... Read more
You Be the Coder:
'Buddy Taping' and CPT® Coding
Question: An established patient reported to our office limping badly after falling o... Read more
Hips:
Debunking Myths About Causes of Hip Surgery Can Maximize Reimbursements
Key: Append modifier 78 if infection occurs during global period of firstprocedure. The c... Read more
E/M:
Find Out the Best Ways to Use EHRs When Coding
Key: EHRs do not track physical examinations. Among the many data tools available to your... Read more
Benchmarking:
Answers to Your Benchmarking Questions Can Improve Your Practice's Operations
Monthly benchmarking means your practice can observe granular trends more easily. A good ... Read more
Reader Question:
Knowing the Site of Injection Changes Your Code
Question: The surgeon treated a patient with De Quervain’s tendinitis. So after... Read more
Reader Question:
A Sequestrectomy Involves More than an Extraction
Question: For a patient with of chronic osteomyelitis in their shoulder, my orthopedi... Read more
Reader Question:
Complex Sports Injury Codes Can Be Made Easy
Question: The surgeon repaired a torn anterior cruciate ligament (ACL) and a torn med... Read more
Reader Question:
Each Metatarsal Fractures Requires a Distinct Service
Question: A patient came in with a Lisfranc fracture in their left foot so the orthop... Read more
You Be the Coder:
You Can Maximize Cast Codes With the Right Know How
Question: I had no trouble coding for an ostectomy for a calcaneus spur, but I’... Read more
Knees:
5 Ways to Overcome the Challenges of Coding PCL Sprains
Key: Understanding 6th and 7th characters leads to fewer denials. As an overlooked but da... Read more
Shoulders:
Revive Your Rotator Cuff Coding By Following These Steps
Key: Knowing the level of trauma will affect what code you use. With so many moving parts... Read more
Modifiers:
Follow These Dos and Don'ts of Using Modifier 78
Master similar modifiers to avoid confusion. Modifiers are important additions to your co... Read more
Reader Question:
The MRI Isn't Always Right
Question: An orthopedic surgeon states in the operative report that he did both a med... Read more
Reader Question:
How to Tell When to Use 77002 and 76000
Question: In the reconstructive surgeon’s office “office where I work, I ... Read more
Reader Question:
Learn About A Less Common 7th Character
Question: I use the code S82.821 to report a torus fracture. The patient in question ... Read more
You Be the Coder:
Choosing a Modifier Depends on Anesthesia
Question: A knee arthroscopy was stopped early because the patient had an unanticipat... Read more
Hips:
3 Elements To Ethically Maximize Your Bottom Line for Traumatic Hip Dislocation Procedures
If you miss the difference between 27250 and 27252, you could miss out on almost $600. Be... Read more
Injuries:
'Tis the Season for Biking Accidents: Common Ailments and How to Code for Them
Here are three tips for reporting Lisfranc injuries. The sun is out. People are on the si... Read more
E/M:
3 Myths Will Neutralize Your 99211 Mistakes Before They Happen
Hint: You can use 99211 for physicians. Although you’re savvy when it comes to repo... Read more
Reader Question:
Check Extent of Erosion in Tumor Excision
Question: Our surgeon did a planned release of an A-1 pulley with excision mass over ... Read more
Reader Question:
Do Not Treat Accessory Soleus as Soft Tissue Tumor
Question: How do we code for excision of accessory soleus muscle in leg? Can we repor... Read more
Reader Question:
Look At Global Period For Repeat Drainage Of Finger Abscess
Question: For a patient who reported back to the ED for a wound check following drain... Read more
You Be the Coder:
Compare Extensive Versus Limited Debridement
Question: I’m not sure if I should use the extensive debridement code or the li... Read more
MACRA:
Prepare Yourself for Orthopedic Quality Reporting With These FAQs
Embrace MIPS as PQRS wanes. If you think that the expiring Physician Quality Reporting Sy... Read more
MACRA:
Highlight These 21 Quality Measures for Your Orthopedic Practice
Make sure your orthopedic practice continues to get the pay you deserve for Medicare benef... Read more
Post-Op:
3 Scenarios Will Hone Your Post-Op Infection Coding
Hint: Look to global period and modifiers for your solutions. You could be sabotaging you... Read more
Reader Question:
Navigate Modifiers 78 and 79 With This Advice
Question: Recently, a patient came to our office for a follow up after he had an arth... Read more
Reader Question:
Determine if 20550 Includes Ultrasound Guidance
Question: My doctor conducted an aspiration of a cyst in the back of the right knee u... Read more
Reader Question:
Looking to Code Injection on the Piriformis With Fluoro? Your Answer is Here
Question: There is some disagreement between my provider and I. For an injection of t... Read more
You Be the Coder:
Discover What Constitutes "Total" With Knee Replacements
Question: My provider conducted an orthopedic surgery on a patient’s knee that ... Read more
CPT® 2017:
Have You Noticed a Difference to Your Bottom Line? Blame These Percutaneous Spinal Procedure Revisions
You should be separately billing for moderate sedation with percutaneous vertebral procedu... Read more
Separate Procedures:
2 Examples Sharpen Your Separate Procedure Claims
CCI is an important tool when you are not sure about a bundle. You shouldn’t assume... Read more
Telehealth:
Always Ace Coding for Your E/M Telemedicine Services
Don’t forget POS code 02 on your telemedicine claims. With CPT® 2017, you&rsquo... Read more
ASCs:
3 Tips Analyze Your ASC Coding Rules
Here’s how to properly use modifier SG. Suppose you bill Medicare when your surgeon... Read more
Reader Question:
Beware Modifier 'Solutions'
Question: When we see a claims denial in our practice, some of our staff is quick to ... 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 an... Read more
You Be the Coder:
Check Out Whether Unlisted-Procedure Codes Have Global Days
Question: I was wondering, does Medicare assign a global period for unlisted-procedur... Read more
Hips:
Solve 3 Scenarios to Hoist Your Total Hip Replacement Coding to Success
Overlooking the underlying cause can put your bottom line in jeopardy. Infections or disl... Read more
SAMPLE MODIFIER 22 LETTER
Note re -22 Modifier for Unusual Procedural Services: A –22 Modifier was added for U... Read more
Shoulders:
Seize the Reimbursement You Deserve For Shoulder Sequestrectomy
Find out if you need to report a code for removing a soft tissue abscess. Although the te... Read more
Add-On Codes:
Bust These 3 Myths Before Applying Add-on Codes
You can report some add-on codes more than once. If you’re relying on modifier 51 e... Read more
Reader Question:
How to Code Both Meniscal, Articular Knee Shavings
Question: My orthopedist performed the following knee procedure: “Examination ... Read more
Reader Question:
Only Report 23480 When Osteotomy Is Documented
Question: Our surgeon did an open repair and internal fixation with Vitoss bone graft... Read more
Reader Question:
Strike Off 77003 for Fluoroscopy with Epidural Injections in 2017
Question: How can we report fluoroscopic guidance with epidural injections in 2017? W... Read more
You Be the Coder:
Tendon Rupture Path May Support Distinct Procedure
Question: Our surgeon repaired a bimalleolar fracture and the posterior tibial tendon... Read more
Fractures:
Boost Your Bottom Line By Knowing How to Use Vertebroplasty, Kyphoplasty Add-On Codes
Hint: Whether levels are contiguous or not, report only one primary procedure. Although v... Read more
ICD-10:
Straining to Find a Neck Sprain Code? Here are Your Options
Watch out: Careful of what seventh character you apply. Neck sprain means that the patien... Read more
E/M Coding:
Do You Know When You Can Use Prolonged-Service Codes? Find Out
Key: Count only face-to-face time and document necessity. When your physician performs an... Read more
Reader Question:
Document '3-Rs' for Consultation E/M
Question: Is it true that we can never code for E/M “consultations?” Sup... Read more
Reader Question:
Underline These Allograft, Autograft Terms
Question: What’s the difference between a spinal allograft and an autograft? O... Read more
You Be the Coder:
Find Out When You Can Bill 29540
Question: Can we report 29540 for strapping with other procedures, such as fracture c... Read more