May 25, 2023 Question: My plastic surgery saw a patient who sustained an approximately 40% total body surface area burn in a fire. He has previously undergone excision and allograft placement of his extremities. He now came back for removal of the eschar that remains present on his torso and bilateral thighs. The total area...
Category: Coding Coach
Is an Annular Repair Separately?
May 25, 2023 Question: Our physician stated he was told at his prior hospital that he could report an annular repair with a discectomy. We have told him this was inclusive but he is asking us to contact KZA. Is the annular repair reportable in addition to the discectomy code? If yes, what CPT code...
Bone Anchored Hearing Implants
May 25, 2023 Question: What CPT code would I report for implanting a bone anchored osseointegrated implant with a magnetic transcutaneous attachment outside of the mastoid? Answer: In 2023 three new CPT were created to report Transcutaneous osseointegrated implants outside of the mastoid. For the implantation the code to report is 69729, for the replacement of the existing device...
Secondary Payor Doesn’t Recognize Consultations
May 25, 2023 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However, Cigna is refusing to process the claim since they no longer pay for consult codes. Am I allowed to change the CPT code and rebill...
Facet Fusion
May 25, 2023 Question: The neurosurgeon documents a placing a cervical “facet implant or intrafacet implant “ with bone graft. Is this coded as 22600, cervical arthrodesis? Answer: No. This is coded with a Category III code, as shown below: Facet Wedge or Dowel Arthrodesis (Intrafacet Implant) Placement of a posterior intrafacet implant(s), unilateral or...
What Does “Separate Procedure” Mean in a CPT Code Description?
May 11, 2023 Question: What does “separate procedure” mean when it follows a CPT code description? Answer: Per CPT : Some of the procedures or services listed in the CPT codebook that are commonly carried out as an integral component of a total service or procedure have been identified by the inclusion of the term...
POST OP Hemorrhage Repair
May 11, 2023 Question: My coder says I cannot bill for taking the patient back to the OR to repair a post-op hemorrhage during the global period. She says that all complications are included in the payment for the initial surgery. Is that correct? Answer: No, that is not the case. You may bill for...
Vessel Exploration
May 11, 2023 Question: What code is used to make an incision over the femoral artery to evaluate for injury, and explore it without any repair? Answer: Use code 35703, Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal) *This response is based on the...
Retrocalcaneal Bursectomy
May 11, 2023 Question: Our surgeon performed a repair of an Achilles tendon, excision Haglund’s deformity of the calcaneus and retrocalcaneal bursectomy. Are we able to code the bursectomy in addition to the repair and excision of Haglund’s? Thank you in advance for your assistance. Answer: Thank you for your inquiry and explanation of procedures...
E/M Coding Based on Time
May 11, 2023 Question: When choosing the level of E/M we are confused about the History and Exam. If we choose a level of E/M based on time, does this time count toward total time, or is it only time spent on MDM? Answer: When choosing a level of E/M based on time, CPT identifies...