March 16, 2023 Question: My surgeon was called to the OR by an OB-GYN who accidently lacerated the small bowel during an open gynecological procedure. She repaired the small bowel with sutures. How is this billed, is my surgeon a co or assistant surgeon? Answer: Neither. Repairing the bowel is not inherent to a gynecological...
March 2, 2023 Question: The surgeon reported an intestinal perforation caused by a trocar during a laparoscopic cholecystectomy due to extensive adhesions. He completed the cholecystectomy and also did a suture repair of one perforation of the small intestine. How is this reported? Answer: Iatrogenic, intraoperative complications that are repaired at the same operative session...
February 16, 2023 Question: One of my colleagues told me that she was doing e-consults with other physicians for Medicare and getting paid. Is this a billable service? Answer: Yes! Medicare has added CPT codes 99446-99452 for interprofessional/ telephone/internet/electronic health record (EHR) consultations to the fee schedule, so they are now payable services. These are...
February 2, 2023 Question: What modifier do we use if a patient is returned to the OR the same day as the original surgery for post-op hemorrhage? Isn’t it 78 for this complication? Answer: Modifier 78 is a global period modifier and the global period begins on post-op day one. So it is not appropriate...
January 19, 2023 Question: I thought the global period of debridement of muscle or bone was 10 days. Is that true? Answer: The debridement codes were revised in 2011 and the global period for all codes (11042-11047) was revised to 0 days. *This response is based on the best information available as of 01/19/23. ...
December 15, 2022 Question: If 10 sq. cm subcutaneous tissue is debrided from the right leg and 20 sq. cm is debrided from the left leg, is it coded as 11042 and 11042-59 or 11042 RT and 11042 LT? Answer: If debridement is performed at the same depth of tissue (all subcutaneous tissue) it is...
December 1, 2022 Question: How do we bill for a trauma resuscitation? Are there codes for hanging fluids and packed cells? Can we use the CPR code 92950? Answer: There is no specific code for a trauma resuscitation or for administering fluids or blood products. The CPR code is specifically for providing cardiopulmonary resuscitation; chest...
November 17, 2022 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 “separate...
November 3, 2022 Question: How is a laparoscopic pyloroplasty reported? Can I use code 43800, Pyloroplasty? Answer: No, codes without the term laparoscopic in their description are intended as open codes and 43800 is an open code. There is no laparoscopic code for pyloroplasty so an unlisted code 43659 unlisted laparoscopic procedure, stomach, must be...
October 20, 2022 Question: I placed the peritoneal catheter for a neurosurgeon placing a V-P shunt. Do I code 49419, insertion of peritoneal catheter? Answer: No, you are a co-surgeon with the neurosurgeon. Code 62223, creation of a ventriculo-peritoneal shunt, includes both the neurosurgeon’s portion of placing the ventricular catheter and your portion of placing the peritoneal...
