Category: CC-Orthopaedics

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Meniscectomy vs. Meniscal Repair

Can you please clarify how to report the following procedure: The surgeon documented medial meniscal repair followed by a medial meniscectomy, both performed in the right leg. There are NCCI edits between the two codes showing 29881 payable and 29882 with a Column 2 edit. Do we code the repair or the meniscectomy since both were performed? The surgeon will be paid more if I report the 29882 if I can only report one code. I am not sure if I can report both codes for the same leg or not?

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Infected Knee

Will you please direct this question to Mary LeGrand? I was consulted to evaluate a patient to rule out a septic knee. I saw the patient in the morning and aspirated the joint; the fluid was cloudy and sent to pathology. Later that day I was notified of an increased cell count and decided to take the patient to the OR later that day for an arthrotomy with lavage. My coder is telling me that I cannot bill CPT code 20610 with the arthrotomy because of a Medicare payment edit. This makes no sense to me. Can you advise if I am able to report this aspiration or not?

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Medicare: Debridement Services in the Shoulder

We attend courses and receive education from KZA consistently on orthopaedic coding. Our practice recently hired a new billing manager and she states that the information we have been given is incorrect for Medicare related to arthroscopic debridement services. The billing managers external resource told her that 29822 or 29823 can be reported with other arthroscopic shoulder services as long there is no NCCI edit in place. We are telling the new manager that this is incorrect for Medicare.

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Different Specialties, Same Tax ID

Can you help clarify the new patient rules related to multiple specialties in the same group practice? If we have different specialties (e.g., Pain Management, Podiatry, Rheumatology, Orthopaedics) can we charge a New Visit code when the patient is seen for the first time by a physician in a different specialty in the practice?

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Cast Changes During the Global Period

We have not been billing for cast changes during the global period, but have recently been told we should be reporting this service. In our orthopedic physician practice, on occasion a patient will require a cast change (for various reasons). If the physician orders the cast change and is present in the office during the cast change by our cast technician, can we bill Medicare during the 90-day global period?

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CPT or HCPCS Tool?

We have recruited a new hand surgeon and she frequently applies aluminum finger splints which are molded by the surgeon or her medical assistant. Can we report CPT code 29130 for the application and molding of this splint?

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