June 8, 2023 Question: We are wondering if you can help address a discussion in our office related to the coding rule changes for hospital services. CPT instructs to report 99221-99223 (inpatient hospital/observation) and 99231-99223 (subsequent hospital/observation) for both inpatient and observation services. Our hospital does not have a dedicated outpatient observation area; all patients...
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...
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...
April 27, 2023 Question: I have a question regarding 2023 shared visit rules. I am reviewing an E&M note where I will select the level of E&M based on the MDM being the substantive part and not time. My question: does each provider have to document their individual time if not a factor in the...
April 13, 2023 Question: Our surgeon documented anterior inferior labral repairs and then documented posterior inferior repairs. The surgeon wants to report 29806 x 2 and I do not believe that is correct. Will you assist? Answer: Thank you for your question. You are correct in that CPT code 29806 may not be reported twice....
March 30, 2023 Question: We saw a patient who presented with chest pain and the physician diagnosed costal chondritis and the administered an injection into the costochondral junction. We are debating what CPT code to report for the injection? Is it 20550, 20600, 20605 or an unlisted code? We are considering CPT code 20600. Answer:...
March 16, 2023 Question: Can we bill comparison in-office x-ray views (usually knees or elbows) if the patient is asymptomatic on the contralateral (opposing) side? Answer: Unless there is a medically necessary reason for the comparison views on the contralateral body part, they should not be billed separately. If documentation does support billing for both...
March 2, 2023 Question: Our physician’s submitted literature to our administration team related to portable handheld ultrasound equipment for purchase consideration. I was asked if this equipment met CPT requirements for ultrasound. Is this equipment acceptable to use when performing ultrasound guided injections? Answer: We recommend you research the website literature for product specifications or...
February 16, 2023 Question: We are submitting a hospital claim form with the modifier 25 and FS modifier. We are unsure which modifier to list first. What is your recommendation? Answer: Thanks for contacting KZA and remembering to use the FS modifier for shared services provided in the hospital. KZA recommends placing the modifier 25...
February 2, 2023 Question: Our surgeon documented in the procedure title that he performed an arthroscopic ORIF of a tibial plateau subchondral fracture with injection of calcium phosphate, and he wants to report CPT code 29855 (Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy). I do not...
