Category: Coding Coach

Excisional Debridement Two Fractures:
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Excisional Debridement Two Fractures:

September 8, 2022 Question: Our surgeon treated a patient who presented with an open fracture of the distal tibia and fibula. The surgeon performed an excisional debridement down to and including the bone removing devitalized tissue and gravel and other debris that imbedded into the open fracture site. Is CPT code 11012 reported twice for...

Radiofrequency Ablation
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Radiofrequency Ablation

August 25, 2022 Question: We have been reporting CPT code 64625 with 3 units when we perform a radiofrequency ablation of the nerves innervating the sacroiliac joint at levels S1. S2, and S3. We have gotten several payer denials recently. Are we coding correctly? Answer: No, CPT code 64625, Radiofrequency ablation, nerves innervating the sacroiliac...

Billing for Lesion Intervention Crossing Territories
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Billing for Lesion Intervention Crossing Territories

August 25, 2022 Question: Our vascular surgeon documented a single intervention for a lesion that crosses the margin between the fem/pop and tibial/peritoneal territories. Should we bill one code or one for each territory? Answer: You would bill one code since a single intervention was performed, even though it crossed into another territory. *This response...

New vs Established Patient
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New vs Established Patient

August 25, 2022 Question: I am a contracted physician with a group practice (Practice A) in our town. I have an opportunity to contract with another practice (Practice B) not in the same town, but near enough that my patients could see me in either location. My question has to do with the definition of...

Attempted Foreign Body
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Attempted Foreign Body

August 25, 2022 Question: When billing a foreign body removal code of 10120, the surgeon incises the finger and looks around for 25 mins and no foreign body is found, do we bill a 52 since no FB was found or do we bill the 10120 without the modifier since the provider did perform the...

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Coding Coaches