August 25, 2022 Question: A major blood vessel was accidentally nicked while a general surgeon was performing a complex case. A vascular surgeon was called in to repair the blood vessel. Since they are different specialties, can the vascular surgeon bill for the repair, even though she is in the same group as the general...
August 25, 2022 Question: If the exposure is thoracic, for example in a thoracic corpectomy, and the documentation states a costotransversectomy was performed, can that be billed separately? Answer: Costotransversectomy (e.g., 21610) is included in a thoracic corpectomy and not separately billed. Note also that 21610 states “separate procedure” so it is never billed with...
August 11, 2022 Question: Can I use modifiers on an unlisted code? What about global period modifiers such as 58, 78 or 79? It seems reasonable to append those modifiers to the unlisted code. Answer: There is not a single right answer to this question. CPT said, in an old CPT Assistant, that generally modifiers...
August 11, 2022 Question: Can we bill for all vessels mentioned if they are documented within the angiogram? Answer: No. You should only bill for vessels that are targeted and are medically necessary. Documentation alone doesn’t mean that procedures are always separately billable. *This response is based on the best information available as of 08/11/22...
August 11, 2022 Question: Our surgeon saw a new patient in the office yesterday. His documentation supported reporting the E&M using time instead of based upon MDM. My question is about the time calculation. Today, he reviewed an MRI that the patient brought in this morning and he wants to add that time to his...
August 11, 2022 Question: Can I bill an office visit in the global period if the diagnosis is different from why I did the original procedure? Answer: Yes, as long as the diagnosis is not for a related issue (e.g., complication from the original procedure). The documentation must be clear that the condition is unrelated...
August 11, 2022 Question: My surgeon was called into a laparoscopic operation that was already underway, to perform extensive lysis of adhesions. Does he need to use a modifier 52 because the patient was already “opened”, or can we just bill for 44180 Laparoscopic lysis of adhesions? Answer: You would bill for 44180 without a...
August 11, 2022 Question: How do you report a spinal procedure for example, arthrodesis or laminectomies when two spinal are involved. For example., both thoracic and lumbar spine? Answer: Report one stand-alone/primary code even when the procedure crosses spine junctional levels. Use the stand-alone code for the spine region where the majority of the procedure/levels...
July 28, 2022 Question: When billing for the muscle flap codes 15733, 15731 etc., can we also code for the surgeon’s cleaning and prepping by debridement before closing the wound with a facial flap? Answer: Yes, the surgical prep codes (15002-15005) may be reported with those flap codes as long as the surgical prep service...
July 28, 2022 Question: I did a left hip intraarticular steroid injection and used fluoroscopic guidance. Can I report the guidance in addition to the procedure? Answer: Yes, you would report CPT code 20610 for the hip injection and 77002-26 for the fluoroscopic guidance. Make certain you use Modifier 26 when performing procedure is a...
