September 22 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…

September 22, 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…

September 22, 2022 Question: I sent a patient out to the hospital for a CTA and the patient brought in the actual images and the radiologist’s report for me to…

September 22, 2022 Question: After a recent audit and review with my physicians, they are telling me that they do not need to document a history and/or exam any more…

September 22, 2022 Question: Is code 42950, Pharyngoplasty (plastic or reconstructive operation on pharynx), reportable when a free skin flap with microvascular anastomosis, is not performed and a limited pharyngectomy…

September 22, 2022 Question: When billing 4 units of 11620 (4 charges with 1unit a piece with 76 modifier) to a Medicare Advantage plans we are getting denied for MUE…

September 22, 2022 Question: What modifier is used to report a colostomy revision during the global period of the stoma creation? Answer: A modifier 78, return to the OR for…

September 22, 2022 Question: In a recent head trauma case, a decompressive craniectomy was performed with a partial temporal lobectomy, due to extensive damage. A hematoma was also evacuated. can…

September 8, 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…

September 8, 2022 Question: The surgeon used a stent and then inserted an embolization coil for an aneurysm. Are both billable? Answer: If the stent is placed to provide a…

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…

September 8, 2022 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However,…

September 8, 2022 Question: If mesh is placed for a laparoscopic hernia repair can an unlisted code be reported for the mesh placement? Answer: No. All laparoscopic hernia repair codes…

September 8, 2022 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However,…

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.…

August 25, 2022 Question: My coder just told me about the new guidelines for 2021 office visit codes. She said I no longer have to document a History. This doesn’t…

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…

August 25, 2022 Question: I am new to an Orthopaedic practice where the coders do all the coding. The current coding staff is applying the 2021 E&M Guidelines to all…

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…

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,…

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…

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…

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…

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…

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…

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…

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…

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…

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…

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…