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Modifiers on Unlisted Codes. Yes or No?

Modifiers on Unlisted Codes. Yes or No?

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…
Angiogram Billing for All Vessels Viewed

Angiogram Billing for All Vessels Viewed

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…
E&M Coding Based on Time

E&M Coding Based on Time

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…
E/M Visit During the Global Period

E/M Visit During the Global Period

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…
Use of Modifier 52

Use of Modifier 52

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…
Coding for Spine Procedures that Cross Spinal Junctions

Coding for Spine Procedures that Cross Spinal Junctions

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…
Coding for Wound Surgical Preparation

Coding for Wound Surgical Preparation

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…
Hip Injection

Hip Injection

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…
Billing for Vascular Access

Billing for Vascular Access

July 28, 2022 Question: I’m new to vascular coding, can we bill for vascular access for a catheterization? The provider documents this, so I’m thinking I am missing a code.…
Two Orthopaedic Surgeons, Two Separate Surgeries

Two Orthopaedic Surgeons, Two Separate Surgeries

July 28, 2022 Question: A patient sustained an ankle fracture and a shoulder fracture and surgery was performed on same day by two different surgeons (partners) during the same surgical…
2021 Evaluation and Management Codes: Is a History Required?

2021 Evaluation and Management Codes: Is a History Required?

July 28, 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…
Diagnosis Coding Help

Diagnosis Coding Help

July 28, 2022 Question: Can you please assist with the diagnosis for a Compound Dysplastic Nevi of back? Biopsy confirmed and not completely excused. Patient comes in for excision of…
Separate Procedure Billing

Separate Procedure Billing

July 28, 2022 Question: The surgeon performed an open colectomy and found a tear in the mesentery close to the incision, 44850 Suture of mesentery is listed as a “separate…
Removal of Interbody Device

Removal of Interbody Device

July 28, 2022 Question: Can code 20680, removal of implant, be used for removal of a previously placed intervertebral device, such as a PEEK cage? Answer: No. There is no…
Craniosynostosis Co-surgery Question

Craniosynostosis Co-surgery Question

July 14, 2022 Question: We have a new plastic surgeon who will start doing craniosynostosis surgery with a pediatric neurosurgeon. Will this be co-surgery using modifier 62? Answer: Potentially yes.…
Co-Surgery Due to Complex Procedure

Co-Surgery Due to Complex Procedure

July 14, 2022 Question:  I have 2 vascular surgeons from the same practice that want to bill co-surgery for a complex open abdominal aneurysm repair. They both performed the same…
New vs Established Patient

New vs Established Patient

July 14, 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…
Modifiers on Unlisted Codes. Yes or No?

Modifiers on Unlisted Codes. Yes or No?

July 14, 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…
Billing for Reopening of Recent Laparotomy

Billing for Reopening of Recent Laparotomy

July 14, 2022 Question: Our surgeon insists on billing for 49002 reopening of a recent laparotomy and a 44005 lysis of adhesions, since the case is complicated because the laparotomy…
Coding for Percutaneous Screws and Rod Placement

Coding for Percutaneous Screws and Rod Placement

July 14, 2022 Question: I placed posterior percutaneous screws and rods without an arthrodesis. I know I have to use an unlisted code, 22899. How should I price it? Answer:…
Modifiers on Unlisted Codes. Yes or no?

Modifiers on Unlisted Codes. Yes or no?

June 30, 2022 Question: Can I use modifiers on an unlisted code? Answer: There is not a single right answer to this question. CPT said, in an old CPT Assistant,…
Category III Codes Effective July 1, 2022

Category III Codes Effective July 1, 2022

June 30, 2022 Question: I  heard someone say the 2022 CPT manual will be updated in July with new codes. I have never heard of this before. Is this a…
Incident to Services

Incident to Services

June 30, 2022 Question: We just recently began hiring PAs to see patient to assist our pain physicians. Our pain doctors want the PAs to see new patients and bill…
Payment and Coding Changes You Need to Know With Open Exposure in EVAR

Payment and Coding Changes You Need to Know With Open Exposure in EVAR

June 30, 2022 Question: Does it matter that the open exposure codes are now add-on codes? Does that change payment or coding in any way? Answer: Yes, this change has…
Confusion Regarding the 2021 E/M Guidelines

Confusion Regarding the 2021 E/M Guidelines

June 30, 2022 Question: The guidelines that came out in 2021 for E/M services is for all types of E/M services, right? Answer: No. The 2021 E/M guidelines are for…
Mohs Coding Dilemma

Mohs Coding Dilemma

June 30, 2022 Question: I am new in Dermatology coding and am currently coding for a Mohs surgeon. I was instructed that if the patient comes in and does not…
2021 Evaluation and Management Codes: Is a History Required?

2021 Evaluation and Management Codes: Is a History Required?

June 30, 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…
E/M Visit During the Global Period

E/M Visit During the Global Period

June 30, 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…
Re-exploration Laminectomy Billing

Re-exploration Laminectomy Billing

June 16, 2022 Question: The patient had a re-do laminectomy for stenosis at L3-L4. Can code 63042 be used for this procedure? Answer: No. CPT 63042 is intended for a…
Skin Lesion Excision – Wait for Pathology?

Skin Lesion Excision – Wait for Pathology?

June 16, 2022 Question: I’ve heard you say to wait for the pathology report in order to bill for the skin lesion excision codes 114xx (benign) and 116xx (malignant)? What…
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