Denied CPT 64495: Q&A With Stephanie Miller of GENASCIS. If a physician performs facet joint injections at the following four levels: L1-L2, L2-L3, L3-L4, and L4-L5, the appropriate codes will be: 64493 x 1, 64494 x 1 and 64495 x 1. Under no circumstances can CPT 64495 be reported more than once.
Read more of “Denied CPT 64495: Q&A With Stephanie Miller of GENASCIS.”
AAOS: 6 Coding Tips for Rehabilitative Services. Evaluations can include assessments and documentation of the patient’s history, function level, systems review, specific tests, diagnosis and prognosis. Unique evaluation and re-evaluation codes for physical therapists include CPT codes 97001 and 97002. Codes for occupational therapists include CPT codes 97003 and 97004.
Read more of “AAOS: 6 Coding Tips for Rehabilitative Services.”
ASC Coding Guidance: Platelet-Rich Plasma Injection. New code CPT 0232T (injection(s) platelet-rich plasma, any tissue, including image guidance, harvesting and preparation) went into effect July 1. This code is billable if it is the only procedure being performed or it is performed at different site than the surgical site. Instillation of the platelets by the surgeon into the surgical site is considered part of the total procedure and therefore this code is not applicable.
Read more of “ASC Coding Guidance: Platelet Rich Plasma Injection.”
ASC Coding Guidance: Interbody Cages. CPT +22851 (Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowel(s), methylmethacrylate) to vertebral defect or interspace) is not a “stand-alone” code and is commonly reported in addition to an arthrodesis procedure. CPT code +22851 is not intended to be reported per cage. This code is reported once per level regardless of the number of cages inserted per level.
Read more of “ASC Coding Guidance: Interbody Cages.”
Arthroscopic Knee Synovectomy Reporting. Let’s say the physician performs an arthroscopic lateral meniscectomy and an arthroscopic two-compartmental synovectomy of the medial and lateral compartments of the right knee. It is incorrect to report an arthroscopic two-compartmental synovectomy, CPT 29876 in this case. The lateral synovectomy, CPT 29875, is inclusive in the lateral meniscectomy procedure reported with CPT 29881. Only the medial compartment will have a final synovectomy reporting of CPT 29875.
Read more of “Arthroscopic Knee Synovectomy Reporting.”
Open Rotator Cuff Repairs of the Shoulder. Review CPT codes 23410-23412 to report open rotator cuff tear repairs (to include mini open rotator cuff tear repairs) with code selection determined by acute versus chronic conditions. Mini open rotator cuff tear repairs typically don’t involve entry into the shoulder joint while the tear can still be visualized and repaired.
Read more of “Open Rotator Cuff Repairs of the Shoulder.”
6 Ways to Avoid Denied Claims for Spinal Procedures. Coders should code the primary procedure first and then include the add-on code for each additional procedure. Do not use the -59 modifier for add-on procedures. Add-on procedures are indicated in the CPT manual with a + sign. Certain spinal procedures may require the coder to append modifier -59 when a separately identifiable procedure has been performed.
Read more of “6 Ways to Avoid Denied Claims for Spinal Procedures.”
Lamintomy (Hemilaminectomy) Vs. Laminectomy–63030 Vs. 63047. Since clinical documentation details both a laminectomy and a laminotomy being performed on different levels of the spine with medical necessity clearly defined, both CPT code 63030 (L1 HNP) and 63047 (L2 spinal stenosis) may be reported with the appropriate modifier.
Read more of “Lamintomy (Hemilaminectomy) Vs. Laminectomy–63030 Vs. 63047.”
10 ASC Coding Tips For All Carriers Applying National Correct Coding Initiatives. Arthroscopic shoulder debridement (29822) is often bundled incorrectly. There are times when it is appropriate to unbundle 29822 with other shoulder procedures. For example, an arthroscopic rotator cuff repair is performed in addition to a subacromial decompression and the debridement of a labral tear. The labral tear is unrelated to the rotator cuff and the subacromial decompression and therefore should be reported with modifier -59.
Read more of “ASC Coding Tips For All Carriers Applying National Correct Coding Initiatives.”
17 Orthopedic Procedure CPT Codes With Separately Billable Implants. Here are 17 orthopedic procedures (by CPT code and description) that should include the use of implants according to GENASCIS, a provider of billing, revenue cycle management services and supporting technologies for surgery centers.
Read more of “17 Orthopedic Procedure CPT Codes With Separately Billable Implants.”
