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Click here for more sample CPC practice exam questions and answers with full rationale

Open knee Anterior Lateral Ligament CPT Code

Hi,

I have a physician that is looking for a code for an ALL knee surgery. (Anterior Lateral Ligament) The code it keeps throwing me to is for an ACL surgery and he says that is not the same surgery he is doing on this particular ligament. I am looking for an open code for this procedure so that we can bill this properly on the surgeons side and our surgery center.

Thanks for any help you can give! :)

Kimmy

Medical Billing and Coding Forum

Open knee Anterior Lateral Ligament CPT Code

Hi,

I have a physician that is looking for a code for an ALL knee surgery. (Anterior Lateral Ligament) The code it keeps throwing me to is for an ACL surgery and he says that is not the same surgery he is doing on this particular ligament. I am looking for an open code for this procedure so that we can bill this properly on the surgeons side and our surgery center.

Thanks for any help you can give!

Kimmy

Medical Billing and Coding Forum

Laparoscopic Colpopexy and Cystocele (anterior) and Rectocele (posterior) repair

Can someone please help me with this confusion. I have been coding these for years and for some reason, this particular OP report has me needing a little assistance. Am I missing something or is the cystocele and rectocele repair not clear in this report? This physician also does the A/P repairs vaginally so I am not used to seeing the entire surgery performed Laparoscopically, therefore I don’t know if 57260 is appropriate because the description is vaginal approach. I doubt this would be unlisted unless she is just not clear in this report and that is why I am not confident about billing the A/P repair. So here goes:

https://www.aapc.com/memberarea/foru…2&d=1549055818
OPreport.jpg

Attached Images

Medical Billing and Coding Forum

Anterior & Posterior capsulorrhaphy

I read an interesting AAOS article ( https://www.aaos.org/AAOSNow/2018/Ma…=email&ssopc=1 ) recently, and wondered about this:

Code 29806 covers both anterior and posterior capsulorrhaphy. If a repair is done both anteriorly and posteriorly, it would be coded as 29806-22. The modifier 22 signifies more work than usual.

I’ve never heard that we could use a 22 mod for this- I had assumed payment for 29806 covered anterior and/or posterior repairs. I haven’t seen this advice elsewhere. Has anyone been coding it this way? What are your thoughts on this?

Medical Billing and Coding Forum

Posterior 22612 and anterior 22558 approaches performed together

I have a surgeon who is questioning why they do not get reimbursed 100% for both codes as they were performed with different approaches. Would insurances accept an appeal based on this or do we just have to accept the multiple procedure reduction on the second code? Thanks in advance for any answers.

Medical Billing and Coding Forum

Anterior labral repair

I’ve searched high and low for an answer without luck. I know the shoulder labrum/capsule is split into superior and inferior in order to bill 29807 or 29806. However, it is rarely cut and dry as to which area it is in. I often see tears that cross over and/or are not designated as SLAP tears. SLAP tears have to be in the anterior AND posterior part of the superior labrum, correct? Not just superior anterior or superior posterior? From the references I can find, 29807 can only be used for SLAP tears. Does that automatically mean repair of the labrum for anything but SLAP tears will be coded as 29806 for capsule repair? My providers are not in the habit of stating what type of SLAP it is when there is one, which makes it even more difficult.

For example, I’m looking at a surgery the provider listed as labral repair for an anterior tear that goes from 1:30 to 6:00. Would it actually be a capsule repair because it doesn’t extend to the superior posterior?

Thanks!

Medical Billing and Coding Forum

Robotic assisted excision of anterior symphysis pubis chondromas

My doctor was doing a robotic laparoscopic prostatectomy and came across these chondromas and decided he need to remove these before he could continue with the prostatectomy.

I then went to the anterior abdominal wall and brought down the medial umbilical ligaments and the urachus and dissected down to the endopelvic fascia. There were significant what appeared to be chondromas growing off of the symphysis pubis. They were mobile. I did take small samples and sent this for a frozen to verify that it was not prostate cancer as it was not terribly fixed, but somewhat soft and firm and adherent to they symphysis area.

Any idea of what CPT code I would use for this, or would this be included in prostatectomy?

Medical Billing and Coding Forum